Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post‑COVID condition: randomized controlled trial

Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post‑COVID condition: randomized controlled trial

Shani Zilberman‑Itskovich^1,2,4, Merav Catalogna^1,4, Efrat Sasson¹, Karin Elman‑Shina^1,2,

Amir Hadanny^1,2, Erez Lang^1,2, Shachar Finci^1,2, Nir Polak^1,2, Gregory Fishlev^1,2,

Calanit Korin^1,2, Ran Shorer¹, Yoav Parag¹, Marina Sova¹ & Shai Efrati^1,2,3*

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This study valuates the effects of hyperbaric oxygen therapy (HBOT) on patients suffering from post-COVID-19 condition, characterized by persistent physical, neurocognitive, and psychiatric symptoms lasting at least three months after infection. ​ It is a randomized, double-blind, sham-controlled trial involving 73 patients (37 HBOT, 36 control). ​ Participants underwent 40 daily sessions of HBOT or sham treatment, with follow-up assessments conducted 1–3 weeks after the last session. ​

Key Findings:

1. Cognitive Improvements: HBOT significantly improved global cognitive function, attention, and executive function compared to the control group. ​
2. Psychiatric and Physical Benefits: HBOT led to improvements in depression, somatization, energy levels, sleep quality, and pain interference. Anxiety improved but did not reach statistical significance. ​
3. Brain Changes: MRI scans showed increased cerebral blood flow (CBF) and microstructural changes in brain regions associated with cognitive and emotional functions, such as the frontal gyrus, insula, and corona radiata. ​
4. Fatigue and Pain: HBOT reduced fatigue and pain interference, which are common symptoms of post-COVID-19 condition. ​
5. Safety: No significant differences in side effects were observed between the HBOT and control groups. ​

Mechanism:

HBOT's benefits are attributed to increased brain perfusion and neuroplasticity, driven by the "hyperoxic-hypoxic paradox," which enhances gene expression, angiogenesis, mitochondrial function, and neurogenesis. ​​

Conclusion:

HBOT shows promise in improving cognitive, psychiatric, and physical symptoms in post-COVID-19 patients, with effects linked to brain perfusion and neuroplasticity. ​