Blood ozonization in patients with mild to moderate COVID-19 pneumonia: a single centre experience

Intern Emerg Med. 2021 Apr;16(3):669-675. doi: 10.1007/s11739-020-02542-6. Epub 2020 Nov 1.


The emerging outbreak of the coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide. We prescribed some promising medication to our patients with mild to moderate pneumonia due to SARS-CoV-2, however such drugs as chloroquine, hydrossichloroquine, azithromycin, antivirals (lopinavir/ritonavir, darunavir/cobicistat) and immunomodulating agents (steroids, tocilizumab) were not confirmed as effective against SARS-CoV2. We, therefore, started to use auto-hemotherapy treated with an oxygen/ozone (O2/O3) gaseous mixture as adjuvant therapy. In Udine University Hospital (Italy) we performed a case-control study involving hospitalized adult patients with confirmed COVID-19 with mild to moderate pneumonia. Clinical presentations are based upon clinical phenotypes identified by the Italian Society of Emergency and Urgency Medicine (SIMEU-Società Italiana di Medicina di Emergenza-Urgenza) and patients that met criteria of phenotypes 2 to 4 were treated with best available therapy (BAT), with or without O3-autohemotherapy. 60 patients were enrolled in the study: 30 patients treated with BAT and O2/O3 mixture, as adjuvant therapy and 30 controls treated with BAT only. In the group treated with O3-autohemotherapy plus BAT, patients were younger but with more severe clinical phenotypes. A decrease of SIMEU clinical phenotypes was observed (2.70 ± 0.67 vs. 2.35 ± 0.88, p = 0.002) in all patients during hospitalization but this clinical improvement was statistically significant only in O3-treated patients (2.87 ± 0.78 vs. 2.27 ± 0.83, p < 0.001), differently to the control group (2.53 ± 0.51 vs. 2.43 ± 0.93, p = 0.522). No adverse events were observed associated with the application of O2/O3 gaseous mixture. O2/O3 therapy as adjuvant therapy could be useful in mild to moderate pneumonia due to SARS-CoV-2. Randomized prospective study is ongoing [Clinical ID: Z7C2CA5837].

Keywords: Autotransfusion; COVID-19; Cytokine release syndrome (CRS); Lipid ozonation products; Medical O3; O3 gas; O3 therapy; Oxidative stress; Reactive oxidative species; SARS-CoV-2.

MeSH terms

  • Aged
  • COVID-19 / blood*
  • COVID-19 / therapy*
  • Case-Control Studies
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Ozone / therapeutic use*
  • Phenotype
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / virology
  • SARS-CoV-2


  • Ozone