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Effects of Hyperbaric Oxygen Therapy on Long COVID : A Systematic Review
Effects of Hyperbaric Oxygen Therapy on Long COVID : A Systematic Review
Bing-Qi Wu 1,† , De-Yi Liu 1,2,† , Te-Chun Shen 2,3,4,5,* , Yu-Ru Lai 2, Tsai-Ling Yu 2, Hsiang-Li Hsu 1,2,
Hsiu-Ming Lee 1,2, Wei-Chih Liao 2,3,4,† and Te-Chun Hsia 2,3,4
1 Department of Education, China Medical University Hospital, Taichung 404, Taiwan;
deyil845@gmail.com (D.-Y.L.); 038122@tool.caaumed.org.tw (H.-L.H.)
2 School of Medicine, China Medical University, Taichung 404, Taiwan; u109001307@cmu.edu.tw (Y.-R.L.)
3 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical
University Hospital, Taichung 404, Taiwan
4 Hyperbaric Oxygen Therapy Center, China Medical University Hospital, Taichung 404, Taiwan
5 Division of Critical Care Medicine, Chu Shang Show Chwan Hospital, Nantou 557, Taiwan
* Correspondence: chestshen@gmail.com; Tel.: +886-4-22052121
† These authors contributed equally to this work.
This study is a systematic review examining the effects of hyperbaric oxygen therapy (HBOT) on long COVID symptoms and its potential as a treatment option.
Understanding Long COVID and Its Symptoms
Long COVID is a condition affecting 20-50% of individuals who have recovered from COVID-19, characterized by a range of persistent symptoms. The most prevalent symptom is fatigue, which affects up to 60% of patients, alongside cognitive impairments and emotional distress.
- Long COVID refers to long-lasting symptoms post-COVID-19 infection.
- Symptoms include fatigue, myalgia, dyspnea, headache, cognitive impairment, anxiety, and depression.
- Fatigue is the most common symptom, affecting up to 60% of patients.
- The pathogenesis of long COVID remains largely unknown, with several potential mechanisms suggested.
- There is currently no established standard treatment for long COVID.
Hyperbaric Oxygen Therapy as a Treatment Option
Hyperbaric oxygen therapy (HBOT) is being explored as a potential treatment for long COVID due to its ability to improve chronic fatigue and cognitive impairments. Emerging research indicates that HBOT may enhance recovery from neurological disorders associated with long COVID.
- HBOT involves administering 100% oxygen in a pressurized chamber to increase oxygen supply to tissues.
- Current indications for HBOT include wound healing, antimicrobial effects, and medical emergencies.
- Research suggests HBOT may improve cognitive functions and alleviate symptoms of chronic fatigue.
- HBOT is emerging as a potential treatment option for long COVID symptoms.
Proposed Mechanisms of HBOT on Long COVID
The proposed mechanisms by which HBOT may alleviate long COVID symptoms include reducing oxidative stress and chronic inflammation, improving endothelial dysfunction, and enhancing neuroplasticity. These effects may lead to improved cognitive function and overall recovery.
- HBOT may reduce oxidative stress and chronic inflammation associated with long COVID.
- It can enhance oxygen delivery to tissues, triggering regenerative processes.
- Improved cerebral blood flow and microstructure integrity may enhance cognitive function.
- HBOT positively affects mitochondrial function, crucial for muscle health.
Research Methodology and Search Strategy
A systematic literature search was conducted to evaluate the efficacy of HBOT for long COVID, resulting in the identification of ten relevant clinical studies. The search covered various databases and included studies from January 2019 to October 2023.
- The literature search was performed across multiple databases, including PubMed and Embase.
- A total of ten clinical studies were identified, including RCTs and observational studies.
- Inclusion criteria focused on patients with long COVID treated with HBOT.
- Studies were limited to human participants and published in English.
Understanding Long COVID and Its Symptoms
Long COVID is a condition affecting 20-50% of individuals who have recovered from COVID-19, characterized by a range of persistent symptoms. The most prevalent symptom is fatigue, which affects up to 60% of patients, alongside cognitive impairments and emotional distress.
- Long COVID refers to long-lasting symptoms post-COVID-19 infection.
- Symptoms include fatigue, myalgia, dyspnea, headache, cognitive impairment, anxiety, and depression.
- Fatigue is the most common symptom, affecting up to 60% of patients.
- The pathogenesis of long COVID remains largely unknown, with several potential mechanisms suggested.
- There is currently no established standard treatment for long COVID.
Hyperbaric Oxygen Therapy as a Treatment Option
Hyperbaric oxygen therapy (HBOT) is being explored as a potential treatment for long COVID due to its ability to improve chronic fatigue and cognitive impairments. Emerging research indicates that HBOT may enhance recovery from neurological disorders associated with long COVID.
- HBOT involves administering 100% oxygen in a pressurized chamber to increase oxygen supply to tissues.
- Current indications for HBOT include wound healing, antimicrobial effects, and medical emergencies.
