Rationale for ozone-therapy as an adjuvant therapy in COVID-19: a narrative review

Abstract

Coronavirus disease 2019 (COVID-19) is the respiratory disease caused by the novel severe acute respiratory syndrome-coronavirus-2 and is characterized by clinical manifestations ranging from mild, flu-like symptoms to severe respiratory insufficiency and multi-organ failure. Patients with more severe symptoms may require intensive care treatments and face a high mortality risk. Also, thrombotic complications such as pulmonary embolisms and disseminated intravascular coagulation are frequent in these patients. Indeed, COVID-19 is characterized by an abnormal inflammatory response resembling a cytokine storm, which is associated to endothelial dysfunction and microvascular complications. To date, no specific treatments are available for COVID-19 and its life-threatening complication. Immunomodulatory drugs, such as hydroxychloroquine and interleukin-6 inhibitors, as well as antithrombotic drugs such as heparin and low molecular weight heparin, are currently being administered with some benefit. Ozone therapy consists in the administration of a mixture of ozone and oxygen, called medical ozone, which has been used for over a century as an unconventional medicine practice for several diseases. Medical ozone rationale in COVID-19 is the possibility of contrasting endothelial dysfunction, modulating the immune response and acting as a virustatic agent. Thus, medical ozone could help to decrease lung inflammation, slow down viral growth, regulate lung circulation and oxygenation and prevent microvascular thrombosis. Ozone-therapy could be considered a feasible, cost-effective and easy to administer adjuvant therapy while waiting for the synthesis of a therapy or the development of the vaccine.

Ozone gas applied through nebulizatıon as adjuvant treatment for lung respiratory dıseases due to COVID-19 infectıons

“…In addition, studies on ozone have shown that ozone has an antiviral, antibacterial and disinfectant effect depending on the concentration, environment and application method. 18 19 Ozone therapy refers to the process of applying ozone gas to the body to treat a disease or wound. It can be used to treat medical conditions by stimulating the immune system.…”

Interleukin-6 in Rheumatoid Arthritis

“…COVID-19 is a disease caused by a novel coronavirus and it can cause a vast array of symptoms, ranging from mild, flu-like symptoms to severe respiratory failure [ 52 ]. Many different therapeutic approaches have been tried, mostly anti-inflammatory therapies, ranging from steroids to antimalaria drugs; even non-conventional therapies, such as ozone-therapy, have been tested [ 53 ]. The most severe symptoms seem to be caused, at least in part, by an autoinflammatory reaction, with characteristics of a cytokine storm [ 52 ]: Binding of the novel coronavirus to TLRs causes an increase in the levels of IL-1β, which mediate fibrosis and inflammation of the lung [ 50 ].…”

Ozonioterapia como opção de tratamento contra COVID-19: uma revisão de literatura

“…TÍTULO IDIOMA RESULTADOS (Ranaldi et al, 2020) Rationale for ozone-therapy as an adjuvant therapy in COVID- Nos pacientes que receberam a terapia com ozônio houve uma diminuição da hipóxia tecidual, redução da hipercoagulação, da função imune moduladora com bloqueio de mediadores inflamatórios, aumento da ação fagocítica e diminuição da replicação viral.…”

“…a indução de interferon gama. Desta forma, esta terapia pode atuar como monoterapia ou como um complemento aos regimes de tratamento padrão, contra a COVID-19(Cattel et al, 2021).Estudo feito porRanaldi et al (2020) constataram que a utilização coadjuvante da ozonioterapia na COVID-19 através da autohemoinfusão ou infusão retal, é capaz de oxigenar melhor os tecidos e equilibrar as reações do sistema imune, pois impede a cascata de liberação de citocinas pelo organismo e regula a microcirculação pulmonar, protegendo e dificultando a hipertrofia muscular, especialmente na fase inicial da infecção pelo vírus.No estudode Cattel et al (2021) foi demonstrado que a terapia com ozônio possui diversos benefícios, entre os quais, previnem as manifestações coronarianas agudas e anomalias ocasionadas pela reperfusão da isquemia. Os autores indicam que o tratamento com ozônio é inovador para a imunoterapia, visto que a sua utilização em associação com outros fármacos antivirais em pacientes infectados com COVID-19 é capaz de torna-se efetivo, benéfico e coadjuvante Shah et al (2021).…”