Compassionate Use of Rectal Ozone (O3) in Severe COVID-19 Pneumonia: a Case-Control Study

An updated overview of recent advances, challenges, and clinical considerations of IL-6 signaling blockade in severe coronavirus disease 2019 (COVID-19)

“…The results of this study indicated that ozone-treated patients had reduced inflammation and improved oxygenation. Mortality was lower in the ozone-treated group but was not statistically different (214) .…”

Ozone as an adjuvant therapy for COVID-19: A systematic review and meta-analysis

“…Robins-I assessment determined that a clinical trial had a moderate risk of bias [22] (Table S3) . The quality assessment of case-control studies utilizing the NOS critical appraisal checklist resulted in three high-quality [18] , [19] , [20] and one medium-quality study [21] (Table S4) . Moreover, the quality of the case series was assessed using JBI and summarized in Supplementary Material s [27] , [28] , [29] , [30] (Table S5-S6) .…”

“…Thirteen studies were finally included, with a total of 241 COVID-19 patients belonging to the ozone as an adjuvant therapy group and 157 patients belonging to the standard therapy only as of the control group, respectively. In this review, the majority were observational studies (4 case-control studies, and 4 case-series) conducted in Spain [19] , [20] , [29] , Italy [18] , [28] , Turkey [21] , Egypt [27] , and China [30] . In addition, there is one clinical trial from India [22] , and four RCTs conducted in Italy [23] , [24] , India [25] and Turkey [26] .…”

Mechanisms of Action of Ozone Therapy in Emerging Viral Diseases: Immunomodulatory Effects and Therapeutic Advantages With Reference to SARS-CoV-2

“…Ozone protocol consisted of eight sessions (one session/day) of intra-rectal ozone (150 ml volume, 35 μg/ml concentration corresponding to 5.25 mg O 3 total dose). They found that the use of rectal ozone improved O 2 saturation, reduced O 2 supply, decreased inflammation biomarkers (fibrinogen, D-dimer, urea, LDH, CRP, and IL-6), and significantly improved radiological outcomes, when compared to the standard of care group ( Fernández-Cuadros et al, 2021 ). Mortality and length of stay were reduced in the ozone group, but this difference was not significant.…”

“…The limit of this study, in addition to the low sample size, was however the reduced concentration of ozone used compared to a previous work conducted by Franzini et al (2020) . In a recent study, Fernández-Cuadros et al (2021) evaluated the effects of rectal ozone therapy in severe COVID-19 pneumonia and compared it to the standard protocols of care (SOC) in a case control study of 28 patients subdivided in two homogeneous groups according to age, comorbidities, O 2 saturation, and O 2 supply. Ozone protocol consisted of eight sessions (one session/day) of intra-rectal ozone (150 ml volume, 35 μg/ml concentration corresponding to 5.25 mg O 3 total dose).…”