- Research suggests HBOT may improve cognitive functions and alleviate symptoms of chronic fatigue.
- HBOT is emerging as a potential treatment option for long COVID symptoms.
Proposed Mechanisms of HBOT on Long COVID
The proposed mechanisms by which HBOT may alleviate long COVID symptoms include reducing oxidative stress and chronic inflammation, improving endothelial dysfunction, and enhancing neuroplasticity. These effects may lead to improved cognitive function and overall recovery.
- HBOT may reduce oxidative stress and chronic inflammation associated with long COVID.
- It can enhance oxygen delivery to tissues, triggering regenerative processes.
- Improved cerebral blood flow and microstructure integrity may enhance cognitive function.
- HBOT positively affects mitochondrial function, crucial for muscle health.
Research Methodology and Search Strategy
A systematic literature search was conducted to evaluate the efficacy of HBOT for long COVID, resulting in the identification of ten relevant clinical studies. The search covered various databases and included studies from January 2019 to October 2023.
- The literature search was performed across multiple databases, including PubMed and Embase.
- A total of ten clinical studies were identified, including RCTs and observational studies.
- Inclusion criteria focused on patients with long COVID treated with HBOT.
- Studies were limited to human participants and published in English.
Evaluation of Study Outcomes and Quality
The studies included in the review utilized various evaluation tools to assess the effectiveness of HBOT on long COVID symptoms. The methodological quality of these studies was appraised using the Cochrane risk of bias tool.
- Evaluation tools included MRI-DTI, cardiopulmonary exercise tests, and various symptom questionnaires.
- The Cochrane risk of bias tool was used to assess the quality of included studies.
- The review aimed to determine improvements in long COVID symptoms and overall quality of life.
- Further rigorous large-scale RCTs are needed to establish precise treatment protocols and evaluations.
Study Identification and Selection Process
The systematic review identified 10 relevant studies on hyperbaric oxygen therapy (HBOT) for long COVID after screening 435 potential titles. The selected studies included one case report, five pretest-post-test studies, one safety report, and three randomized controlled trials (RCTs).
- Initial search yielded 435 titles.
- After screening and removing duplicates, 10 articles were included.
- Study types: 1 case report, 5 pretest-post-test studies, 1 safety report, 3 RCTs.
Methodological Quality Assessment of Studies
The methodological quality of the included RCTs varied, with two studies showing some risk of bias and one showing low risk. A detailed risk of bias assessment was conducted using the Cochrane risk of bias 2 tools.
- Two RCTs had some risk of bias.
- One RCT had a low risk of bias.
- Quality assessment summarized in a detailed table.
HBOT Application in Long COVID Non-RCT Trials
Non-RCT studies on HBOT for long COVID reported significant improvements in various symptoms, including cognitive function and physical fitness. The case report highlighted substantial enhancements in brain perfusion and microstructure after HBOT treatment.
- Case report by Bhaiyat et al. showed cognitive and physical improvements after 60 sessions.
- Significant improvements in fatigue, memory, and exercise capacity were noted.
- Other studies reported improvements in fatigue, quality of life, and cognitive functions.
HBOT Application in Long COVID RCT Trials
RCTs demonstrated that HBOT can improve cognitive functions and physical symptoms in long COVID patients. The studies indicated significant group-by-time interactions in cognitive scores and improvements in brain perfusion and microstructures.
- Zilberman-Itskovich et al. found significant improvements in cognitive scores and brain function.
- Catalogna et al. reported changes in brain connectivity associated with cognitive recovery.
- Leitman et al. noted improvements in left ventricular systolic function in the HBOT group.
All Resources on HBOT:
Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post‑COVID condition: randomized controlled trialHyperbaric Oxygen Therapy in Managing Minimally Invasive Aesthetic Procedure Complications: A Report of Three CasesHyperbaric Oxygen Therapy in Sports Musculoskeletal InjuriesA General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational OpportunitiesPost-COVID-19 fatigue: A systematic reviewTherapeutic Effects of Hyperbaric Oxygen: Integrated ReviewTranscutaneous oxygen tension-guided hyperbaric oxygen therapy for preventing skin necrosis after hyaluronic acid filler injectionsHyperbaric Oxygen – Its Mechanisms and EfficacyHyperbaric Oxygen Therapy: Future Prospects in Regenerative Therapy and Anti-AgingHyperbaric Oxygen Treatment: Effects on Mitochondrial Function and Oxidative StressHyperbaric Oxygen Therapy: Antimicrobial Mechanisms and Clinical Application for InfectionsEffects of Hyperbaric Oxygen Therapy on Long COVID : A Systematic ReviewEffects of Hyperbaric Oxygen Therapy on Inflammation, Oxidative/Antioxidant Balance, and Muscle Damage after Acute Exercise in Normobaric, Normoxic and Hypobaric, Hypoxic Environments: A Pilot StudyHyperbaric Oxygen Therapy to Reverse Skin AgingOur Mission
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