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Can hyperbaric oxygen safely serve as an anti-inflammatory treatment for COVID-19?
Anders Kjellberg1, Antonio De Maio2, Peter Lindholm3
1Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden; Perioperative Medicine and Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden.
Introduction:
SARS-CoV-2 affects part of the innate immune response and activates an inflammatory cascade stimulating the release of cytokines and chemokines, particularly within the lung. Indeed, the inflammatory response during COVID-19 is likely the cause for the development of acute respiratory distress syndrome (ARDS). Patients with mild symptoms also show significant changes on pulmonary CT-scan suggestive of severe inflammatory involvement.
Hypothesis:
The overall hypothesis is that HBO2 is safe and reduces the inflammatory response in COVID-19 pneumonitis by attenuation of the innate immune system, increase hypoxia tolerance and thereby prevent organ failure and reduce mortality.
Evaluation Of The Hypothesis:
HBO2 is used in clinical practice to treat inflammatory conditions but has not been scientifically evaluated for COVID-19. Experimental and empirical data suggests that HBO2 may reduce inflammatory response in COVID-19. However, there are concerns regarding pulmonary safety in patients with pre-existing viral pneumonitis.
Empirical Data:
Anecdotes from "compassionate use" and two published case reports show promising results.
Consequences Of The Hypothesis And Discussion:
Small prospective clinical trials are on the way and we are conducting a randomized clinical trial.
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