Friction Tubes to Generate Nanobubble Ozone Water with an Increased Half-Life for Virucidal Activity (preprint)

Nanobubbles and related technologies are expected to be highly utilized in water resource-based industries such as water purification, crops, horticulture, medicine, bio, and sterilization. Ozone, a chemical with high sterilizing power, is known as a natural substance that is reduced to oxygen and water after reacting with pollutants. Ozone water, which is generated by dissolving ozone in water, has been used in various industrial sectors such as medical care, food, and environment. Due to the unstable molecular state of ozone, however, it is difficult to produce, use, and supply ozone at industrial sites in a stable manner. This study proposed a method for constructing a system that can generate high-concentration ozone water in large quantities using low power in real time and maintaining the concentration of the generated ozone water over the long term. Friction tubes (called 'nanotube') played a key role to generate nanobubble ozone water with an increased half-life for virus killing activity. In addition, the safety of ozone water during its spray into the air was explained, and virucidal activity test cases for the influenza A (H1N1/A/PR8) and COVID-19 (SARS-CoV-2) virus using high-concentration ozone water as well as its technical efficacy were described.

Is Ozone therapy an adjunct treatment for SARS-CoV-2 / COVID-19 infection?

Abstract Up to today, there is no specific treatment against SARS-CoV-2 / COVID-19 infection; there the necessity to search for alternatives that help patients with COVID-19. The objective of this study was to review the use of ozone therapy as adjunct treatment for SARS-CoV-2 / COVID-19 infection, highlighting the mechanisms of action, forms of application and current clinical evidence. A systematic review was conducted in electronic databases, searching the terminology Ozone "or" Ozone therapy "and" SARS-CoV-2 or COVID-19 or Coronavirus. Results: nineteen studies were included; ten were editorials, comments, brief reports or reviews, and nine clinical studies. We found that ozone therapy could be favorable for treating patients infected with SARS-CoV-2 / COVID-19, through a direct antiviral effect, regulation of oxidative stress, immunomodulation and improvement of oxygen metabolism. Patients who were treated with ozone therapy responded favorably; therefore, ozone therapy appears to be a promising treatment for patients infected with SARS-CoV-2 / COVID-19. Its mechanism of action justifies its use as an adjuvant therapy; however, scientific evidence is based on case series and clinical trials are necessary to corroborate its effectiveness and safety.

Clinical effectiveness of medical ozone therapy in COVID-19: the evidence and gaps map.

Ozone therapy (OT), a medical procedure, has been showing good results during the coronavirus disease (COVID-19). We aimed to build an evidence and gaps map (EGM) of OT in the COVID-19 ranking the articles found according to levels of evidence and outcomes. The EGM brings bubbles of different sizes and different colors according to the articles. The OT intervention used was major or minor autohemotherapy, rectal insufflation and ozonized saline solution. EGM was based on 13 clinical studies using OT for COVID-19 involving a total of 271 patients. We found 30 outcomes related to OT in COVID-19. Our EGM divided the outcomes into six groups: 1-clinical improvement; 2-hospitalization; 3-inflammatory, thromboembolic, infectious, or metabolic markers; 4-radiological aspects, 5-viral infection and 6-adverse events. Major autohemotherapy was present in 19 outcomes, followed by rectal insufflation. Improvement in clinical symptoms of COVID-19, improvement of respiratory function, improvement of oxygen saturation, reduction in hospital internment, decrease in C-reactive protein, decrease in ferritin, decrease in lactate dehydrogenase, decrease in interleukin 6, decrease in D-dimer, radiological improvement of lung lesions and absence of reported adverse events were related in the papers. The most commonly used concentrations of OT in major autohemotherapy and in rectal insufflation were 40 µg/mL and 35 µg/mL, respectively. Here, we bring the first EGM showing the efficacy and safety of OT in the treatment of COVID-19. OT can be used as integrative medical therapy in COVID-19 at a low cost and improve the health conditions of the patients.

Benefits of ozone on mortality in patients with COVID-19: A systematic review and meta-analysis.

