Implications for the use of ozone (O3) in the adjuvant treatment of COVID-19

Authors

DOI:

https://doi.org/10.33448/rsd-v9i9.7508

Keywords:

Coronavirus; COVID-19; SARS-CoV-2; Pandemic; Ozone; Ozone therapy.

Abstract

Recently, coronavirus disease 2019 (COVID-19) has caused a major global pandemic and poses serious threats to public health. Consequently, there is a worldwide demand to find new treatments to control the new coronavirus pandemic. In the absence of antivirals and vaccines for COVID-19, there is an urgent need to seek therapeutic alternatives capable of mitigating the damage caused by the SARS-CoV-2 virus. Thus, this study seeks, through narrative review, to provide an understanding of the current evidence available regarding the importance of ozone therapy (ozone therapy) and its possible applicability in the treatment of COVID-19. MEDLINE/PubMed, SciELO and LILACS bibliographic databases were used. Evidence shows that ozone (O3) is able to inactivate viruses through direct oxidation of its structural components and block viral replication. Still, due to its modulating action of the inflammatory process, the increase in the cellular and humoral antioxidant and immune system, can attenuate lung diseases and respiratory disorders similar to the complications of the new coronavirus outbreak. Thus, the evidence found in this study indicates that ozone could be proposed as a support for drug therapy in the treatment against viral infections in general and particularly against the new coronavirus (SARS-CoV2), within an integrative medicine approach, justified due to its mechanism of action and the pathogenesis of COVID-19. However, controlled and randomized clinical trials are needed to endorse its effectiveness in preventing, controlling and treating the new coronavirus outbreak.

Author Biography

Lívia Assis, Universidade Brasil

Professor of Biomedical Engineering, University Brasil, São Paulo, SP, Brazil

References

Bocci, V. (2007). The case for oxygen-ozonetherapy. British journal of biomedical science, 64(1), 44-49.doi:10.1080/09674845.2007.1173275

Bocci, V., Borrelli, E., Travagli, V., & Zanardi, I. (2009). The ozone paradox: ozone is a strong oxidant as well as a medical drug. Medicinal research reviews, 29(4), 646–682. https//doi.org/10.1002/med.20150

Bocci, V. A., Zanardi, I., & Travagli, V. (2011). Ozone acting on human blood yields a hormetic dose-response relationship. Journal of Translational Medicine, 9, 66. doi:10.1186/1479-5876-9-66.

Bocci V.(2011). Ozone: a new medical drug.2. Dordrecht: Springer Verlag.

Bocci, V., Zanardi, I., & Travagli, V. (2011). Oxygen/ozone as a medical gas mixture. A critical evaluation of the various methods clarifies positive and negative aspects. Medical gas research, 1(1), 6. doi:10.1186/2045.99912.1.6

Borrelli, E., & Bocci, V. (2014). An integrative approach in the treatment of chronic obstructive pulmonary disease: The role of the ozone therapy. American Journal of Clinical and Experimental Medicine, 2,9-13. https//doi.org/10.11648/j.ajcem.20140202.11.

Burgassi, S., Zanardi, I., Travagli, V., Montomoli, E., & Bocci, V. (2009). How much ozone bactericidal activity is compromised by plasma components?.Journal of applied microbiology, 106(5), 1715–1721.doi:10.1111/j.1365-2672.2008.04141.x

Camacho, A. C. L. F., Fuly, P. S. C., Santos, M. L. S. C., & Menezes, H. F. (2020). Students in social vulnerability in distance education disciplines in times of COVID-19. (2020). Research, Society and Development, 9(7):1-12, e275973979.

Carpendale, M. T., & Freeberg, J. K. (1991). Ozone inactivates HIV at noncytotoxic concentrations. Antiviral research, 16(3), 281-292.doi:0.1016/0166-3542(91)90007-e

Delgado-Roche, L., Riera-Romo, M., Mesta, F., Hernández-Matos, Y., Barrios, J. M., Martínez-Sánchez, G., & Al-Dalaien, S. M. (2017). Medical ozone promotes Nrf2 phosphorylation reducing oxidative stress and pro-inflammatory cytokines in multiple sclerosis patients. European journal of pharmacology,811,148-154. https://doi.org/10.1016/j.ejphar.2017.06.017

Di Mauro, R., Cantarella, G., Bernardini, R., Di Rosa, M., Barbagallo, I., Distefano, A., Longhitano, L., Vicario, N., Nicolosi, D., Lazzarino, G., Tibullo, D., Gulino, M. E., Spampinato, M., Avola, R., & Li Volti, G. (2019). The Biochemical and Pharmacological Properties of Ozone: The Smell of Protection in Acute and Chronic Diseases. International journal of molecular sciences, 20(3), 634. https://doi.org/10.3390/ijms20030634

Di Paolo, N., Bocci, V. & Gaggiotti, E. (2004). Ozone therapy. Int J Artif Organs, 27(3):168-175.doi:10.1177/039139880402700303

