HBOT a potential treatment for people with long-term COVID-19
Q: I got COVID-19, which wasn’t too bad. But now I have a long COVID. I’m exhausted all the time, my heart is racing and I have brain fog. It derails my life. I saw on the news that the method of dealing with divers with bends has been working for a long time COVID. Is it true? Can I see her?
A: As you may already know, the long term COVID-19 refers to the persistent symptoms that can follow infection with SARS-CoV-2, the coronavirus that causes COVID-19. While the initial illness lasts two to six weeks – depending on severity – the symptoms of long COVID linger for months – even years.
The latest survey data shows that the long COVID is affecting at least 20% of people who have recovered from coronavirus infection. The chronic exhaustion you experience is a common symptom, as are a range of cognitive issues. It has become clear that the long COVID is pushing millions of people apart, and researchers are looking for treatments to ease the symptoms.
Several studies have looked at the potential benefits of hyperbaric oxygen therapy, also known as HBOT. It’s when someone breathes pure oxygen into a pressurized chamber or room. You are correct that it is used to treat decompression sickness in divers, also known as bends. Hyperbaric oxygen therapy is approved for a range of other uses, including carbon monoxide poisoning, wound healing, severe anemia, infectious diseases that deprive tissues of oxygen, and certain types of hearing loss sudden and unexplained.
The news stories that caught your attention report the results of the most recent study on HBOT as a potential treatment for people living with long COVID. Led by researchers in Israel, the study looked at a group of patients whose cognitive symptoms of long COVID had lasted at least three months. Half underwent 40 sessions of HBO over the course of two months. They received varying exposures of 100% oxygen over the course of 90 minutes, delivered via a mask, while in a hyperbaric chamber with twice the atmospheric pressure of sea level.
The other group of patients served as a control group. They also spent 40 sessions in a hyperbaric chamber, but breathed regular air, and at regular pressure. At the end of the study, the patients who benefited from true hyperbaric oxygen therapy reported a marked improvement in cognitive functions. The therapy also had a positive effect on energy levels, sleep disturbances and mood. The same results were not observed in the control group.
This echoes the results of research carried out last year by scientists in England. In this study, patients had 10 HBO sessions over 12 days. Tests to assess fatigue and cognitive function also showed marked improvements between the start and end of treatment. Although the results are encouraging, the research is still in its infancy.
At this time, HBOT is not approved by the Food and Drug Administration for the treatment of long COVID. It is also important to note that it is not suitable for everyone. A person who has a cold, fever, and certain lung, ear, and eye conditions should not have HBOT.
Q: Can you please explain why hot weather is so dangerous? We had a few heat waves with high humidity, and my grandfather didn’t even realize he was suffering from heat exhaustion. Air conditioning is not common in our area and our children also have difficulty. Honestly, it’s a little scary.
A: A series of extreme heat waves, often accompanied by high humidity, make summer difficult for much of the United States. Even regions with generally mild climates are being hit hard. The result has been a sharp increase in heat-related illnesses, hospitalizations and, tragically, deaths. This happens because, in order to function properly, warm-blooded creatures need their core temperature to stay within a narrow range. For humans, it’s somewhere in the neighborhood of 97 to 99 degrees Fahrenheit.
When ambient temperature, physical activity, or a combination of the two cause overheating, our bodies use various physiological processes to attempt to cool themselves. The first are reddening of the skin and sweating. The first sends blood to the surface of the skin in order to cool it, and the second moistens the skin itself, allowing an evaporation and cooling effect.
But when temperatures are high enough, flushing cannot cool the blood. And on humid days, when water saturates the air, sweat evaporates much more slowly, if at all. With the body’s natural cooling systems overridden, the core temperature begins to rise. This marks the advent of an increasingly serious range of heat-related illnesses.
The milder of these illnesses, also known as hyperthermia, are heat-related dizziness or fainting and heat cramps. When these occur, the person should stop all activity, move to a cool, shady place, and gradually drink water to rehydrate.
A serious set of heat-related symptoms is known as heat exhaustion. It is characterized by dizziness, profuse sweating, clammy skin, headache, exhaustion, weak and rapid pulse, decreased urine output, slightly elevated body temperature, and sometimes nausea or vomiting.
In addition to following the steps above, a person suffering from heat exhaustion should directly cool their skin. This can be done with a cold bath or shower, or by misting or blotting the skin with cold water.
If left untreated, heat exhaustion can quickly lead to heat stroke. These symptoms include hot to the touch and often dry skin, body temperature of 104 degrees Fahrenheit or higher, mental confusion, loss of consciousness, and a rapid pounding pulse. Heatstroke is an emergency. Immediate medical attention is needed to prevent brain damage, organ damage, and even death.
Never ignore any form of heat-related illness – even the mildest form can escalate into a medical emergency.
In this time of unusual summer heat, it’s important to have a heat safety plan. Learn about the different options for staying cool that are available in your community. This includes air-conditioned public spaces such as shopping malls, public libraries and senior centers. Many communities open dedicated cooling centers during a heat wave. Keep up to date with weather reports. Whenever a heat wave hits, stay safe by putting your safety plan into immediate action.
• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to [email protected]