Hyperbaric Oxygen Therapy: An Emerging Therapy for Post–COVID-19 Condition

Abstract

What Is the Issue?
 
 Post–COVID-19 condition presents an important challenge to health care decision-makers in Canada and across the world due to the high volume of potential patients, diverse presentations of symptoms, few clinical guidelines and treatments, and unknown pathophysiology.
 
 What Is the Technology?
 
 Hyperbaric oxygen therapy (HBOT) is an established treatment for certain wound injuries, vascular conditions, and in specific medical emergencies. It is now being tested for post–COVID-19 condition, also known as long COVID. The therapy delivers a high concentration of oxygen inside specialized pressure chambers. HBOT has been proposed as a treatment to help resolve prominent symptoms of post–COVID-19 condition, such as fatigue and brain fog. The therapy may induce physiological changes that aid in recovering from the long-term effects and tissue damage due to severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection.
 
 What Is the Potential Impact?
 
 Results from early studies indicate that HBOT could improve a range of post–COVID-19 symptoms and its use is generally safe with few adverse effects. These results are based on 2 randomized control trials and small nonrandomized studies and case reports. However, published results have been based on studies with limited sample sizes and limited long-term follow-up.
 HBOT could offer a therapy option that could support millions of people around the world with post–COVID-19 condition if the ongoing and subsequent studies show efficacy.
 
 What Else Do We Need to Know?
 
 As of now, there are uncertainties about how to effectively deliver and dose the therapy and the potential safety implications for people with post–COVID-19 condition. Implementation considerations, such as the number and location of hyperbaric oxygen chambers, will be important if HBOT is appropriate for a large number of people. As the evidence base develops, the potential role of HBOT in therapy for people with post–COVID-19 condition will become clearer and will provide an indication of what kind of health system planning may be needed to provide HBOT for those who can benefit.