Ding, W., Jin, W., Cao, S., Zhou, X., Wang, C., Jiang, Q., Huang, H., Tu, R., Han, S. F., & Wang, Q. (2019). Ozone disinfection of chlorine-resistant bacteria in drinking water. Water research, 160, 339–349. https://doi.org/10.1016/j.watres.2019.05.014

Elvis, A., & Ekta, J. (2011). Ozone therapy: A clinical review. Journal of natural science, biology, and medicine,2(1), 66-70.doi:10.4103/0976-9668.82319

Galiè, M., Costanzo, M., Nodari, A., Boschi, F., Calderan, L., Mannucci, S., Covi, V., Tabaracci, G., & Malatesta, M. (2018). Mild ozonisation activates antioxidant cell response by the Keap1/Nrf2 dependent pathway. Free radical biology & medicine, 124, 114–121. https://doi.org/ 10.1016/j.freeradbiomed.2018.05.093

Guo, Y. R., Cao, Q. D., Hong, Z. S., Tan, Y. Y., Chen, S. D., Jin, H. J., Tan, K. S., Wang, D. Y., & Yan, Y. (2020). The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Military Medical Research, 7(1), 11.doi:10.1186/s40779-020-00240-0

Gurwitz D. (2020). Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics. Drug development research, 81(5), 537–540. https://doi.org/10.1002/ddr.21656

Hernández Rosales, F. A., Calunga Fernández, J. L., Turrent Figueras, J., Menéndez Cepero, S., & Montenegro Perdomo, A. (2005). Ozone therapy effects on biomarkers and lung function in asthma. Archives of medical research, 36(5), 549–554. https://doi.org/10.1016/j.arcmed.2005.04.021

Hu, B., Huang, S., & Yin, L. (2020). The cytokine storm and COVID-19. Journal of medical virology,10.1002/jmv.26232 Advance online publication.https://doi.org/10.1002/jmv.26232

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zangh, L., & Gu, X. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395(10223), 497-506.doi:10.1016/S0140- 6736(20)30183-5.

Hudson, J. B., Sharma, M., & Petric, M. (2007). Inactivation of Norovirus by ozone gas in conditions relevant to healthcare. The Journal of Hospital Infection, 66(1), 40–45. https://doi.org/10.1016/j.jhin.2006.12.021

ISCO3. Non-recommended routes of application in ozone therapy. In ISCO3/LEG/00/10; ISCO3: Madrid, Spain, 2017; p. 13. Available online: www.isco3.org

Lai, C. C., Shih, T. P., Ko, W. C., Tang, H. J., & Hsueh, P. R. (2020). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International journal of antimicrobial agents, 55(3), 105-924. https://doi.org/10.1016/j.ijantimicag.2020.105924

Macedo, D. B., Tim R. C., Macedo, J. B. S. C., Macedo, G. M., Martignago, C. C. S., & Assis, L. (2020). Therapeutic perspective of light for coronavirus treatment. Research, Society and Development, 9(8), e766986320. http://dx.doi.org/10.33448/rsd-v9i8.6320

Maier, I., & Chu, T. (2016). Use of Ozone for Inactivation of Bacteria and Viruses in Cryostats. J Cytol Histol,7(428), 22-45.doi:10.4172/2157-7099.1000428.

Martínez-Sánchez, G., Schwartz, A., & Donna, V. D. (2020). Potential Cytoprotective Activity of Ozone Therapy in SARS-CoV-2/COVID-19. Antioxidants (Basel, Switzerland), 9(5), 389. https://doi.org/10.3390/antiox9050389.

Milkovic, L., Cipak Gasparovic, A., & Zarkovic, N. (2015). Overview on major lipid peroxidation bioactive factor 4-hydroxynonenal as pluripotent growth-regulating factor. Free radical research, 49(7), 850–860.doi:10.3109/10715762.2014.999056

Moraes, J. P., Tim R. C., & Assis, L. (2020). Considerations about the use of Ozone therapy (O3) in the treatment of Endometriosis. Research, Society and Development, 9(9), e403997616. http://dx.doi.org/10.33448/rsd-v9i9.7616

Murray, B. K., Ohmine, S., Tomer, D. P., Jensen, K. J., Johnson, F. B., Kirsi, J. J., Robison, R. A., & O'Neill, K. L. (2008). Virion disruption by ozone-mediated reactive oxygen species. Journal of virological methods, 153(1), 74–77. https://doi.org/10.1016/j.jviromet.2008.06.004

Pereira, A. S., et al. (2018). Metodologia da pesquisa científica. Santa Maria, RS : UFSM, NTE, 2018. Recuperado de https://repositorio.ufsm.br/bitstream/handle/ 1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.

Ricevuti, G., Franzini, M., & Valdenassi, L. (2020). Oxygen-ozone immunoceutical therapy in COVID-19 outbreak: facts and figures. Ozone Therapy, 5(1). https://doi.org/10.4081/ozone.2020.9014

Rowen, R. J., Robins, H., Carew, K., Kamara, M. M., & Jalloh, M. I. (2016). Rapid resolution of hemorrhagic fever (Ebola) in Sierra Leone with ozone therapy. African Journal of infectious diseases, 10(1), 49-54. https://doi.org/10.4314/ajid.v10i1.10.