BACKGROUND: The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. Ozone therapy has long been used in the treatment of a variety of infectious diseases, probably through its antioxidant properties and the supply of oxygen to hypoxic tissues. This systematic review and meta-analysis aimed to determine the efficacy of ozone on mortality in patients with COVID-19. METHODS: A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Prospective controlled trials on treatment of COVID-19 with ozone, compared with placebo or blank, were reviewed. Studies were pooled to risk ratios (RRs) and weighted mean differences (WMDs), with 95% confidence intervals (CIs). RESULTS: Eight trials (enrolling 371 participants) met the inclusion criteria. Ozone therapy showed significant effects on mortality (RR 0.38, 95% CI 0.17-0.85; P = 0.02), length of hospital stay (WMD -1.63 days, 95% CI -3.05 to -0.22 days; P = 0.02), and polymerase chain reaction (PCR) positivity (RR 0.07, 95% CI 0.01-0.34; P = 0.001). CONCLUSIONS: Ozone therapy significantly reduced mortality, PCR positivity, and length of stay in hospitalized patients with COVID-19. Ozone therapy should be considered for COVID-19 patients.

Pulmonary and Inflammatory Responses Following Exposure to a Low Concentration of Ozone or Clean Air

[The role of systemic ozone therapy in the rehabilitation of patients after COVID-19]. / Rol' sistemnoi ozonoterapii v reabilitatsii patsientov, perenesshikh COVID-19.

OBJECTIVE: To evaluate the effectiveness and safety of ozone therapy in rehabilitation of patients with previous COVID-19. MATERIAL AND METHODS: A randomized controlled clinical trial included 51 patients aged 29 - 78 years with SARS-CoV-2 pneumonia (J12.8). Patients were divided into 3 comparable groups depending on the complex of rehabilitation. In the first (control) group (n=17), a 10-day course included daily breathing exercises and physiotherapy for the lungs (drug electrophoresis and low-frequency magnetotherapy). In the second (main) group (n=18), rehabilitation was combined with daily intravenous infusions of ozonized saline with ozone concentration of 2.0 mg/l within 5 days with subsequent standard rehabilitation. In the third group (n=16), patients received 5 ozone therapy procedures every other day. To determine the effectiveness and safety of systemic ozone therapy in rehabilitation of patients with previous COVID-19, we analyzed oxygen saturation, laboratory data (D-dimer and C-reactive protein), need for oxygen support before and after rehabilitation course. Complaints and quality of life throughout the rehabilitation program were assessed using the EQ-5D questionnaire. RESULTS: All patients had positive changes of all parameters. There were no adverse reactions throughout the rehabilitation program and 2 months later. We observed higher effectiveness of rehabilitation with systemic ozone therapy. Moreover, daily ozone therapy had a better effect on laboratory parameters compared to ozone therapy every other day. CONCLUSION: Ozone therapy is safe and effective in complex rehabilitation of patients with previous COVID-19. Further studies of large samples are needed to determine indications and appropriate criteria for this rehabilitation program.

Instant inactivation of aerosolized SARS-CoV-2 by dielectric filter discharge.

This study aimed to evaluate the instant inactivation effect of dielectric filter discharge (DFD) on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) aerosols. The filter consisted of one layer of ZrO2 beads covered by aluminum mesh electrodes; this porous structure of DFD part generates filter-type surface discharge and reactive oxygen species. In a closed cylindrical chamber, DFD treated air flow containing SARS-CoV-2 aerosols, primarily composed of particle diameters of ≤ 1 µm. A polypropylene melt-blown filter collected the treated bioaerosols for inactivation analysis. Plaque and polymerase chain reaction assays showed that the aerosolized SARS-CoV-2 that passed through the filter were more than 99.84% inactivated with degradation of SARS-CoV-2 genes (ORF1ab and E). However, ozone exposure without DFD passage was not found to be effective for bioaerosol inactivation in plaque assay.

Plasma generated ozone and reactive oxygen species for point of use PPE decontamination system.

