As the hunt for the COVID-19 vaccine keeps the medical world on its toes, compassionate suggestions like hyperbaric oxygen therapy (HBOT) are making a progressive move.
SARS-CoV-2 is a pathogenic, RNA developed, single-stranded virus that primarily affects the human respiratory system. When clinically presented, it varies across asymptomatic, mild, and severe states inducing pulmonary and cardiac complications.
Most of us are aware of how the SARS-CoV-2 targets innate immunity, thus inducing inflammation. As such, it stimulates the release of both chemokines as well as cytokines, especially around the lung area. It is the inflammatory response in COVID affected individuals that leads to acute respiratory distress syndrome (ARDS).
During the initial month of the outbreak, a certain medical institution sought HBOT to treat COVID patients fighting tachypnoea as well as low saturation of oxygen. The implementation of HBOT was chiefly done to do away with mechanical ventilation. The patients were administered two to six HBOT sessions, each of ninety-minutes duration, at 2 ATA. Subsequently, it showed dramatic improvement in reversing the symptoms.
Thus, it makes for a hypothesis where HBOT is looked at as a safe form of treatment to reduce inflammatory responses in the case of COVID-19 pneumonitis. It not only helped to up-regulate the immune system but also helped with hypoxia tolerance, mitigating chances of organ failure.
While medical researchers and clinical trials are underway to find a cure for the world, this post takes an open and unbiased look at the efficacy of HBOT for COVID-19.
How HBOT works in case of COVID-19 infections
HBOT as a potent form of treatment allows oxygen delivery at elevated concentrations right across the tissues. It not only helps in the preservation of mitochondrial activity and cellular metabolism but also reverses hypoxic conditions.
Multiple medical studies also suggest HBOT improving kidney functions, following COVID infection. Other notable mentions include protecting organs from ischemia or reperfusion injury.
A single session of HBOT at 2.4 ATA over an hour, depicted an overwhelming response in an experimental sepsis study involving animals. The outcome of the very experiment was correlated with reduced inflammation. Furthermore, it also established the efficacy of HBOT noted across all earlier trials to enhance the working of sepsis.
Among all effects of HBOT, the most overwhelming seems to be its anti-inflammatory property, at the base of which lies the oxidative stress modulation. HBOT, while treating COVID-19 cases aims at reducing the inflammatory cytokines, based on the following transcriptional factors:
- HIF-I (Hypoxia Inducible Factor 1)
- NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells)
For all HBOT applications that are sporadic and paradoxical, it offers protection to lungs against oxygen toxicity. The very extent of COVID-19 pathology remains unknown which demands the toxicity of oxygen be actively monitored across such clinical trials.
A couple of case studies from Wuhan formed the basis of empirical analysis in exploring the efficacy of HBOT for COVID-19 treatment. In both cases, the COVID affected showed marked improvement after undergoing one to six sessions of hyperbaric therapy. It not only worked to upregulate the blood oxygen saturation level but also significantly reduced lung inflammation.
In another study from the USA, five patients awaiting intubation underwent HBOT and were soon relieved of the symptoms. More so, they never required mechanical ventilation.
Every single encounter of an unknown pathogen leaves health professionals baffled to find an effective cure in a time-bound manner. Likewise, the current treatment options for COVID-19 is extremely limited. Although the rate of recovery has been promising in some places, it majorly rests on supportive care.
The elderly and some other patients with underlying medical conditions often respond negatively to traditional forms of supportive care. As a result, mechanical ventilation seems to be the only viable option. However, once a patient is subjected to mechanical ventilation, it lessens the chances of recovery.
HBOT is backed by decades of data treating patients with safety and promises low morbidity. Hypoxia, one of the major symptoms of COVID-19 stands a chance to be treated by breathing oxygen at atmospheric pressure. Additionally, the anti-inflammatory and virucidal nature of HBOT makes it a potential treatment option.
HBOT as a compassionate form of treatment gains authority with patients whose lives couldn’t be risked, waiting for the protocol. Now that HBOT has been successful in treating COVID-19 symptoms, an online protocol has been made available for health professionals to refer in case of an emergency.
Besides, physicians are being asked to register data about COVID-19 treatment across websites and apps. It would help to consider the varying conditions for further research into finding a permanent cure.
Several case-controlled clinical trials are underway globally offering significant information to deal with the epidemic. Similar to other drugs like cortisone, L-6 inhibitors, and Chloroquine, HBOT is also being recommended as compassionate treatment. However, unlike other drugs, HBOT is yet to witness random trials.
As we continue to brave COVID-19 and get on with our daily lives, it is of utmost necessity that respective governments should intervene to try alternate forms of treatment. HBOT, by all means, is a significant contributor to COVID-19 research, and only randomized trials can help establish its potential at the hands of qualified medical professionals.