The effectiveness of the inclusion of ozone therapy in comprehensive rehabilitation programs for post-COVID syndrome

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BACKGROUND: The global scale of the pandemic of a new coronavirus infection is determined by the involvement of the entire world population in the problem. Recently, the scientific and medical community has been paying increased attention to the consequences of COVID-19, including aspects of the rehabilitation of patients who have had this infection.

AIM: to evaluate the effectiveness and safety of including ozone therapy in the rehabilitation of patients with long COVID.

MATERIALS AND METHODS: This randomized controlled clinical trial included 51 patients aged 29 to 78 years with a confirmed diagnosis of pneumonia associated with SARS-CoV-2 (J12.8). Patients were divided into three statistically comparable groups depending on the complex of rehabilitation treatment, which they received. In the first (control) group (n=17), a 10-day course included daily breathing exercises and physiotherapy for the lungs. In the second (main) group (n=18), in addition to the complex of basic measures, daily intravenous infusions of ozonized saline with an ozone concentration of 2.0 mg/l were performed daily. Patients in the third group (comparison, n=16) received ozone therapy every other day. In order to determine the effectiveness and safety of the inclusion of systemic ozone therapy in a comprehensive program for the rehabilitation of patients after COVID-19, an analysis of blood oxygen saturation in air, laboratory parameters (D-dimer and C-reactive protein), changes in peripheral blood flow, a decrease in patients' oxygen demand to and after a 10-day course of rehabilitation treatment. The dynamics of patients' complaints and changes in the patient's quality of life during rehabilitation were assessed using the EQ–5D questionnaire.

RESULTS: All patients during rehabilitation had positive dynamics in all parameters, there were no adverse reactions during the course and 2 months after rehabilitation. An analysis of various indicators revealed a greater effectiveness in prescribing systemic ozone therapy for rehabilitation. When comparing different methods, it turned out that daily ozone therapy had a better effect on laboratory parameters than daily ozone therapy.

CONCLUSIONS: The use of ozone therapy in the complex rehabilitation of patients after COVID-19 is safe and effective. Further study in more patients is needed to determine indications and criteria for use.

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About the authors

Alena V. Tsvetkova

The First Sechenov Moscow State Medical University (Sechenov University); MEDSI Group of Companies

Author for correspondence.
ORCID iD: 0000-0002-2698-3514

MD, Assistant Lecturer

Russian Federation, Moscow, Moscow Region

Elizaveta S. Koneva

The First Sechenov Moscow State Medical University (Sechenov University); MEDSI Group of Companies

ORCID iD: 0000-0002-9859-194X
SPIN-code: 8200-2155

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow Region

Danil S. Malyutin

MEDSI Group of Companies

ORCID iD: 0000-0002-9196-9268
Russian Federation, Moscow Region

Arina M. Lysak

The First Sechenov Moscow State Medical University (Sechenov University)

ORCID iD: 0000-0001-9177-8229
Russian Federation, Moscow

Alexandra Kostenko

The First Sechenov Moscow State Medical University (Sechenov University); MEDSI Group of Companies

