Ozone therapy for the treatment of COVID-19 pneumonia: A scoping review

Abstract

Severe forms of COVID-19 can evolve into pneumonia, featured by acute respiratory failure due to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In viral diseases, the replication of viruses is seemingly stimulated by an imbalance between pro-oxidant and antioxidant activity as well as by the deprivation of antioxidant mechanisms. In COVID-19 pneumonia, oxidative stress also appears to be highly detrimental to lung tissues. Although inhaling ozone (O3) gas has been shown to be toxic to the lungs, recent evidence suggests that its administration via appropriate routes and at small doses can paradoxically induce an adaptive reaction capable of decreasing the endogenous oxidative stress. Ozone therapy is recommended to counter the disruptive effects of severe COVID-19 on lung tissues, especially if administered in early stages of the disease, thereby preventing the progression to ARDS.

Keywords: ALI; ARDS; COVID-19; Oxidative stress; Ozone (O3) the; Pneumonia.

Graphical abstract

Fig. 1

Possible mechanisms by which ozone therapy can reduce oxidative stress and disease severity in COVID-19 patients. Green lines denote activating effects and red lines denote inhibiting effects. NF-kB, Nuclear Factor kappa-light-chain-enhancer of activated B cells; Nrf2, Nuclear factor erythroid 2-related factor 2; RAAS, Renin Angiotensin Aldosterone System. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)