Hyperbaric Oxygen Therapy for Long COVID: What the Research Shows

Long COVID, which the World Health Organization calls post COVID-19 condition, describes symptoms that usually begin within three months of a COVID-19 infection and last at least two months without another explanation. Common complaints include fatigue, "brain fog," trouble concentrating, poor sleep, shortness of breath and pain. For many people, these symptoms make work and family life hard, and there is still no established treatment that works for everyone. It is understandable that people look for options.

Researchers have proposed several reasons symptoms may persist. These include injury to the smallest blood vessels, ongoing inflammation in the brain and body, and problems with how cells produce energy. These are hypotheses, not settled facts.

Hyperbaric researchers have suggested that HBOT might play a role because, in other settings, high-pressure oxygen has been studied for its effects on new blood-vessel growth and inflammatory signaling. You can read more about angiogenesis and anti-inflammatory effects in our explainer on how HBOT works. Whether any of that translates into meaningful improvement for people with long COVID is exactly what the trials below tried to test.

It is just as important to be clear about what these studies cannot tell you:

• Not that HBOT cures long COVID. No study claims that, and the only large controlled trials disagree.
• Not that results apply to everyone. Participants in the positive trial were mostly middle-aged adults with cognitive complaints lasting at least three months. People with other symptom patterns were not studied the same way.
• Not that a short course works. The 10-session trial found no difference from placebo.
• Not the right dose. No study has compared different numbers of sessions or pressures head to head.
• Not long-term durability. The only follow-up beyond a year had no control group and followed fewer than half of the original participants.
• Not safety in people with lung damage from COVID. Lung disease can be a relative contraindication for HBOT, and people with significant lung injury need careful individual assessment. Read about relative contraindications including lung disease.
• Not insurance coverage. No insurer covers HBOT for long COVID. See why investigational uses are not covered.

HBOT also carries its own side effects, even when it is used for cleared indications. The most common are ear and sinus pressure, temporary nearsightedness and tiredness. Rare but serious risks include oxygen toxicity seizures and lung injury from pressure changes.

Because long COVID is not a cleared indication, Medicare and commercial insurers do not cover HBOT for it. Any clinic offering it is charging self-pay for an investigational use, often for a course of 40 sessions. At the published national range of $150 to $450 per session, that adds up quickly.

If you are searching for HBOT for long COVID in Modesto or anywhere else, here is our honest answer: Generations Wellness does not offer it for this condition. If you are considering it elsewhere, ask the clinic the five questions from our HBOT research overview. Ask which trial their protocol is based on, what pressure and how many sessions they use, and whether a physician will assess you first. Our guide to questions to ask any clinic can help too.

If you want to follow the science, you may also find the same research group's TBI work useful, since several of the long COVID investigators also study brain injury.