COVID-19: Use of Hyperbaric Oxygen Therapy (HBOT) in Treatment of Severe Cases

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COVID-19 pandemic has caused a major economic impact all over the globe and has resulted in disruption of “normal” life. Countries across the world are battling to find solutions to this disease that includes strengthening the immune system and developing vaccines to combat the pandemic. In this context, use of Hyperbaric Oxygen Therapy (HBOT) may seem to hold a promise for the treatment of severe cases of COVID-19. HBOT involves delivering oxygen to the body’s tissues at higher pressures than atmospheric pressure with the hope of reducing inflammation and revival of cells thereby improving the immune system 

The COVID-19 pandemic has thrown life out of gear in almost the entire world. Scientists and researchers across the globe are in race against time to develop a cure for this disease that has affected millions and resulted in hospitalization and deaths of thousands of people, especially those above the age of 70 and having comorbidities such as diabetes, asthma and cardiovascular disease. A number of anti-viral medications to combat COVID-19 have been tried to stop viral replication along with lifestyle changes such as wearing a mask and maintaining social distancing to prevent community spread. Recently, a number of different type of vaccines (1-3) have been approved for emergency use authorization by governments in various countries that will hopefully help in developing and providing immunity against COVID-19 for a long term. The idea behind these is to strengthen the immune system to help the body fight infections. Hyperbaric Oxygen Therapy (HBOT) can also be looked at as a potential treatment for treatment of severe cases of COVID-19, especially those that require hospitalization.  

HBOT involves delivering 100% oxygen to the body tissues at high pressures (higher than the atmospheric pressure). This hyperoxic condition results in delivering higher amounts of oxygen to body’s cells thereby improving their revival and survival. HBOT has been reported almost four centuries ago, however, has not been implemented as a definitive treatment due to lack of scientific evidence. However, recent preliminary data from clinical trials suggest significant improvements with respect to morbidity and mortality in severe cases of COVID-19 patients when treated with 100% oxygen at high atmospheric pressures. A small single centre trial carried out in USA on 20 COVID-19 patients and 60 matched controls using HBOT gave encouraging results with respect to in patient mortality and ventilator requirement (4). Another randomised controlled trial has been planned to investigate effects of normobaric oxygen therapy (NBOT) versus hyperbaric oxygen therapy (HBOT) for severe cases of hypoxic COVID-19 patients (5). The advantage of HBOT is that it is a non-invasive technique that is cost effective compared to other treatment regimens. However, care should be taken that it needs to be administered by trained personnel and should noy be carried out at home under normobaric conditions using pure oxygen cylinders available in the market. 

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While HBOT promises to be a low-risk intervention for the treatment of severe cases of COVID-19, it will require a large number of randomised controlled clinical trials with a significant number of patients resulting in a strong positive outcome, before the therapy can be approved beyond a reasonable doubt. 

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References 

  1. Prasad U., 2021. Types of COVID-19 Vaccines in Vogue: Could There be Something Amiss? Scientific European January 2021. DOI: https://doi.org/10.29198/scieu/210101  
  1. Prasad U., 2020. COVID-19 mRNA Vaccine: A Milestone in Science and a Game Changer in Medicine. Scientific European December 2020. Available online at https://www.scientificeuropean.co.uk/covid-19-mrna-vaccine-a-milestone-in-science-and-a-game-changer-in-medicine/ Accessed on 24 January 2021.  
  1. Prasad U., 2021. DNA Vaccine Against SARS-COV-2: A Brief Update. Scientific European. Posted 15 January 2021. Available online at https://www.scientificeuropean.co.uk/dna-vaccine-against-sars-cov-2-a-brief-update/ Accessed on 24 January 2021.  
  1. Gorenstein SA, Castellano ML, et al 2020. Hyperbaric oxygen therapy for COVID-19 patients with respiratory distress: treated cases versus propensity-matched controls. Undersea Hyperb Med. 2020 Third-Quarter;47(3):405-413. PMID: 32931666. Available online at https://pubmed.ncbi.nlm.nih.gov/32931666/  Accessed on 24 January 2021.  
  1. Boet S., Katznelson R., et al., 2021. Protocol for a multicentre randomized controlled trial of normobaric versus hyperbaric oxygen therapy for hypoxemic COVID-19 patients  Preprint medRxiv. Posted July 16, 2020. DOI: https://doi.org/10.1101/2020.07.15.20154609  

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