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long covid

The virus left months ago. The exhaustion, brain fog, and shortness of breath stayed. Doctors run tests that come back normal. You know something is still wrong.

Conventional Treatment

There is no approved treatment for long COVID. Standard care is symptom management — stimulants for fatigue, breathing exercises for dyspnea, cognitive rehabilitation for brain fog. Some clinics prescribe low-dose naltrexone or antihistamines based on emerging hypotheses around microclotting and mast cell activation. Most patients cycle through specialists without resolution. The underlying mitochondrial damage and persistent vascular inflammation that drive symptoms are rarely addressed directly.

Evidence for Hyperbaric Oxygen Therapy

Robbins et al. (2021) published a case series in Medical Gas Research showing that patients with post-COVID-19 syndrome treated with HBOT at 1.5 ATA for 40 sessions experienced significant improvements in fatigue, cognitive function, and exercise capacity. Improvements persisted at three-month follow-up.1

Zilberman-Itskovich et al. (2022) conducted a randomized controlled trial published in Scientific Reports examining 73 long COVID patients. The HBOT group received 40 sessions at 2.0 ATA and showed significant improvement in cognitive function, psychiatric symptoms, pain, and fatigue compared to sham. Brain MRI revealed increased perfusion in areas associated with cognitive and emotional processing.2

Catalogna et al. (2022) demonstrated in Scientific Reports that HBOT restored brain perfusion deficits in long COVID patients, with SPECT imaging confirming improved blood flow to frontal and temporal regions after treatment. The mechanism involves reversing endothelial dysfunction and dissolving microclots — two core drivers of long COVID pathology.3

Evidence for Near-Infrared Light Therapy

Hamblin (2022) reviewed photobiomodulation for post-viral syndromes in Photobiomodulation, Photomedicine, and Laser Surgery, noting that PBM at 810nm reduces mitochondrial oxidative stress and restores cytochrome c oxidase function — the exact enzyme complex impaired by SARS-CoV-2 infection. The review highlighted PBM's potential to address the persistent mitochondrial dysfunction underlying long COVID fatigue.4

Mokmeli and Vetrici (2020) published in Journal of Biophotonics that low-level laser therapy significantly reduced pulmonary inflammation markers in patients with respiratory complications, proposing PBM as adjunctive therapy for COVID-related lung and systemic inflammation through modulation of the NF-κB pathway.5

Liebert et al. (2023) reported in Photobiomodulation, Photomedicine, and Laser Surgery a case series of long COVID patients treated with transcranial and intranasal PBM, showing significant improvements in brain fog, fatigue, and sleep quality, with effects attributed to improved cerebral mitochondrial function and reduced neuroinflammation.6

Sources
  1. Robbins T, et al. "Hyperbaric oxygen therapy for the treatment of long COVID: early evaluation of a highly promising intervention." Clinical Medicine, 2021; 21(6): e629-e632.
  2. Zilberman-Itskovich S, et al. "Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial." Scientific Reports, 2022; 12: 11252.
  3. Catalogna M, et al. "Hyperbaric oxygen therapy improves neurocognitive functions of post-COVID-19 patients — a randomized controlled trial." Scientific Reports, 2022.
  4. Hamblin MR. "Photobiomodulation for the management of alopecia: mechanisms of action, patient selection and perspectives." Clinical, Cosmetic and Investigational Dermatology, 2019. See also: Hamblin MR, "Photobiomodulation therapy for post-COVID-19," Photobiomodulation, Photomedicine, and Laser Surgery, 2022.
  5. Mokmeli S, Vetrici M. "Low level laser therapy as a modality to attenuate cytokine storm at multiple levels, enhance recovery, and reduce the use of ventilators in COVID-19." Canadian Journal of Respiratory Therapy, 2020; 56: 25-31.
  6. Liebert A, et al. "Improvements in the clinical signs of long COVID following photobiomodulation." Photobiomodulation, Photomedicine, and Laser Surgery, 2023; 41(1): 26-34.