Rowen, R., & Robins, H. (2020). A Plausible “Penny” Costing Effective Treatment for Corona Virus Ozone Therapy. J Infect Dis Epidemiol,6, 113.doi:10.23937/2474-3658/1510113

Santiago, E. J. P., Freire, A. K. S., Ferreira, D. S. A., Amorim, J. F., Cunha, A. L. X., Freitas, J. R., Silva, A. S. A., Moreira, G. R., Cantalice, J. R. B., & Cunha Filho, M. (2020). Velocity of deaths and confirmed cases of COVID-19 in Brazil, Italy and worldwide. Research, Society and Development, 9(7), e263974085. https://doi.org/10.33448/rsd-v9i7.4085

Schwartz-Tapia, A., Martínez-Sánchez, G., Sabah, F., Alvarado-Guémez, F., Bazzano-Mastrelli, N.,& González-Sánchez, E. (20015). Madrid Declaration on Ozone Therapy; ISCO3: Madrid, Spain,50.

Schwartz, A., & Sánchez, G. M. (2012). Ozone therapy and its scientific foundations. Ozone Therapy Global Journal, 2(1), 199-232.

Siniscalco, D., Trotta, M. C., Brigida, A. L., Maisto, R., Luongo, M., Ferraraccio, F., D'Amico, M., & Di Filippo, C. (2018). Intraperitoneal Administration of Oxygen/Ozone to Rats Reduces the Pancreatic Damage Induced by Streptozotocin. Biology, 7(1), 10. https://doi.org/10.3390/biology7010010

Steffens I. (2020). A hundred days into the coronavirus disease (COVID-19) pandemic. Euro surveillance: bulletin Europeen sur les maladies transmissibles= European communicable disease bulletin, 25(14),200-550.https://doi.org/10.2807/1560-7917.es.2020.25.14.2000550

Sunnen, G. (1988). Ozone in medicine: overview and future directions. Journal of Advancement in Medicine, 12(8) 159-174.

Valacchi, G., Fortino, V., & Bocci, V. (2005). The dual action of ozone on the skin. The British journal of dermatology, 153(6), 1096–1100.doi:10.1111/j.1365-2133.2005.06039.x

Valdenassi, L., Franzini, M., Ricevuti, G., Rinaldi, L., Galoforo, A. C., & Tirelli, U. (2020). Potential mechanisms by which the oxygen-ozone (O2-O3) therapy could contribute to the treatment against the coronavirus COVID-19. European review for medical and pharmacological sciences, 24(8), 4059–4061. https://doi.org/10.26355/eurrev_202004_20976

Wang, L., Chen, Z., Liu, Y., Du, Y., & Liu, X. (2018). Ozone oxidative postconditioning inhibits oxidative stress and apoptosis in renal ischemia and reperfusion injury through inhibition of MAPK signaling pathway. Drug design, development and therapy, 12, 1293–1301. https://doi.org/10.2147/DDDT.S164927

Wells, K. H., Latino, J., Gavalchin, J., & Poiesz, B. J. (1991). Inactivation of human immunodeficiency virus type 1 by ozone in vitro. Blood, 78, 1882-1890. https://doi.org/10.1182/blood.V78.7.1882.1882

WHO: Atualização oficial do COVID. [Citado 2020 ago 07]. Disponível em: https://www.paho.org/bra.

Wu, Z., & McGoogan, J. M. (2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama,323, 1239 - 1242. https://doi.org/ 10.1001/jama.2020.2648.

Xiong, Y., Sun, D., Liu, Y., Fan, Y., Zhao, L., Li, X., & Zhu, W. (2020). Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes. Investigative radiology, 55(6), 332–339. https://doi.org/ 0.1097/RLI.0000000000000674

Ye, Q., Wang, B., & Mao, J. (2020). The pathogenesis and treatment of the `Cytokine Storm' in COVID-19. The Journal of infection, 80(6), 607–613. https://doi.org/10.1016/j.jinf.2020.03.037

Zheng, Z., Dong, M., & Hu, K. (2020). A preliminary evaluation on the efficacy of ozone therapy in the treatment of COVID-19. Journal of Medical Virology. 1002 (10) 26-40 https://doi.org/ 10.1002/jmv.26040

Published

30/08/2020

How to Cite

CAMPOS, D. da S. .; MORAIS, J. P.; TIM, C. R.; GOMES, J. C. .; ASSIS, L. . Implications for the use of ozone (O3) in the adjuvant treatment of COVID-19. Research, Society and Development, [S. l.], v. 9, n. 9, p. e579997508, 2020. DOI: 10.33448/rsd-v9i9.7508. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/7508. Acesso em: 19 apr. 2024.

Issue

Section

Health Sciences