Patients with long-term COVID-19 symptoms that were exposed to new protocols of Hyperbaric Oxygen Therapy (HBOT) showed significant improvement in cognitive, neurological, and psychiatric functions compared to a control group according to a recent Israeli study.
The study was published in Scientific Reports and was conducted by the Sagol Center for Hyperbaric Medicine and Research at Tel Aviv University, Israel, by a research team led by Professor Shai Efrati, director of the Sagol Center.
According to the study, 10–30% of the patients infected during the COVID-19 pandemic remain with persistent symptoms that have devastating effects on their quality of life. WHO has recognized this clinical condition and defined it as post-COVID-19 condition (long COVID).
Currently studied treatment options of post-COVID-19 condition are targeted anti-inflammatory molecules, specific diets, and cognitive behavioral therapy. However, none have been determined effective.
Patients with long COVID continue to suffer from cognitive symptoms such as inability to concentrate, brain fog, forgetfulness and difficulty recalling words or thoughts more than three months following a test confirming COVID-19 infection. The study was the first of its kind where HBOT treatment against long COVID was tested in a randomized, double-blind, placebo-controlled clinical trial.
“Today we understand that in some patients, the COVID-19 virus penetrates the brain through the cribriform plate, the part of the skull located just above our nose, and triggers chronic brain injury - mainly in brain regions in the frontal lobe, responsible for cognitive function, mental status and pain interpretation,” Professor Efrati told The Brussels Times. “Consequently, affected patients experience a long-term cognitive decline.”
Hyperbaric oxygen therapy (HBOT) has been around for years for treating scuba and deep-sea divers affected by the rapid change in pressure around them. It is also used as a treatment against infections in tissues and some specific diseases.
Is there any difference between HBOT treatment of injured brain tissues and other tissues in the body?
“The basics are the same but different air pressures and oxygen fluctuations are applied,” he explained. “We used specific protocols to repair damaged brain tissues based on the understanding that HBOT repairs brain damage through a process of regeneration, generating new neurons and blood vessels.”
The beneficial effects of the unique treatment protocol in the study can be attributed to renewed neuroplasticity and increased brain perfusion in regions associated with cognitive and emotional roles.
The protocol consisted of 40 daily HBOT sessions, five sessions per week within a two-month period, in which patients entered a multi-place HBOT chamber and breathed 100% oxygen by mask at 2 atmospheres absolute (ATA) for 90 minutes with oxygen fluctuations every 20 minutes. The control group received placebo treatment, breathing normal air. For some patients the treatment can be even longer.
Up to 30 % of infected people might suffer from long Covid. Is it realistic to provide HBOT treatment to all of them?
“The number of patients suffering from long COVID was that high in the beginning of the pandemic but is estimated to about 10 % today. The questions we should ask is if HBOT is an effective treatment against long COVID and if the patients meet the conditions for benefitting from such treatment. The answers to both questions are affirmative.”
Did you notice any negative effects of HBOT - is it completely safe?
“All kinds of treatments have the potential to have unwanted effects and have to be considered by the physicians in charge. In our case, when patients are appropriately selected, we noticed mainly side effects affecting the ears but they are reversible.”
According to the study, there was no significant difference in any of the reported side effects between the HBOT group and the control group. None of the patients needed to discontinue the treatment because of side effects.
Are more clinical trials required to get approval from regulatory bodies such as FDA in the US and EMA in the EU?
“HBOT is already an approved therapy for other indications and proved now to be effective in a prospective controlled trial. Whether the treatment is recognized and covered by health insurance bodies is another matter and might take time. In our centers, based on the research done, we can treat the patients but the general insurance is still not covering it.”
The study shows that HBOT works against cognitive problems and depression due to long COVID. Do you foresee that HBOT can also be used to treat mental disorders such as depression and schizophrenia?
“The study suggests that other neurological and psychiatric syndromes might be triggered by biological agents such as viruses, opening new possibilities for future treatments with HBOT. Currently HBOT is only used for treatment of brain injuries caused by long COVID, traumatic brain injuries or stroke. Further studies are needed for other indications.”
“For millions suffering from long-term COVID-19 symptoms, the study provides new hope for recovery," Professor Efrati concluded.
The Brussels Times