A Dive Into the Neurological Impact of Long COVID and Hyperbaric Oxygen Therapy: Amir Hadanny, MD, PhD

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The chief medical research officer and head of research at Aviv Clinics discussed the impact of long COVID on patients and shared findings from a recently published study on using hyperbaric oxygen therapy protocol as a treatment for these patients. [WATCH TIME: 8 minutes]

WATCH TIME: 8 minutes

"The more we learned about long COVID, the more we realized its complexity. Even today, we're not entirely sure about the pathogenesis or pathophysiology. Our goal was to target the pathophysiology, exploring recovery and regeneration in brain injuries to apply similar principles to long COVID. The trial revealed significant improvements, not just in symptoms but in the actual brain regions affected by COVID, bringing us closer to understanding and treating long COVID effectively."

Long COVID is a condition that refers to a span of consistent physical, neurocognitive, and neuropsychological symptoms following the infection of COVID-19 in a patient.1 The suggested mechanisms of the condition related to brain tissue pathology may be caused by virus invasion or indirectly through neuroinflammation and hypercoagulability.2 A randomized controlled trial recently published in Scientific Reports showed positive effects of a specific hyperbaric oxygen therapy (HBOT) protocol on neurocognitive functions and symptoms among patients with long COVID. These findings suggest HBOT can induce neuroplasticity and improve cognitive, psychiatric, fatigue, sleep and pain symptoms in patients with long COVID.3

Coauthor Amir Hadanny, MD, PhD, a neurosurgeon, and colleagues, evaluated the effect of HBOT among 73 post-COVID-19 patients for at least 3 months. Following HBOT, investigators observed a significant group-by-time interaction in global cognitive function (d = .495; P = .038), attention (d = .477; P = .04) and executive function (d = .463; P = .05). In addition, HBOT demonstrated significant improvement in the energy domain (d = .522; P = .029), sleep (d = -.48; P = .042), psychiatric symptoms (d = .636; P = .008), and pain interference (d = .737; P = 0.001). Overall, authors noted clinical outcomes were associated with significant improvement in brain MRI perfusion and microstructural changes in the supramarginal gyrus, left supplementary motor area, right insula, left frontal precentral gyrus, right middle frontal gyrus, and superior corona radiate.

Recently Hadanny, who is also the chief medical research officer and head of research at Aviv Clinics, sat down in an interview with NeurologyLive® to discuss how the patients responded to the HBOT protocol. Hadanny also spoke about the 3 main theories surrounding the pathophysiology of long COVID, and how they impact specific areas of the brain. He also talked about how the traditional symptom-focused approach to managing long COVID differs from the innovative HBOT protocol. Hadanny explained what factors determine whether a long COVID patient should undergo 40 or 60 sessions of HBOT, and how the duration of symptoms plays a crucial role with the treatment process.

REFERENCES
1. Stefano GB. Historical Insight into Infections and Disorders Associated with Neurological and Psychiatric Sequelae Similar to Long COVID. Med Sci Monit. 2021;27:e931447. Published 2021 Feb 26. doi:10.12659/MSM.931447
2. Silva Andrade B, Siqueira S, de Assis Soares WR, et al. Long-COVID and Post-COVID Health Complications: An Up-to-Date Review on Clinical Conditions and Their Possible Molecular Mechanisms. Viruses. 2021;13(4):700. Published 2021 Apr 18. doi:10.3390/v13040700
3. Zilberman-Itskovich S, Catalogna M, Sasson E, et al. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial. Sci Rep. 2022;12(1):11252. Published 2022 Jul 12. doi:10.1038/s41598-022-15565-0
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