10 sessions of HBOT (Hyperbaric Oxygen Therapy) in a mixed population of long covid patients did not detect an improvement in self-reported physical function evaluated by RAND-36, or any of the main secondary outcomes in the short term.
Kjellberg A, et al – BMJ
Summary
- A recent phase II clinical trial (HOT-LoCO), published in the BMJ, found no statistically significant benefit of hyperbaric oxygen therapy (HBOT) over placebo in treating Long Covid.
- Dr Charles Shepherd, MEA Hon. Medical Advisor, emphasises that, while some small studies exist, “there is no sound evidence of benefit and it should also be noted that HBOT can cause side effects.”
On the 14th April, the BMJ (British Medical Journal) published the following research paper, “Ten sessions of hyperbaric oxygen versus sham treatment in patients with long covid (HOT-LoCO): a randomised, placebo-controlled, double-blind, phase II trial,” Kjellberg A, et al. Dr Charles Shepherd, MEA Hon Medical Advisor, has discussed the evidence and safety of hyperbaric oxygen therapy for people with Long Covid previously and provides comment on this research paper.
Extracts
No effective evidence-based pharmacological treatment options for the underlying condition [Long Covid] have been widely adopted into clinical practice, and many patients seek expensive and potentially harmful ‘remedies’ for selfmanagement. Hyperbaric oxygen treatment (HBOT) has 14 internationally approved indications with demonstrated potential in a multitude of applications in inflammatory and systemic conditions but remains controversial despite half a century of clinical use.
HOT-LoCO (hyperbaric oxygen for treatment of long covid syndrome) is an investigator-initiated, randomised, placebo-controlled, double blind, parallel-arms, phase II clinical trial that was conducted at the hyperbaric outpatient clinic at Karolinska University Hospital, Stockholm, Sweden.
Patients were recruited through long covid outpatient clinics, directly or by advertisement through Svenska Covidföreningen.
We could not detect a statistically significant difference between HBOT and sham treatment in any of the primary or main secondary endpoints in the overall subject population.
MEA Comment:
Results from this clinical trial do not provide any evidence of benefit for hyperbaric oxygen therapy (HBOT) in the treatment of Long Covid.
There have now been a number of small and sometimes poor quality clinical trials to assess the benefits and safety of HBOT in the treatment of both Long Covid and ME/CFS.
The results so far in both Long Covid and ME/CFS are mixed and some of these trials have not involved a control group.
Overall, there is no sound evidence of benefit and it should also be noted that HBOT can cause side effects.
Dr Charles Shepherd,
Trustee and Hon. Medical Adviser to the ME Association,
Member of the 2018-2021 NICE guideline on ME/CFS committee,
Member of the 2002 Chief Medical Officer's Working Group on ME/CFS
