What is the role of hyperbaric oxygen therapy (HBOT) in the treatment of coronavirus disease 2019 (COVID-19)?

Updated: Nov 16, 2020
  • Author: Emi Latham, MD, FACEP, FAAEM, UHM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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The current coronavirus disease 2019 (COVID-19) worldwide pandemic is caused by the coronavirus SARS-CoV-2. The rate and route of infection are not precisely known. The symptoms presented by an infected person can range from asymptomatic to respiratory illness to death. There is no known cure, definitive treatment, or vaccine to treat patients with COVID-19; patients receive supportive care.

HBOT is currently used off-label to treat COVID-19 pneumonia patients. In addition to effectively delivering oxygen to patients who may have bilateral pneumonias and exhibit a ventilation perfusion mismatch due to emboli and microemboli preventing perfusion of functional bronchoalveolar units, HBOT has been shown to mitigate inflammatory reactions. Much of the pathogenesis of COVID-19 is due to an overly active immune response generating inflammation that becomes a major etiology of subsequent consequences of the infection. [126]

The current treatments reported are anecdotal, but promising. There is currently a multicenter trial investigating adults with moderate COVID-19 who are admitted to the hospital requiring oxygen and at least two risk factors for increased morbidity and mortality. The UHMS has a position statement, which is updated periodically, about HBOT and treatment of COVID-19. [127]

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