Ozone therapy as a component of a comprehensive rehabilitation program for patients after polysegmental pneumonia associated with SARS-CoV2 infection

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.6.233891

Keywords:

rehabilitation, ozonotherapy, pneumonia viral, SARS-CoV2 infection, long-term COVID-19

Abstract

Aim: to analyze the effectiveness of intravenous ozone therapy in long COVID-19 patients experienced community-acquired polysegmental pneumonia (associated with SARS-CoV2 infection).

Materials and methods. The study involved 42 long COVID-19 individuals aged 41–82 years who underwent rehabilitation after community-acquired polysegmental pneumonia associated with SARS-CoV2 infection. The patients were examined and followed up subjectively (by the G. Borg and PCFS scales) and objectively (oxygen saturation, C-reactive protein, ferritin, D-dimer, urea and creatinine, 6-minute walk test).

All patients received similar medicamentous therapy, and combined intravenous ozone therapy was additionally prescribed to the main group patients (n = 21): an alternate-day infusion of 200 ml ozonized saline at a concentration of 20 mg/ml and major autohemotherapy (100 ml ozonized saline at a concentration of 30 mg/ml mixed with 100 ml of the patient’s blood), 10 sessions per treatment course.

Results. The integrated approach to the complex program of long COVID-19 treatment and rehabilitation for patients after pneumonia associated with SARS-CoV2 infection using intravenous ozone therapy has demonstrated its significant effectiveness based on the objective and subjective findings (P < 0.01).

Twice as many patients in the main group (n = 18) achieved endpoints of the study (absence of dyspnea, normalization of blood biochemical markers and oxygen saturation levels, restoration of exercise tolerance) as compared to the control group (n = 9).

Conclusions. The use of combined intravenous ozone therapy (alternating infusion of ozonized saline and ozonized saline mixed with the patient’s blood) in the rehabilitation program for patients after experienced community-acquired polysegmental pneumonia associated with SARS-CoV2 infection is pathogenetically substantiated, effective and cost-effective addition to complex health recovery tools.

Author Biographies

I. B. Baranova, National Pirogov Memorial Medical University, Vinnytsia, Ukraine

MD, PhD, Associate Professor of the Department of Physical and Rehabilitation Medicine; Head of the Department of Rehabilitation, University Clinic of National Pirogov Memorial Medical University, Vinnytsia, Ukraine

A. F. Gumeniuk, National Pirogov Memorial Medical University, Vinnytsia, Ukraine

MD, PhD, Associate Professor of the Department of Internal Medicine of the Medical Faculty №2

A. I. Semenenko, National Pirogov Memorial Medical University, Ukraine

MD, PhD, DSc, Professor  of the Department of Anesthesiology, Intensive care and Emergency Medicine; Director of the University Clinic

I. A. Iliuk, National Pirogov Memorial Medical University, Vinnytsia, Ukraine

MD, PhD, Associate Professor of the Department of Internal Medicine №2

I. P. Osypenko, National Pirogov Memorial Medical University, Vinnytsia, Ukraine

MD, PhD, Assistant of the Department of Internal Medicine No. 2

References

Ferraro, F., Calafiore, D., Dambruoso, F., Guidarini, S., & de Sire, A. (2021). COVID-19 related fatigue: Which role for rehabilitation in post-COVID-19 patients? A case series. Journal of Medical Virology, 93(4), 1896-1899. https://doi.org/10.1002/jmv.26717

Spielmanns, M., Pekacka-Egli, A. M., Schoendorf, S., Windisch, W., & Hermann, M. (2021). Effects of a Comprehensive Pulmonary Rehabilitation in Severe Post-COVID-19 Patients. International Journal of Environmental Research and Public Health, 18(5), Article 2695. https://doi.org/10.3390/ijerph18052695

Savielieva-Kulyk, N. O. (2021, February 19). COVID-19: likuvannia za naiavnosti dovhotryvalykh naslidkiv khvoroby [COVID-19: a treatment of long-term consequences of the disease]. Ukrainskyi medychnyi chasopys. https://www.umj.com.ua/article/199563/covid-19-likuvannya-za-nayavnosti-dovgotrivalih-naslidkiv-hvorobi [in Ukrainian].

