At least 1 in 6 COVID-19 patients admitted to hospital to receive extra oxygen will dieof complications. In patients with COVID-19, invasive treatment such as mechanicalventilation (e.g. breathing with a machine) is associated with a 50% increased risk ofdeath. Invasive treatments use a lot of healthcare resources in intensive care units andmay lead to further deaths if patients do not have access to care.The investigators aim to improve outcomes for COVID-19 patients by implementinghyperbaric oxygen therapy (HBOT). HBOT allows patients to breathe 100% oxygen in aspecial chamber at a pressure higher than sea level. It is approved by Health Canada for14 conditions. HBOT is safe when administered by experienced teams.There are two main causes of death in severe COVID-19 respiratory infections: (i) adecreased diffusion of oxygen from the lungs to the blood and (ii) an increasedinflammatory response (also called a "cytokine storm"). HBOT leads to increased oxygenlevel in blood, has strong anti-inflammatory effects, and may destroy the virusresponsible for COVID-19 disease. The initial experience with HBOT and COVID-19 fromChina, France and the United States is promising in that it prevents further worsening ofthe condition and need for intensive care.The investigators propose to test the effectiveness of HBOT for COVID-19 patients who areadmitted to hospital to receive extra oxygen. Using the most rigorous and innovativeresearch methods, this Canadian-led international study will operate at 5 centers across3 countries (Canada: Ottawa, Toronto, Edmonton; Switzerland: Geneva; UK: Rugby/London).The investigators anticipate that when treated by HBOT, COVID-19 patients needing extraoxygen to breathe will see significant health improvements as well as a decrease incomplications, inflammation in the blood, need for invasive care, death, and cost ofcare.
Drug: Oxygen
Hyperbaric oxygen therapy delivered in a monoplace or multi-place chamber. Supervised by
a hyperbaric oxygen therapy physician and a chamber operator.
Inclusion Criteria:
- Male or non-pregnant female patients
- Age ≥18 years
- Confirmed COVID-19 positive by RT-PCR or another validated method
- Diagnosed with pneumonia requiring 21%
- Able and willing to comply with study procedures and follow-up examinations
contained within the written consent form
Exclusion Criteria:
- Patient clinical status felt to be incompatible with HBOT, e.g. respiratory failure
requiring mechanical ventilation
- Pregnancy, determined by a serum or urine test
- Hemodynamic instability requiring vasopressors
- Inability to maintain a sitting position during treatment
- Inability to effectively understand and communicate with the hyperbaric operator, or
to give consent
- Inability to spontaneously equalize ears and refusal of myringotomies
- Contraindications to HBOT (e.g. pneumothorax)
The Ottawa Hospital
Ottawa, Ontario, Canada
Rouge Valley Hyperbaric Medical Centre
Scarborough, Ontario, Canada
Sylvain Boet, MD, PhD
613-737-8899 - 78187
sboet@toh.ca
Joseph Burns, MSc
613-798-5555 - 14775
josburns@ohri.ca
Sylvain Boet, MD, PhD, Principal Investigator
The Ottawa Hospital