Hyperbaric Oxygen Therapy for improving symptoms of long Covid-19 syndrome: baseline report of a living systematic review

Article type
Authors
Carmona M1, García-Carpintero E2, Pedrosa-Pérez L2, Sánchez-Gómez L1, Verdugo F3, Audell A4, Rojas M5
1Health Technology Assessment Agency. Instituto de Salud Carlos III, 28029, Madrid, Spain; Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 28029, Madrid, Spain
2Health Technology Assessment Agency. Instituto de Salud Carlos III, 28029, Madrid, Spain
3Epistemonikos Foundation. Chile Faculty of Medicine, Av. Holanda 895, Providencia. Santiago, Chile; Living evidence to Inform Health Decisions Program, Barcelona, Spain
4Living evidence to Inform Health Decisions Program, Barcelona, Spain
5Living evidence to Inform Health Decisions Program, Barcelona, Spain; Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Carrer de Sant Quintí, 77. 08041, Barcelona, Spain
Abstract
"Background: Hyperbaric Oxygen Therapy (HBOT) has been shown to be safe and effective in the treatment of chronic fatigue syndrome. However, its efficacy in the treatment of long-Covid is still uncertain.
Objective: To assess the efficacy and safety of the use of HBOT in patients with long-Covid in comparison with other therapies such as Normobaric Oxygentherapy (NBOT), the standard care and placebo.
Methods: This is a Living Evidence synthesis, which started with a baseline synthesis report. We seek to assess systematic reviews, randomized controlled trials and non-randomized studies evaluating the effect of HBOT on fatigue, dyspnoea, systemic pain, insomnia, anxiety, depression and quality of life. The questions were set up in a “living mode” supported by the Living evidence to Inform Health Decisions Program, in which the evidence monitoring is doing in a monthly basis. We will continue monitoring the evidence until the predefined criteria to suspending it are reached.
Results: The baseline synthesis identified one RCT including 73 long-Covid patients, randomized to HBOT (n=37) or control (n=36). Low quality evidence suggests that HBOT may result in little to no difference in neurocognitive performance (MD=0.495, IC95% 0,03 to 0,96), executive functions (MD=0.477, IC95% 0.01 to 0.94). Low quality evidence suggest HBOT may improve sleep and psychological outcomes measured by Pittsburgh Sleep Quality Index (MD=-0.48, IC95% -0.96 to 0,03); psychological distress measure with the Brief Symptom Inventory (BSI) (MD=-0.636, IC95% -1,1 to -0.16); and pain measured by Brief Pain Inventory (MD=-0.74, IC95% -1,22 to -0,27).
Conclusions: HBOT seems to improve long-Covid symptoms particularly pain and psychological distress, nevertheless the evidence is affected by impression and new studies are need to define the real beneficial effects of this therapy which justifies to keep the question in living mode.
Declaration of funding: This baseline report was commissioned by the Health Technology Assessment Agency of Instituto de Salud Carlos III without external funding. This study is part of the project “Strengthening decision-making capacity in the Spanish Health System through living evidence: An innovative framework” with funding from the Spanish Government. Co-funded by FONDOS FEDER. Instituto de Salud Carlos III Grant PI21/01564; 2021 call.
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