Authors: Kjellberg A, De Maio A, Lindholm P

PMID: 33254531 PMCID: PMC7456590 DOI: 10.1016/j.mehy.2020.110224


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.

Keywords: hyperbaric oxygen therapy, anti-inflammation, COVID-19, SARS-CoV-2