Hyperbaric Oxygen Therapy for Long COVID: 3-Month Follow up Results from a Prospective Registry of 232 patients, 2024, Jur van Berkel et al

[Mij]

Abstract
A potential beneficial effect of hyperbaric oxygen therapy (HBOT) on complaints of long COVID was found, leading to increased demand for this treatment despite many remaining clinical questions and lack of formal guideline recommendations and reimbursement.

A registry was set up in order to gain more insight into patient characteristics and (long-term) outcomes of long COVID patients undergoing HBOT. Patient-reported outcome measures were collected at baseline, after treatment and at 3-month follow up. The primary outcome measures were the mental and physical component score (MCS/PCS) of the SF-36 questionnaire 3 months after HBOT. A clinically relevant positive or negative response was defined as an increase or decrease of ≥10% in MCS and/or PCS after 3 months. Secondary outcomes included the EQ-5D, severity of complaints and ability to work.

In this prospective registry of 232 long COVID patients, 65% of long term-ill patients had a clinically relevant increase in quality of life. However, 15% of the patients experienced deterioration in quality of life. Symptoms that showed most improvement were predominantly in the cognitive domain. This indicates that HBOT may have a positive effect on complaints of long COVID, but alertness for worsening of the condition should be exercised.

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[forestglip]

I'd like to see them also follow a group matched for duration of illness and other relevant variables, but that didn't do HBOT to see how these outcomes compare. Although it looks like an RCT is planned:

LIMITATIONS: Limitations of this study are the lack of a control group, possible selection and confirmation biases and the questionnaires that were used. Given the uncontrolled nature of this study, a direct causal effect of HBOT on the outcomes cannot be established. For this a randomized, controlled trial is planned in the Netherlands, and data of this registry will serve as pilot-data for this future study. A control group would have served to notice any improvement due to time passing. However, the median time from COVID infection to the start of HBOT was 20 months, which makes natural resolution of symptoms less likely; studies suggests that recovery of long COVID appears to plateau after 6-12 months after infection, and few patients achieve full remission.[5,6]

 

[Eleanor]

At 3-month follow up, 11% of patients who were not working at baseline due to long COVID were able to resume activities at work. On average, they were able to work for 9 (IQR 4 - 32) hours per week. Patients who were already working at baseline but who had reduced their working hours because of long COVID, were not able to work more hours per week at 3-month follow up (median 12 (IQR 8 - 20), p 0,294).

I think those unimpressive numbers probably say more about the success or otherwise of the c.40 sessions of treatment (which the patients were paying for) than whether they improved by a few points on the SF-36 questionnaire.