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Clinical and biochemical short-term effects of hyperbaric oxygen therapy on SARS-Cov-2+ hospitalized patients with hypoxemic respiratory failure.
Keller, Guillermo A; Colaianni, Ivana; Coria, Javier; Di Girolamo, Guillermo; Miranda, Silvia.
  • Keller GA; Universidad de Buenos Aires, Facultad de Medicina, Centro de Vigilancia y Seguridad de Medicamentos, Argentina; Hospital General de Agudos Donación Francisco J. Santojanni, Departamento de Urgencias, Argentina.
  • Colaianni I; Hospital General de Agudos Donación Francisco J. Santojanni, Departamento de Urgencias, Argentina.
  • Coria J; Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional (IATIMET), Argentina.
  • Di Girolamo G; Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional (IATIMET), Argentina.
  • Miranda S; Universidad de Buenos Aires- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Alberto C. Taquini de Investigaciones en Medicina Traslacional (IATIMET), Argentina. Electronic address: smiranda@ffyb.uba.ar.
Respir Med ; 209: 107155, 2023 04.
Article in English | MEDLINE | ID: covidwho-2242077
ABSTRACT

BACKGROUND:

Hyperbaric oxygen therapy (HBOT) has been proposed to address COVID-19- associated respiratory failure. However, its biochemical effects are poorly known.

METHOD:

50 patients with hypoxemic COVID-19 pneumonia were divided into C group (standard care) and H group (standard care plus HBOT). Blood was obtained at t = 0 and t = 5 days. Oxygen saturation (O2 Sat) was followed up. White blood cell (WC) count, lymphocytes (L) and platelets (P) and serum analysis (glucose, urea, creatinine, sodium, potassium, ferritin, D dimer, LDH and CRP) were carried out. Plasma levels of sVCAM, sICAM, sPselectin, SAA and MPO, and of cytokines (IL-1ß, IL-1RA, IL-6, TNFα, IFNα, IFNγ, IL-15, VEGF, MIP1α, IL-12p70, IL-2 and IP-10) were measured by multiplex assays. Angiotensin Converting Enzyme 2 (ACE-2) levels were determined by ELISA.

RESULTS:

The average basal O2 Sat was 85 ± 3%. The days needed to reach O2 Sat >90% were H 3 ± 1 and C 5 ± 1 (P < 0,01). At term, H increased WC, L and P counts (all, H vs C P < 0,01). Also, H diminished D dimer levels (H vs C, P < 0,001) and LDH concentration (H vs C, P < 0.01]. At term, H showed lower levels of sVCAM, sPselectin and SAA than C with respect to basal values (H vs C ΔsVCAM P < 0,01; ΔsPselectin P < 0,05; ΔSAA P < 0,01). Similarly, H showed diminished levels of TNFα (ΔTNFα P < 0,05) and increased levels of IL-1RA and VEGF than C respect to basal values (H vs C ΔIL-1RA and ΔVEGF P < 0,05).

CONCLUSION:

Patients underwent HBOT improved O2 Sat with lower levels of severity markers (WC and platelets count, D dimer, LDH, SAA). Moreover, HBOT reduced proinflammatory agents (sVCAM, sPselectin, TNFα) and increased anti-inflammatory and pro-angiogenic ones (IL-1RA and VEGF).
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / COVID-19 / Hyperbaric Oxygenation Type of study: Experimental Studies / Prognostic study Topics: Long Covid / Variants Limits: Humans Language: English Journal: Respir Med Year: 2023 Document Type: Article Affiliation country: J.rmed.2023.107155

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Insufficiency / COVID-19 / Hyperbaric Oxygenation Type of study: Experimental Studies / Prognostic study Topics: Long Covid / Variants Limits: Humans Language: English Journal: Respir Med Year: 2023 Document Type: Article Affiliation country: J.rmed.2023.107155