HBOT for the Treatment of Severe COVID-19 Disease
Ray Cralle PT
We are in the midst of a global pandemic caused by the novel SARS-CoV-2 virus that results in COVID-19 disease. Globally, as of 3:35pm CEST, 17 September 2020, there have been 29,737,453 confirmed cases of COVID-19, including 937,391 deaths, reported to the WHO. The number of deaths is fast approaching the melancholic 1 million milestone.
The leading cause of death in COVID-19 patients is respiratory failure from acute respiratory distress syndrome (ARDS) and multiorgan failure (MOF).
Getting life-saving oxygen to patients suffering from COVID-19 is key
Normal blood-oxygen levels are around 97%, at levels below 90%, the brain may not get sufficient oxygen, and patients might start experiencing confusion, lethargy or other mental disruptions. As levels drop into the low 80s or below, the danger of acute respiratory failure rises.
Mechanical ventilators have become a symbol of the COVID-19 pandemic, but this treatment has about a 50% success rate and comes with its own set of drawbacks. Even with a ventilator, patients cannot get enough oxygen to their tissues.
Bottom line, patients are dying due to lack of oxygen because their lungs are inflamed due to the reaction to COVID-19.
Pandemics and HBOT – Learning from history
There are no vaccines or approved antivirals to stop the SARS-CoV-2 virus from infecting and harming more people. The current COVID-19 pandemic bears several similarities to the 1918 influenza pandemic “the Spanish flu” that infected over one third of the global population. The Spanish flu had a death toll estimated at around 50 million, making it one of the deadliest pandemics in human history.
For those severely infected with the 1918 flu, death was primarily by pulmonary infection and its ensuing hypoxemia (low oxygen levels) and respiratory failure. There were no antivirals or vaccines to combat the 1918 influenza virus either, but a physician by the name of Dr. Orval Cunningham made an important observation that would prove to be life-saving. He noticed that patients suffering from the flu who lived at higher altitudes had a poorer prognosis than those living close to sea level. Cunningham theorized that atmospheric pressure or barometric factors were responsible for the higher mortality rates of those located at higher elevations.
Reports show that Dr. Cunningham treated his first flu patient who was moribund and blue with compressed air at 1.68 atmospheres absolute for just one hour, and the patient improved. Combined with additional hyperbaric treatments over the next 3 days this patient’s life was saved, and many others followed.
Hyperbaric therapy was life-saving for those severely affected by the 1918 influenza virus, so it comes as no surprise that HBOT therapy is showing very promising effects for treating COVID-19 disease. For a review of HBOT for COVID-19 click here
Indications for the use of HBOT
Probably the most well-known use of HBOT is for the treatment of decompression sickness or the bends. HBOT is also used to restore normal oxygen levels in patients suffering from carbon monoxide poisoning or anemia.
Notably, most of the UHMS accepted indications for HBOT are for the treatment of chronic or acute wounds (i.e. tissue damage). These include treatments for crush injury, compartment syndromes, and other acute traumatic ischemias; enhancement of healing in selected problem wounds; exceptional blood loss; delayed radiation injury; compromised skin grafts and flaps.
Interestingly there are several indications for HBOT that are for treating infection-induced wounds: Clostridial myonecrosis (gas gangrene); necrotizing soft tissue infections (flesh eating bacteria); osteomyelitis (refractory) or (acute) infections in compromised host (bone infections); intracranial abscess.
The major lethality of COVID-19 disease is a result of virus-induced tissue damage of the lung. HBOT targets the lung damage directly therefore providing immediate healing results. A recent report claimed that “the THERAPEUTIC EFFECT [of HBOT treatment] of 5 patients was VERY SIGNIFICANT, and both the subjective and objective clinical indexes showed that the deterioration of hypoxia was interrupted immediately and then the whole body recovered gradually after the first HBOT.” For the full report click here
Validating the Use of Hyperbaric Oxygen Therapy in Treating COVID-19 Randomized controlled clinical trials (RCTs) are needed to provide the ultimate acceptance of HBOT for COVID-19 treatment. However, given the current dire situation, single-arm Phase I/II trials are the most likely route forward and several clinical trials are already in progress. the field of HBOT came together to set forth some recommendations for the treatment of COVID-19. Please click here for more information.
HBOT is readily available
There are an over 3,000 HBOT chambers available in the U.S. alone. Once protocols are optimized, and infectious disease protocols are in place, HBOT chambers across America can be put into action. With the appropriately trained healthcare professionals, HBOT can be ready to start treating patients within a week or less.
“Hyperbaric Oxygen Therapy saves lives by combating inflammation and hypoxia.”
The mechanisms behind the therapeutic effects of HBOT in COVID-19