This paper reports a plasma reactive oxygen species (ROS) method for decontamination of PPE (N95 respirators and gowns) using a surface DBD source to meet the increased need of PPE due to the COVID-19 pandemic. A system is presented consisting of a mobile trailer (35 m3) along with several Dielectric barrier discharge sources installed for generating a plasma ROS level to achieve viral decontamination. The plasma ROS treated respirators were evaluated at the CDC NPPTL, and additional PPE specimens and material functionality testing were performed at Texas A&M. The effects of decontamination on the performance of respirators were tested using a modified version of the NIOSH Standard Test Procedure TEB-APR-STP-0059 to determine particulate filtration efficiency. The treated Prestige Ameritech and BYD brand N95 respirators show filtration efficiencies greater than 95% and maintain their integrity. The overall mechanical and functionality tests for plasma ROS treated PPE show no significant variations.

Decisive role of ozone formation control in winter PM2.5 mitigation in Shenzhen, China.

During the COVID-19 lockdown, atmospheric PM2.5 in the Pearl River Delta (PRD) showed the highest reduction in China, but the reasons, being a critical question for future air quality policy design, are not yet clear. In this study, we analyzed the relationships among gaseous precursors, secondary aerosols and atmospheric oxidation capacity in Shenzhen, a megacity in the PRD, during the lockdown period in 2020 and the same period in 2021. The comprehensive observational datasets showed large lockdown declines in all primary and secondary pollutants (including O3). We found that, however, the daytime concentrations of secondary aerosols during the lockdown period and normal period were rather similar when the corresponding odd oxygen (Ox≡O3+NO2, an indicator of photochemical processing avoiding the titration effect of O3 by freshly emitted NO) were at similar levels. Therefore, reduced Ox, rather than the large reduction in precursors, was a direct driver to achieve the decline in secondary aerosols. Moreover, Ox was also found to determine the spatial distribution of intercity PM2.5 levels in winter PRD. Thus, an effective strategy for winter PM2.5 mitigation should emphasize on control of winter O3 formation in the PRD and other regions with similar conditions.

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

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 mog/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.

Potential therapeutic effect of oxygen-ozone in controlling of COVID-19 disease.

Atmospheric ozone is produced when nitrogen oxides react with volatile organic compounds. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome contains a unique N-terminal fragment in the Spike protein, which allows it to bind to air pollutants in the environment. 'Our approach in this review is to study ozone and its effect on the SARS-CoV-2 virus and patients with coronavirus disease 2019 (COVID-19). Article data were collected from PubMed, Scopus, and Google Scholar databases. Ozone therapy has antiviral properties, improves blood flow, facilitates the transfer of oxygen in hypoxemic tissues, and reduces blood coagulation phenomena in COVID-19 patients. Ozone has immunomodulatory effects by modulating cytokines (reduction of interleukin-1, interleukin-6, tumor necrosis factor-α, and interleukin-10), induction of interferon-γ, anti-inflammatory properties by modulating NOD-, LRR- and pyrin domain-containing protein 3, inhibition of cytokine storm (blocking nuclear factor-κB and stimulating nuclear factor erythroid 2-related factor 2 pathway), stimulates cellular/humoral immunity/phagocytic function and blocks angiotensin-converting enzyme 2. In direct oxygen-ozone injection, oxygen reacts with several biological molecules such as thiol groups in albumin to form ozonoids. Intravenous injection of ozonated saline significantly increases the length of time a person can remain hypoxic. The rectal ozone protocol is rectal ozone insufflation, resulting in clinical improvement in oxygen saturation and biochemical improvement (fibrinogen, D-dimer, urea, ferritin, LDH, interleukin-6, and C-reactive protein). In general, many studies have shown the positive effect of ozone therapy as a complementary therapy in the recovery of COVID-19 patients. All the findings indicate that systemic ozone therapy is nontoxic and has no side effects in these patients.

Fatigue in post-acute sequelae of SARS-CoV2 (PASC) treated with oxygen-ozone autohemotherapy - preliminary results on 100 patients.

