Prevention and Treatment of Life-Threatening COVID-19 May Be Possible with Oxygen Treatment

Abstract

Most SARS CoV-2 infections probably occur unnoticed or cause only cause a mild common cold that does not require medical intervention. A significant proportion of more severe cases is characterized by early neurological symptoms such as headache, fatigue, and impaired consciousness, including respiratory distress. These symptoms suggest hypoxia, specifically affecting the brain. The condition is best explained by primary replication of the virus in the nasal respiratory and/or the olfactory epithelia, followed by an invasion of the virus into the central nervous system, including the respiratory centers, either along a transneural route, through disruption of the blood-brain barrier, or both. In patients, presenting with early dyspnea, the primary goal of therapy should be the reversal of brain hypoxia as efficiently as possible. The first approach should be intermittent treatment with 100% oxygen using a tight oronasal mask or a hood. If this does not help within a few hours, an enclosure is needed to increase the ambient pressure. This management approach is well established in the hypoxia-related diseases in diving and aerospace medicine and preserves the patient’s spontaneous breathing. Preliminary research evidence indicates that even a small elevation of the ambient pressure might be lifesaving. Other neurological symptoms, presenting particularly in long COVID-19, suggest imbalance of the autonomous nervous system, i.e., dysautonomia. These patients could benefit from vagal nerve stimulation.

COVID-19 Prevention and Treatment

“…As of December 2020, when the therapeutic agents approved for COVID-19 were limited all over the world, plasma from individuals recovered from COVID-19 was the first therapeutic tool adopted. Another four papers addressing treatment are related to the potential therapeutic implications of different substances or models [ 16 , 17 , 18 , 19 ]. The studies covered the use of Renessans, a product with iodine complexes and ascorbic acid (the study was designed to determine its efficacy for SARS-CoV-2 in Rhesus macaque ), characterized by antimicrobial activity; the use of oxygen (the study clearly underlines how, in patients presenting with early dyspnea, the primary goal of therapy should be the reversal of brain hypoxia with a first approach of intermittent treatment with 100% oxygen using a tight oronasal mask or a hood); the use of 14 Mev neutron irradiation (neutron radiation is usually used to sterilize viruses because neutron radiation is 10 times more effective than gamma rays in inactivating viruses: the authors established a closed SARS-CoV-2 inactivation container model and simulated the inactivation performance by using several different neutron sources); and the application of lung imaging scores (the main goal of the paper was to propose a prediction model involving imaging methods, specifically ultrasound).…”

Clinical and Epidemiological Characteristics of Patients with COVID-19 Admitted to the Intensive Care Unit: A Two-Year Retrospective Analysis

“…Approximately 20% of individuals with COVID-19 develop the severe form of the disease, requiring hospitalization and oxygen therapy support, associated with lung injury and hypoxemic respiratory failure. Around 5% are admitted to the Intensive Care Unit (ICU), where they need invasive mechanical ventilation for the treatment of ARDS, followed by an invasion of the virus into the central nervous system, including the brainstem, followed by acute respiratory distress syndrome as a later complication [ 6 ]. For this reason, a personalized respiratory and monitoring strategy in patients with SARS-CoV-2 infection is paramount.…”

“…For this reason, a personalized respiratory and monitoring strategy in patients with SARS-CoV-2 infection is paramount. An individualized ventilatory approach based on lung physiology, morphology, imaging, and identification of biological phenotypes may improve COVID-19 outcomes while individualizing mechanical ventilation practices [ 6 , 7 ].…”