Hyperbaric oxygen treatment for long coronavirus disease-19: a case report

Abstract

Background The coronavirus disease 2019 pandemic has resulted in a growing population of individuals who experience a wide range of persistent symptoms referred to as “long COVID.” Symptoms include neurocognitive impairment and fatigue. Two potential mechanisms could be responsible for these long-term unremitting symptoms: hypercoagulability, which increases the risk of blood vessel occlusion, and an uncontrolled continuous inflammatory response. Currently, no known treatment is available for long COVID. One of the options to reverse hypoxia, reduce neuroinflammation, and induce neuroplasticity is hyperbaric oxygen therapy. In this article, we present the first case report of a previously healthy athletic individual who suffered from long COVID syndrome treated successfully with hyperbaric oxygen therapy. Case presentation A previously healthy 55-year-old Caucasian man presented 3 months after severe coronavirus disease 2019 infection with long COVID syndrome. His symptoms included a decline in memory, multitasking abilities, energy, breathing, and physical fitness. After evaluation that included brain perfusion magnetic resonance imaging, diffusion tensor imaging, computerized cognitive tests, and cardiopulmonary test, he was treated with hyperbaric oxygen therapy. Each session included exposure to 90 minutes of 100% oxygen at 2 atmosphere absolute pressure with 5-minute air breaks every 20 minutes for 60 sessions, 5 days per week. Evaluation after completing the treatment showed significant improvements in brain perfusion and microstructure by magnetic resonance imaging and significant improvement in memory with the most dominant effect being on nonverbal memory, executive functions, attention, information procession speed, cognitive flexibility, and multitasking. The improved cognitive functions correlated with the increased cerebral blood flow in brain regions as measured by perfusion magnetic resonance imaging. With regard to physical capacity, there was a 34% increase in the maximum rate of oxygen consumed during exercise and a 44% improvement in forced vital capacity. The improved physical measurements correlated with the regain of his pre-COVID physical capacity. Conclusions We report the first case of successfully treated long COVID symptoms with hyperbaric oxygen therapy with improvements in cognition and cardiopulmonary function. The beneficial effects of hyperbaric oxygen shed additional light on the pathophysiology of long COVID. As this is a single case report, further prospective randomized control studies are needed.

Is There a Role for Hyperbaric Oxygen Therapy in Reducing Long-Term COVID-19 Sequelae?

“…Interestingly, Robbins et al reported that HBOT in ten patients with long complications of COVID-19 (i.e., refractory fatigue and perceived cognitive impairment) reduced fatigue and led to improvements in global cognition, attention, speech, and information processing [ 10 ]. This finding is consistent with a recent case report by Bhaiyat et al, where patients with long COVID treated with HBOT experienced significant clinical improvements in cognitive ability and cardiopulmonary function [ 11 ]. Importantly, the British Medical Journal recently published a protocol paper for a randomized, placebo-controlled, double-blind, parallel-groups clinical trial to evaluate the safety and efficacy of HBOT in patients with long COVID [ 12 ].…”

Post-COVID-19 fatigue: A systematic review

“…Bhaiyat et al ( 21 ) reported in a case-report of a 55-year-old healthy man the use of hyperbaric oxygen therapy. The man suffered from persistent symptoms including fatigue, memory problems, low energy, breathlessness and reduced physical fitness, which all started 3 months after the acute infection of COVID-19.…”

The potential role of ischaemia–reperfusion injury in chronic, relapsing diseases such as rheumatoid arthritis, Long COVID, and ME/CFS: evidence, mechanisms, and therapeutic implications

“…If ischaemia is an important part of Long COVID, then preventing it (while not mimicking reperfusion) should be of value [ 1004 , 1005 ]. To this end, hyperbaric oxygen therapy [ 1006–1008 ] has been recommended, and in some cases found useful in rheumatoid arthritis [ 1009–1011 ], acute [ 1012 , 1013 ] and Long COVID [ 1006 , 1014 ]. An alternative involves O 2 nanobubbles [ 1015 ].…”