The SARS-Cov-2 (COVID-19) pandemic remains a major worldwide public health issue. Initially, improved supportive and anti-inflammatory intervention, often employing known drugs or technologies, provided measurable improvement in management. We have recently seen advances in specific therapeutic interventions and in
vaccines. Nevertheless, it will be months before most of the world's population can be vaccinated to achieve herd immunity. In the interim, hyperbaric
oxygen (HBO2) treatment offers several potentially beneficial
therapeutic effects. Three small published series, one with a propensity-score-matched control group, have demonstrated safety and initial efficacy. Additional anecdotal reports are consistent with these publications. HBO2 delivers
oxygen in extreme conditions of
hypoxemia and tissue
hypoxia, even in the presence of lung pathology. It provides anti-inflammatory and anti-proinflammatory effects likely to ameliorate the overexuberant immune response common to
COVID-19. Unlike
steroids, it exerts these effects without immune suppression. One study suggests HBO2 may reduce the
hypercoagulability seen in COVID patients. Also, hyperbaric
oxygen offers a likely successful intervention to address the
oxygen debt expected to arise from a prolonged period of
hypoxemia and tissue
hypoxia. To date, 11 studies designed to investigate the impact of HBO2 on patients infected with SARS-Cov-2 have been posted on clinicaltrials.gov. This paper describes the promising physiologic and biochemical effects of hyperbaric
oxygen in
COVID-19 and potentially in other disorders with similar pathologic mechanisms.