OZONE THERAPY USE AS A COMPLEMENTARY SUPPORT IN TREATMENT OF ICU COVID-19 PATIENTS
DOI:
https://doi.org/10.32782/2411-9164.19.1-10Keywords:
Ozone therapy, SARS-CoV-2, Pandemic, Autohemotherapy, COVID-19Abstract
Introduction and objectives: There is still no specific treatment strategies aside from supportive management of huge amount of fatal Pandemic COVID-19 cases. The use of ozone (O3) gas as a therapy in alternative medicine has attracted skepticism due to its unstable molecular structure. Today we can affirm strongly that ozone is capable to modulate inflammation acting on the “cytokine storm”, to reduce tissue hypoxia, to decrease hypercoagulability and impaired viral replication. Due to many uncertainties around the management of COVID-19, there has been lots of interest in the potential role of adjuvant ozone therapies that can very well complement the standard COVID-19 therapy. A wide range of interventions, including antiviral medications, immunomodulators, convalescent plasma, and herbal medicinal therapy were not confirmed as effective against SARS-CoV2. The goal of this research was evaluation of the influence of ozone therapy on COVID-19 patients outcome. Materials and methods: A prospective randomized case-control clinical study, including a number of 100 Covid-19 patients with moderate pneumonia admitted in ICU between July 2020-February 2021 divided random in two groups. Study group with 50 patients, receive standard treatment and ozone autohemotherapy (O3-AHT) once daily for seven days consecutive. Ozone autohemotherapy involved administration of 150 ml autologous whole blood enriched with 150 ml of oxygenozone mixture with a 40 μg/mL ozone concentration. Control group included 50 patients, receive standard treatment according to the institutional protocol. Were analyzed primary outcome (mortality) and secondary outcomes (noninvasive ventilation duration, ICU and hospital length of stay, Brixia score at 1st and 7th day of ozone therapy and P/F ratio at 1st and 7th day of ozone therapy). Results: The mortality in control group versus study group was 34% (CI95% 22.1, 47.7) vs. 26% (CI95% 15.4, 39.3) without statistical significance (p = 0.513). The secondary outcome like length of stay in ICU and hospital, did not show any statistical significance among the examined groups. The P/F ratio on day 7 of ozone therapy was higher in study group 287 (IQR 150) vs 210 (180.75) with statistical significance (p=0.007). Brixia score at day 7th of ozone therapy was lover in study group 8 (IQR-5) vs 9 (IQR – 7) (p= 0.037). Conclusion: In this study, was demonstrated that application of ozone therapy, like a complimentary support to COVID-19 hospitalized patients does not influence the mortality. At the same time, the positive effect of ozone was observed in improvement of P/F ratio and Brixia score at day seven of ozone therapy. No side effects related to ozone therapy were observed in our study.
References
IRMS – Nicolae Testemitanu SUMPh: Tratamentele medicamentoase, utilizate în cadrul terapiei intensive a pacienţilor cu SARS-CoV-2: revistă critică de literatură.
Scientific and medical aspects of ozone therapy. State of the art. Bocci VAArch Med Res. 2006 May; 37(4):425-35. [PubMed]), (Ozone therapy: A clinical review. Elvis AM, Ekta JS J Nat Sci Biol Med. 2011 Jan; 2(1):66-70. [PubMed]).
Morrison, C., Atkinson, A., Zamyadi, A., Kibuye, F., Mckie, M., Hogard, S., Mollica, P., Jasim, S., & Wert, E. C. (2020). Critical Review and Research Needs of Ozone Applications Related to Virus Inactivation: Potential Implications for SARS-CoV-2. URL: https://doi.org/10.1080/01919512.2020.1839739.
Şahin Çolak1 | Burcu Genç Yavuz1 | Mürsel Yavuz2 | Burak Özçelik1 | Metin Öner1 | Asu Özgültekin3 | Seniha Şenbayrak. (2021). Effectiveness of ozone therapy in addition to conventional treatment on mortality in patients with COVID-19. URL: https://doi.org/10.1111/ijcp.14321.
