Highlights Ozone therapy as an adjuvant care can shorten hospitalization and need for intensive care. Ozone therapy enhances the quality of care in COVID-19 by exhibiting immune-modulatory effects. Ozone therapy as an adjuvant therapy is safe and effective in COVID-19 care . Ozone therapy relieves cardinal symptoms of SARS-CoV-2 like breathlessness, cough etc.

Objective Ozone therapy has tremendous therapeutic potential owing to its antiviral, anti-inflammatory and antioxidant properties, and potential to improve oxygenation. A pilot clinical trial was conducted to evaluate the safety and efficacy of intravenous ozonised saline treatment in patients with moderate COVID-19 pneumonia. Patients and Methods 10 patients were administered 200 ml freshly prepared ozonised saline intravenously over 1 hour once a day for 8 days along with standard medical treatment. Clinical symptoms were monitored everyday and laboratory biomarkers, radiological findings at 1,3,6,10 days. Telephonic follow up was done for all after discharge till Day 14. 7 out of 10 patients required oxygen supplementation at recruitment. Results There was severe adverse event recorded in the study group. All patients improved from moderate to mild category in average 8 days and were discharged in average 9.7 days. None deteriorated to severe stage. All clinical symptoms resolved within 6 days and oxygen supplementation requirement reduced to none within 4.1 days. There was statistically significant reduction in CRP (p=0.003), D-Dimer (p=0.049), IL6 (p=0.002) and statistically significant improvement (p=0.001) in SpO2/FiO2 ratio. Change in LDH was borderline statistically not significant (p=0.058). All patients showed significant resolution of bilateral interstitial infiltrates at the end of 10 days. Conclusion Resolved clinical symptoms, improved oxygenation, clearance of infiltrates on Chest X-ray and improvement in biomarkers in a short period with non-progression of the disease showed that IV ozonised saline therapy was safe and effective to prevent disease progression in COVID-19, making it an effective novel therapeutic tool.

Background: Multiple drug-resistant tuberculosis (MDR-TB) is a growing public health threat. Oxidative stress is reckoned as one of the rate-limiting steps in the progression of TB. Oxidative stress increases the level of tissue injury and organ damage. The use of medical ozone therapy is gaining popularity due to its anti-microbial property and its homeostatic potential. Objectives: The present study investigates the role of ozone therapy in boosting the antioxidant status of MDR-TB patients. Methods: Medical Ozone therapy was given through rectal insufflations for 21 days in seven MDR-TB patients (five males and two females) who were under anti-Koch Treatment-4 were enrolled after obtaining written consent. The sessions were spaced out at a rate of three sessions per week. Blood serum and plasma samples were collected from the patients at the baseline and at the end of the 21st session to assess the antioxidant status of superoxide dismutase (SOD) and glutathione reductase (GR) and other biochemical parameters. Results: Statistically significant rise was observed in SOD (P = 0.028), but not in GR (P = 0.058). No other biochemical profiles showed any statistically significant change except for a reduction in serum glutamic-pyruvic transaminase (P = 0.026). Participants also expressed subjective improvement in their mental status. However, we have not used any validated scales to record their mental status. Conclusions:The present study suggests that ozone can be a promising medium in tackling the oxidative stress and enhancing the positive mental attitude in ailing MDR-TB patients. Therefore, it can be considered as adjuvant therapy in treating MDR-TB. However, there are major limitations like smaller sample size and lack of control group. Large scale randomized trials are warranted.

It is well recognized that oxidative stress and oxidative damage to DNA, RNA, protein and cell membranes is responsible for early ageing and lifestyle disorders. In various pathological conditions the main problem is related to a rapid increase in the cellular ROS concentration that exceeds the capacity of the cell to eliminate them. ROS derived from the ozone therapy can exert its protective effects by means of an oxidative preconditioning, stimulating and/or preserving the endogenous antioxidant systems. The aim of this paper is to evaluate the ozone effects, in a preliminary clinical treatment in the oxidative stress disorders. We enrolled 12 patients having type2 diabetes who were prone for cardiovascular risk disorders. Ozone treatment improved glycemic control and prevented oxidative stress associated to diabetes mellitus and its complications. This was also correlated with lab testing of HbA1c and C-reactive protein levels before and after Ozone treatment of 20 rectal insufflation 20 sessions (with an ozone dose of 9000mcg, ozone concentration: 30 mcg/ml) and 10 Major Auto heamotherapy (with an ozone dose of 2000mcg, with Ozone concentration: 20mcg/ml) with Rectal twice a week and M-AHT once a week.C-reactive protein (CRP) predicts cardiovascular outcome. Oxidative stress is considered to be involved in endothelial alteration. CRP is used mainly as a marker of inflammation. Apart from liver failure, there are few known factors that interfere with CRP production. CRP levels are associated not only with clinical cardiovascular risk factors but also with oxidative stress. There are significant interrelationships among inflammation, oxidative stress, and traditional cardiovascular risk. Inflammation and oxidative stress play a key role in the pathogenesis of atherosclerosis. We examined the interrelationships among C-reactive protein (CRP), oxidative stress, and traditional cardiovascular risk factors.Ozone treatment significantly improved the antioxidant status of patients reducing biomarkers of protein and lipid oxidation, enhancing total intracellular antioxidant status. Improvement of blood circulation and oxygen delivery to ischemic and neoplastic tissues. Improvement of the general metabolism.Correcting the chronic oxidative stress by upregulating the antioxidant system. Induce a mild activation of the immune system and Procure a state of well-being in patients by activating the neuro-endocrine system. Conclusion: Ozone therapy given systemically improved patient's Creactive protein from range of 20-34 mg/dL to the range of 4-5 mg/dL. General wellbeing was enhanced with better controlled blood sugar levels. These results may be preliminary but shows the efficacy of Ozone therapy in oxidative stress disorders and inflammation markers.Keywords: ozone therapy, ozone oxidative preconditioning, antioxidant defence mechanism, oxidative stress, C-reactive proteins and HbA1c Test, Inflammation markers.

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