Puchner, B., Sahanic, S., Kirchmair, R., Pizzini, A., Sonnweber, B., Wöll, E., Mühlbacher, A., Garimorth, K., Dareb, B., Ehling, R., Wenter, J., Schneider, S., Brenneis, C., Weiss, G., Tancevski, I., Sonnweber, T., & Löffler-Ragg, J. (2021). Beneficial effects of multi-disciplinary rehabilitation in postacute COVID-19: an observational cohort study. European Journal of Physical and Rehabilitation Medicine, 57(2), 189-198. https://doi.org/10.23736/S1973-9087.21.06549-7

Singh, S. J., Barradell, A. C., Greening, N. J., Bolton, C., Jenkins, G., Preston, L., & Hurst, J. R. (2020). British Thoracic Society survey of rehabilitation to support recovery of the post-COVID-19 population. BMJ Open, 10(12), Article e040213. https://doi.org/10.1136/bmjopen-2020-040213

Gorna, R., MacDermott, N., Rayner, C., O’Hara, M., Evans, S., Agyen, L., Nutland, W., Rogers, N., & Hastie, C. (2021). Long COVID guidelines need to reflect lived experience. The Lancet, 397(10273), 455-457. https://doi.org/10.1016/S0140-6736(20)32705-7

International Scientific Committee of Ozone Therapy. (March 14, 2020). Potential use of ozone in SARS-CoV-2 / COVID-19. https://isco3.org/officialdocs/

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

Franzini, M., Valdenassi, L., Ricevuti, G., Chirumbolo, S., Depfenhart, M., Bertossi, D., & Tirelli, U. (2020). Oxygen-ozone (O2-O3) immunoceutical therapy for patients with COVID-19. Preliminary evidence reported. International Immunopharmacology, 88, Article 106879. https://doi.org/10.1016/j.intimp.2020.106879

Varga, Z., Flammer, A. J., Steiger, P., Haberecker, M., Andermatt, R., Zinkernagel, A. S., Mehra, M. R., Schuepbach, R. A., Ruschitzka, F., & Moch, H. (2020). Endothelial cell infection and endotheliitis in COVID-19. The Lancet, 395(10234), 1417-1418. https://doi.org/10.1016/S0140-6736(20)30937-5

Viebahn-Hänsler, R., León Fernández, O. S., & Fahmy, Z. (2012). Ozone in Medicine: The Low-Dose Ozone Concept-Guidelines and Treatment Strategies. Ozone: Science & Engineering, 34(6), 408-424. https://doi.org/10.1080/01919512.2012.717847

Chekman, I. S., Syrovaya, A. O., Makarov, V. A., Makarov, V. V., Lapshin, V. V., & Shapoval, E. V. (2013). Ozon i ozonoterapiya [Ozone and ozonotherapy]. Tsyfrova drukarnia № 1. [in Russian].

Izadi, M., Cegolon, L., Javanbakht, M., Sarafzadeh, A., Abolghasemi, H., Alishiri, G., Zhao, S., Einollahi, B., Kashaki, M., Jonaidi-Jafari, N., Asadi, M., Jafari, R., Fathi, S., Nikoueinejad, H., Ebrahimi, M., Imanizadeh, S., & Ghazale, A. H. (2021). Ozone therapy for the treatment of COVID-19 pneumonia: A scoping review. International Immunopharmacology, 92, Article 107307. https://doi.org/10.1016/j.intimp.2020.107307

Sharma, A., Shah, M., Lakshmi, S., Sane, H., Captain, J., Gokulchandran, N., Khubchandani, P., Pradeep, M. K., Gote, P., Tuppekar, B., Kulkarni, P., Paranjape, A., Pradhan, R., Varghese, R., Kasekar, S., Nair, V., & Khanbande, U. (2021). A pilot study for treatment of COVID-19 patients in moderate stage using intravenous administration of ozonized saline as an adjuvant treatment-registered clinical trial. International Immunopharmacology, 96, Article 107743. https://doi.org/10.1016/j.intimp.2021.107743

Carda, S., Invernizzi, M., Bavikatte, G., Bensmaïl, D., Bianchi, F., Deltombe, T., Draulans, N., Esquenazi, A., Francisco, G. E., Gross, R., Jacinto, L. J., Moraleda Pérez, S., O’dell, M. W., Reebye, R., Verduzco-Gutierrez, M., Wissel, J., & Molteni, F. (2020). COVID-19 pandemic. What should Physical and Rehabilitation Medicine specialists do? A clinician’s perspective. European Journal of Physical and Rehabilitation Medicine, 56(4), 515-524. https://doi.org/10.23736/S1973-9087.20.06317-0

(n.d.). COVID-19 CO-RADS klasyfikatsiia [CO-RADS Classification of COVID-19]. https://vita-com.kiev.ua/covid-19-co-rads.html [in Ukrainian].

