Hyperbaric Oxygen Therapy Applications in COVID-19 Management

Hyperbaric oxygen therapy (HBOT) involves the intermittent administration of 100 per cent oxygen at elevated pressures in a specialised chamber, markedly increasing dissolved oxygen in plasma and enhancing tissue oxygen delivery. In the context of COVID-19, HBOT has been investigated as an adjunct to standard respiratory support, targeting the profound hypoxaemia and inflammatory dysregulation that characterise severe disease. By raising arterial oxygen tensions, HBOT may mitigate organ ischaemia and support cellular metabolism, while its putative anti-inflammatory effects could attenuate the cytokine-driven lung injury that leads to acute respiratory distress syndrome (ARDS). Early clinical experiences and mechanistic studies suggest potential benefits in reducing oxygen requirements, improving immune cell function and accelerating recovery of pulmonary function. Nonetheless, variability in treatment protocols, patient selection and study outcomes underscores the need for rigorous trials to define optimal dosing, safety parameters and long-term sequelae. Globally, interest in HBOT has grown as healthcare systems seek scalable interventions to reduce intensive care burden and improve outcomes, particularly in regions with constrained ventilator capacity. Integration of findings across diverse settings highlights both promise and the imperative for standardised multicentre evaluation to clarify the role of HBOT in the evolving management of COVID-19.

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Hyperbaric Oxygen Therapy Applications in COVID-19 Management publication trend

The graph below shows the total number of articles in hyperbaric oxygen therapy applications in covid-19 management across all publications each year (not limited to Nature Index journals).

Technical terms

Hyperbaric Oxygen Therapy (HBOT): A treatment in which patients breathe pure oxygen under increased atmospheric pressure to enhance arterial and tissue oxygen levels.

Acute Respiratory Distress Syndrome (ARDS): A severe form of respiratory failure characterised by rapid onset of widespread inflammation in the lungs and refractory hypoxaemia.

Atmospheres Absolute (ATA): A unit of pressure measurement reflecting total pressure, including ambient atmospheric pressure, used to specify HBOT chamber settings.

PaO₂/FiO₂ Ratio: The ratio of arterial oxygen partial pressure (PaO₂) to fractional inspired oxygen (FiO₂), an index of gas exchange efficiency in the lungs.

References

1. The effects of hyperbaric oxygen therapy (HBOT) on coronavirus disease-2019 (COVID-19): a systematic review. European Journal of Medical Research (2021).
2. Effectiveness of Hyperbaric Oxygen Therapy in SARS-CoV-2 Pneumonia: The Primary Results of a Randomised Clinical Trial. Journal of Clinical Medicine (2022).
3. COVID-19-Induced Acute Respiratory Distress Syndrome Treated with Hyperbaric Oxygen: Interim Safety Report from a Randomized Clinical Trial (COVID-19-HBO). Journal of Clinical Medicine (2023).
4. Five sessions of hyperbaric oxygen for critically ill patients with COVID-19-induced ARDS: A randomised, open label, phase II trial. Respiratory Medicine (2024).