A pilot study investigating the use of hyperbaric oxygen therapy in people affected by long COVID

In our blog this week Paul Gill (@pw_gill), Nichola Gale, Sara Lyden and Hannah Beetham provide a summary of a study investigating the use of hyperbaric oxygen therapy in people affected by Long Covid

As yet, there are no effective treatment options for Long Covid. However, emerging research indicates that hyperbaric oxygen therapy (HBOT) may help to improve some of the main Long Covid symptoms. HBOT involves providing high percentage oxygen at increased atmospheric pressure. It is believed that breathing in high percentage, pressurised oxygen may help improve oxygen provision to the cells, which may reduce inflammation and promote healing. However, research in this area remains limited.

In Autumn 2022, we therefore undertook a small pilot study, exploring the potential impact of HBOT on fatigue, shortness of breath and quality of life in those affected by Long Covid. The study was funded by the Accelerate programme in Cardiff University, which supports researchers to work with businesses, to undertake novel projects that have the potential to result in longer term impact.

Our business partner was Gravells community pharmacy, which is based in Llanelli, West Wales. We worked together to evaluate 4 weeks of HBOT in a small group of people with Long Covid. The funding allowed us to purchase a single person chamber (the Henshaw Sport Recline XL) which provides HBOT at 1.4 times greater than normal atmospheric pressure. The chamber was operated by trained personnel at Gravells pharmacy, who provided HBOT in a private treatment room in Llanelli. We worked closely with them throughout the project and evaluated the impact of HBOT on people with Long Covid.

After gaining ?research ethics approval, we recruited potential participants, via the long COVID Wales Facebook group, using an agreed criteria (e.g. 18 years of age or older, confirmed Long Covid and not suffering from medical conditions that may preclude high percentage, pressurised oxygen) to ensure that therapy could be provided safely. We recruited 10 participants into the study and they received 7-20 sessions (each session lasted around an hour) of HBOT over a 4 week period. We collected data before treatment started and at weekly intervals for four weeks using three separate, established questionnaires that allowed us to measure chronic fatigue, breathlessness and quality of life . We then also conducted online group discussions after therapy had ended to explore their experiences of HBOT service provision in a community setting.

Of the six participants who completed all questionnaires, we found that fatigue, breathlessness and quality of life all improved. Experiences of HBOT provision were positive and people reported ?improvements in main symptoms. However, attending regular therapy sessions was challenging, due to the ongoing difficulties associated with Long Covid.

Due to the size and nature of the study, findings must be treated cautiously. Nonetheless, it appears that HBOT has the potential to improve key symptoms in people with Long Covid. Further controlled studies are, however, now needed.?The work has been written up and submitted for publication in an academic journal and we are also currently working with several healthcare collaborators on a funding application to support a larger clinical trial.