Greenhalgh, T., Knight, M., A’Court, C., Buxton, M., & Husain, L. (2020). Management of post-acute covid-19 in primary care. BMJ, 370, Article m3026. https://doi.org/10.1136/bmj.m3026

Ministry of Health of Ukraine. (2021, April 20). Pro zatverdzhennia Protokolu nadannia reabilitatsiinoi dopomohy patsiientam z koronavirusnoiu khvoroboiu (COVID-19) ta rekonvalestsentam [On approval of the Protocol for providing rehabilitation care to patients with coronavirus disease (COVID-19) and convalescents (No. 771)]. https://moz.gov.ua/article/ministry-mandates/nakaz-moz-ukraini-vid-20042021--771-pro-zatverdzhennja-protokolu-nadannja-reabilitacijnoi-dopomogi-pacientam-z-koronavirusnoju-hvoroboju--covid-19-ta-rekonvalescentam

Ministry of Health of Ukraine. (2020, April 2). Pro zatverdzhennia protokolu «Nadannia medychnoi dopomohy dlia likuvannia koronavirusnoi khvoroby (COVID-19)» [On approval of the Protocol «Provision of medical care for the treatment of coronavirus disease (COVID-19)» (No. 762)]. https://moz.gov.ua/article/ministry-mandates/nakaz-moz-ukraini-vid-2042020--762-pro-zatverdzhennja-protokolu-nadannja-medichnoi-dopomogi-dlja-likuvannja-koronavirusnoi-hvorobi-covid-19

Poznyak, T., Blanco, P. G., Martínez, A. P., Oria, I. C., & Cuevas, Clara-L. S. (2018). Ozone Dosage is the Key Factor of Its Effect in Biological Systems. In J. Derco & M. Koman (Eds.), Ozone in Nature and Practice. IntechOpen. https://www.intechopen.com/chapters/61286

Kogan, E. A., Berezovsky, Yu. S., Protsenko, D. D., Bagdasaryan, T. R., Gretsov, E. M., Demura, S. A., Demyashkin, G. A., Kalinin, D. V., Kukleva, A. D., Kurilina, E. V., Nekrasova, T. P., Paramonova, N. B., Ponomarev, A. B., Radenska-Lopovok, S. G., Semyonova, L. A., & Tertychny, A. S. (2020). Patologicheskaya anatomiya infektsii, vyzvannoi SARS-CoV-2 [Pathological anatomy of infection caused by SARS-COV-2]. Sudebnaya meditsina, 6(2), 8-30. https://doi.org/10.19048/2411-8729-2020-6-2-8-30 [in Russian].

Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X., & Peng, Z. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 323(11), 1061-1069. https://doi.org/10.1001/jama.2020.1585

Thorp, J. A., Hollonbeck, S. A., Viglione, D. D., Green, P. C., Hodge, J. R., Tamburro, J. A., Tran, T. N., & Glassman, D. S. (2020). Novel therapy for COVID-19 does intravenous ozonated-saline affect blood and tissue oxygenation? Journal of Gynecological Research and Obstetrics, 6(2), 046-050. https://doi.org/10.17352/jgro.000085

Wang, L., Chen, H., Liu, X. H., Chen, Z. Y., Weng, X. D., Qiu, T., Liu, L., & Zhu, H. C. (2014). Ozone oxidative preconditioning inhibits renal fibrosis induced by ischemia and reperfusion injury in rats. Experimental and Therapeutic Medicine, 8(6), 1764-1768. https://doi.org/10.3892/etm.2014.2004

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

Published

2021-11-03

How to Cite

1.
Baranova IB, Gumeniuk AF, Semenenko AI, Iliuk IA, Osypenko IP. Ozone therapy as a component of a comprehensive rehabilitation program for patients after polysegmental pneumonia associated with SARS-CoV2 infection. Zaporozhye Medical Journal [Internet]. 2021Nov.3 [cited 2024Oct.5];23(6):752-8. Available from: http://zmj.zsmu.edu.ua/article/view/233891

Issue

Section

Original research