ORCID iD: 0000-0002-9653-2313
Russian Federation, Moscow, Moscow Region


  1. Horby P, Lim WS, Emberson JR, et al. Dexamethasone in hospitalized patients with COVID-19. N Engl J Med. 2021;384(8):693–704.doi: 10.1056/NEJMoa2021436
  2. Recovery Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021;397(10285):1637–1645. doi: 10.1016/S0140-6736(21)00676-0
  3. Garg P, Arora U, Kumar A, Wig N. The post-COVID syndrome: how deep is the damage? J Med Virol. 2021;2(93):673–674.doi: 10.1002/jmv.26465
  4. Michelen M, Manoharan L, Elkheir N, et al. Characterising longterm Covid-19: a rapid living systematic review. medRxiv. 2020. doi: 10.1101/2020.12.08.20246025
  5. Halpin SJ, McIvor C, Whyatt G, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J Med Virol. 2021;93(2):1013–1022. doi: 10.1002/jmv.26368
  6. McDonald LT. Healing after COVID-19: are survivors at risk for pulmonary fibrosis? Am J Physiol Lung Cell Mol Physiol. 2021;320(2):L257–L265. doi: 10.1152/ajplung.00238.2020
  7. Calabrese F, Pezzuto F, Fortarezza F, et al. Pulmonary pathology and COVID-19: lessons from autopsy. The experience of European Pulmonary Pathologists. Virchows Arch. 2020;477(3):359–372. doi: 10.1007/s00428-020-02886-6
  8. Adilov AA, Zimbalist NS, Volkov AV, Babichenko II. Organ changes detected during postmortem examination of patients with COVID-19. Arch Pathology. 2020;82(6):63–69. (In Russ).doi: 10.17116/patol20208206163
  9. Silva AC, Silveira KD, Ferreira AJ, Teixeira MM. ACE2, angiotensin-(1-7) and Mas receptor axis in inflammation and fibrosis. Br J Pharmacol. 2013;169(3):477–492. doi: 10.1111/bph.12159
  10. Tortorici MA, Veesler D. Structural insights into coronavirus entry. Adv Virus Res. 2019;105:93–116.doi: 10.1016/bs.aivir.2019.08.002
  11. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5
  12. Sarzi-Puttini P, Giorgi V, Sirotti S, et al. COVID-19, cytokines and immunosuppression: what can we learn from severe acute respiratory syndrome? Clin Exp Rheumatol. 2020;38(2):337–342. doi: 10.55563/clinexprheumatol/xcdary
  13. Samaniego F, Conte G. SARS-CoV-2 infection as a thrombo-inflammatory endothelial disease. Rev Med Chil. 2020;148(10):1467–1474.doi: 10.4067/S0034-98872020001001467
  14. Barrantes FJ. The unfolding palette of COVID-19 multisystemic syndrome and its neurological manifestations. Brain Behav Immun Health. 2021;14:100251. doi: 10.1016/j.bbih.2021.100251
  15. Rostami M, Mansouritorghabeh H. D-dimer level in COVID-19 infection: a systematic review. Expert Rev Hematol. 2020;13(11):1265–1275. doi: 10.1080/17474086.2020.1831383
  16. Voitenkov VB, Ekusheva EV. On the issue of neurotropy and neuroinvasiveness of coronaviruses. Clin Practice. 2020;11(2):81–86. doi: 10.17816/clinpract34890
  17. Desforges M, Le Coupanec A, Stodola JK, et al. Human coronaviruses: viral and cellular factors involved in neuroinvasiveness and neuropathogenesis. Virus Res. 2014;194:145–158.doi: 10.1016/j.virusres.2014.09.011
  18. Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683–690.doi: 10.1001/jamaneurol.2020.1127
  19. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. medRxiv. 2021;11(1):16144.doi: 10.1101/2021.01.27.21250617
  20. Al Chikhanie Y, Veale D, Schoeffler M, et al. Effectiveness of pulmonary rehabilitation in COVID-19 respiratory failure patients post-ICU. Respir Physiol Neurobiol. 2021;287:103639.doi: 10.1016/j.resp.2021.103639
  21. Arzani P, Zavieh KM, Khademi-Kalantari K, Baghban AA. Pulmonary rehabilitation and exercise therapy in a patient with COVID-19: a case report. Med J Islam Repub Iran. 2020;34:106. doi: 10.34171/mjiri.34.106
  22. Zuikova AA, Bugrimov DY, Krasnorutskaya ON, Kotova YA. Practical experience in the use of rehabilitation treatment programs for patients after COVID-19 in outpatient polyclinic medical organizations. Attending Physician. 2020;12(23):72–79. (In Russ).doi: 10.26295/OS.2020.19.74.014
  23. Rowen RJ, Robins H. A plausible "penny" costing effective treatment for corona virus ― ozone therapy. J Infect Dis Epidemiol. 2020;6:113. doi: 10.23937/2474-3658/1510113
  24. World Federation of Ozone Therapy website. Available from: Accessed: 06.12.2021.
  25. Zheng Z, Dong M, Hu K. A preliminary evaluation on the efficacy of ozone therapy in the treatment of COVID-19. J Med Virol. 2020;92(11):2348–2350 doi: 10.1002/jmv.26040
  26. Scientific Society of Oxygen Ozone Therapy website: report 7. Available from: Accessed: 06.12.2021.
  27. Scientific Society of Oxygen Ozone Therapy website: report 8. Available from: Accessed: 06.12.2021.
  28. Bocci VA. Scientific and medical aspects of ozone therapy. State of the art. Arch Med Res. 2006;37(4):425–435.doi: 10.1016/j.arcmed.2005.08.006
  29. Hernández A, Papadakos PJ, Torres A, et al. Two known therapies could be useful as adjuvant therapy in critical patients infected by COVID-19. Rev Esp Anestesiol Reanim. 2020;67(5):245–252.doi: 10.1016/j.redar.2020.03.004
  30. Italian "Istituto Superiore di Sanità" biocide COVID-19 working group. Raccomandazioni ad interim sulla sanificazione di strutture non sanitarie nell'attuale emergenza COVID-19: superfici, ambienti interni e abbigliamento. Version 15th. May, 2020. Available from: Accessed: 06.12.2021.
  31. Murray BK, Ohmine S, Tomer DP, et al. Virion disruption by ozone-mediated reactive oxygen species. J Virol Methods. 2008;153(1):74–77. doi: 10.1016/j.jviromet.2008.06.004
  32. Kurilchik AV, Smirnova EV, Bulda VI. Ozone therapy in modern clinical practice. Praktiuchy likar. 2016;5(3):92–94. (In Russ).
  33. Litus I. Ozone therapy: "for" and "against". Cosmetologist. 2006;(6):48–49. (In Russ).

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