Bocci V. Ozone: a new medical drug. 2nd ed. Dordrecht: Springer Verlag; 2011.27.
Eren E, Saribek F, Kayalayci, Yilmaz N. How to cripple SARS- COV-2 virus with Ozone treatment thiol groups in viruses and SARS-COV-2, Traditional and Complementary Medicine, 2020.
B. Bayarri, A. Cruz-Alcalde, N. L´ opez-Vinent, M.M. Mic´ o, C. Sans, Can ozone inactivate SARSCoV-2? A review of mechanisms and performance on viruses, J Hazard Mater. 5 (415) (2021 Aug), 125658. URL: https://doi.org/10.1016/j. jhazmat.2021.125658.
Delgado-Roche L, Riera-Romo M, Mesta F, Hernández-Matos Y, Barrios JM, Martínez-Sánchez G. Medical ozone promotes Nrf2 phosphorylation reducing oxidative stress and proinflammatory cy- tokines in multiple sclerosis patients. Rev Esp Ozonoterapia. 2018;8(2Supp 1):48-9.
Fernández-Cuadros, M. E., María, &, Albaladejo-Florín, J., Peña-Lora, D., Álava-Rabasa, S., & Susana Pérez-Moro, O. (n.d.). Ozone (O3) and SARS-CoV-2: Physiological Bases and Their Therapeutic Possibilities According to COVID-19 Evolutionary Stage. URL: https://doi.org/10.1007/s42399-020-00328-7/Published).
Schwartz A, Martinez-Sánchez G. Uso potencial complementario y compasivo de la ozonoterapia sistemica en el COVI-19. AEPROMO, 2020, In Press.
A., Hernandez, V., Montserrat, A., Pablos, F., Vlas, P., J., Papadokos, D., N., Wijeeysundera, M., Vives. Ozone therapy for patients with SARS-CoV2 pneumonia: a single-center prospective cohort study MedRXiv. doi: https://doi.org/10.1101/2020.06.03.20117994, June 12, 2020.
Franzini, M., Valdenassi, L., Ricevuti, G., Chirumbolo, S., Depfenhart, M., Bertossi, D., & Tirelli, U. (2020). International Immunopharmacology Oxygen-ozone (O 2-O 3) immunoceutical therapy for patients with COVID-19. Preliminary evidence reported. International Immunopharmacology, 88(May), 106879. URL: https://doi.org/10.1016/j.intimp.2020.106879.
Tascini, C., Sermann, G., Pagotto, A., Sozio, E., De Carlo, C., Giacinta, A., Sbrana, F., Ripoli, A., Castaldo, N., Merelli, M., Cadeo, B., Macor, C., & De Monte, · Amato. (2021). Blood ozonization in patients with mild to moderate COVID-19 pneumonia: a single centre experience. Internal and Emergency Medicine, 16, 669–675. URL: https://doi.org/10.1007/s11739-020-02542-6.
Sozio, E., De Monte, A., Sermann, G., Bassi, F., Sacchet, D., Sbrana, F., Ripoli, A., Curcio, F., Fabris, M., Marengo, S., Italiani, D., Luciana Boccalatte-Rosa, D., & Tascini, C. (2021). CORonavirus-19 mild to moderate pneumonia Management with blood Ozonization in patients with Respiratory failure (CORMOR) multicentric prospective randomized clinical trial. International Immunopharmacology, 98 (June). URL: https://doi.org/10.1016/j.intimp.2021.107874.
Shah, M., Captain, J., Vaidya, V., Kulkarni, A., Valsangkar, K., Nair, P. M. K., & Ganu, G. (2021). Safety and efficacy of ozone therapy in mild to moderate COVID-19 patients: A phase 1/11 randomized control trial (SEOT study). International Immunopharmacology, 91, 107301. URL: https://doi.org/10.1016/J.INTIMP.2020.107301.
