Hyperbaric oxygen therapy for the treatment of long COVID: early evaluation of a highly promising intervention, 2021, Robbins et al

[ola_cohn]

Abstract
Background Long COVID is a common occurrence following COVID-19 infection. The most common symptom reported is fatigue. Limited interventional treatment options exist. We report the first evaluation of hyperbaric oxygen therapy (HBOT) for long COVID treatment.

Methods A total of 10 consecutive patients received 10 sessions of HBOT to 2.4 atmospheres over 12 days. Each treatment session lasted 105 minutes, consisting of three 30-minute exposures to 100% oxygen, interspersed with 5-minute air breaks. Validated fatigue and cognitive scoring assessments were performed at day 1 and 10. Statistical analysis was with Wilcoxon signed-rank testing reported alongside effect sizes.

Results HBOT yielded a statistically significant improvement in the Chalder fatigue scale (p=0.0059; d=1.75 (very large)), global cognition (p=0.0137; d=–1.07 (large)), executive function (p=0.0039; d=–1.06 (large)), attention (p=0.0020; d=–1.2 (very large)), information processing (p=0.0059; d=–1.25 (very large)) and verbal function (p=0.0098; d=–0.92 (large)).

Conclusion Long COVID-related fatigue can be debilitating, and may affect young people who were previously in economic employment. The results presented here suggest potential benefits of HBOT, with statistically significant results following 10 sessions.

KEYWORDS:
LONG COVID
HYPERBARIC OXYGEN THERAPY
FATIGUE

Authors Tim Robbins, Michael Gonevski, Cain Clark, Sudhanshu Baitule, Kavi Sharma, Angel Magar, Kiran Patel, Sailesh Sankar, Ioannis Kyrou, Asad Ali and Harpal S Randeva

Open access full text
https://www.rcpjournals.org/content/clinmedicine/21/6/e629

 

[Jonathan Edwards]

It sounds as if they didn't even have ethical approval to treat these patients at the time they were treated.

It would be interesting to know how a group receiving Lightning Process training would have compared.

 

[Fainbrog]

Seeing the use of the Chalder Fatigue Scale is enough for me to stop reading any further than the abstract.

 

[Milo]

It sounds as if they didn't even have ethical approval to treat these patients at the time they were treated.

We retrospectively evaluated the response of fatigue symptoms of patients with long COVID-related fatigue receiving HBOT at the Midlands Diving Chamber medical facility, Hospital of St Cross, Rugby. This retrospective evaluation was approved by the University Hospitals Coventry and Warwickshire NHS Trust COVID-19 Research Ethics Committee through the GAFREC Process (ID: 10026).

We evaluated 10 consecutive patients undergoing HBOT for long COVID-related fatigue at the Midlands Diving Chamber. All patients were suffering from new fatigue that developed during or after an infection consistent with COVID-19 and continuing for more than 12 weeks.

The way it is written, they only got ethics approval to check the charts. I am not sure patients actually gave consent to participate in the study.

i am also unclear as of whether the patients paid for the treatments, whether they self-referred and how did they know to try HBOT.

Edit to add:

In particular, HBOT has been shown to be safe and effective in the treatment of chronic fatigue syndrome

That’s concerning

 

[5vforest]

If they were serious about this they could also add a control arm that receives 100% oxygen without the pressure changing inside the chamber.

Or they could have a group that only gets HBOT with 1.3 atmospheres.

I've come to realize that these studies are probably not designed to be serious, and they are designed maybe to serve an existing bias, or to show to everyone, "look, we're doing something!"

I actually felt a little bit better after my first week of HBOT. Then I felt a lot worse after my second week.

I would love to see a rigorous study, since there are many many, anecdotal reports of hyperbaric being useful for various conditions that it is not FDA-approved for.

 

[rvallee]

I've come to realize that these studies are probably not designed to be serious, and they are designed maybe to serve an existing bias, or to show to everyone, "look, we're doing something!"

It turns our that using as a metric of academic success the number and reach of published papers is a terrible idea. Academia is basically half-clickbait by now because of this, publishing papers to get funding to publish more papers to get more fun...