OBJECTIVE: Post-acute sequelae of SARS-CoV2 infection (PASC) are a novel terminology used to describe post-COVID persistent symptoms, mimicking somehow the previously described chronic fatigue syndrome (CFS). In this manuscript, we evaluated a therapeutical approach to address PASC-derived fatigue in a cohort of past-COVID-19 positive patients. PATIENTS AND METHODS: A number of 100 patients, previously diagnosed as COVID-19 positive subjects and meeting our eligibility criteria, was diagnosed having PASC-related fatigue. They were recruited in the study and treated with oxygen-ozone autohemotherapy (O2-O3-AHT), according to the SIOOT protocol. Patients' response to O2-O3-AHT and changes in fatigue were measured with the 7-scoring Fatigue Severity Scale (FSS), according to previously published protocols. RESULTS: Statistics assessed that the effects of O2-O3-AHT on fatigue reduced PASC symptoms by 67%, as a mean, in all the investigated cohort of patients (H = 148.4786 p < 0.0001) (Figure 1). Patients following O2-O3-AHT therapy, quite completely recovered for PASC-associated fatigue, a quote amounting to about two fifths (around 40%) of the whole cohort undergoing ozone treatment and despite most of patients were female subjects, the effect was not influenced by sex distribution (H = 0.7353, p = 0.39117). CONCLUSIONS: Ozone therapy is able to recover normal functionality and to relief pain and discomfort in the form of PASC-associated fatigue in at least 67% of patients suffering from post-COVID sequelae, aside from sex and age distribution.

Rectal ozone therapy in high-risk symptomatic SARS-CoV-2 positive patients

What Impact Has Air Pollution on Health of Human Beings and Environment? Is There Any Relation Between COVID-19 & Air Pollution? (preprint)

Almost all the countries around the world are experiencing high levels of air pollution. How does pollution impact our body in times of COVID-19? Air pollution and related climatic-environmental changes is one of the prime concern and biggest challenge globally in 21st century faced by most of the nations. The global impact of this public health problem can be assessed and understood from the data of morbidity and mortality as well as DALY (disability adjusted life years) & QALY (quality adjusted life years), YLL (years of life lost) measurements. Today global air is having several varieties and types of air pollutants which are taking lives of people on daily basis and the death count may be more as compared to COVID-19 deaths. The finest and smallest particulate matters present in air as byproducts of several human and industry related activities are able to infiltrate the respiratory system through inhalation while breathing, leading to respiratory and cardiovascular system(CVS) diseases, reproductive and central nervous system(CNS) diseases and malfunctioning as well as various carcinoma. Ozone (O3) protects us from harmful effects of UV (ultra violet) radiations which can cause cancers, skin diseases as well as mutations etc but at the same time it is harmful when in high concentration at ground level, affecting the respiratory and cardiovascular system. Added to this other pollutants present in air such as nitrogen oxide(NO), sulfur dioxide(SO2), Volatile Organic Compounds (VOCs), dioxins, and polycyclic aromatic hydrocarbons (PAHs) are all important air pollutants which are known to be harmful to human beings. Carbon monoxide (CO) can bind with haemoglobin (Hb) very tightly (not allowing oxygen to be released at tissue level causing tissue hypoxia) forming carboxy-haemoglobin which can cause poisoning when breathed in at high levels. Heavy metals for example lead (Pb) can lead to direct poisoning (plumbinism or saturnism) or chronic intoxication can lead to a variety of CNS, GIT(gastrointestinal tract), and reproductive system diseases, depending on the exposure. Air pollution usually causes respiratory problems such as Chronic Obstructive Pulmonary Disease (COPD), asthma, bronchiolitis, lung cancer, cardiovascular events, central nervous system dysfunctions, and cutaneous diseases. Added to this, the climate change resulting from environmental pollution affects the geographical distribution of many infectious diseases like natural disasters as well as affects social and environmental determinants of health. The only way to tackle this problem is through public health awareness, strategies to reduce air pollution as well as environmental protection measures with a multidisciplinary Intersectoral approach by scientific experts of national and international organizations. The global leaders must address the emergence of this threat and propose sustainable and suitable solutions to deal this challenging issue.

CORonavirus-19 mild to moderate pneumonia Management with blood Ozonization in patients with Respiratory failure (CORMOR) multicentric prospective randomized clinical trial.

BACKGROUND: Following positive experience on the use of blood ozonation in SARS-CoV-2, the CORMOR randomized trial was designed to evaluate the adjuvant role of oxygen/ozone therapy in mild to moderate SARS-CoV-2 pneumonia. METHODS: The trial (ClinicalTrial.gov NCT04388514) was conducted in four different Italian centers (April-October 2020). Patients were treated according to best available standard of care (SoC) therapy, with or without O3-autohemotherapy (O3-AHT). RESULTS: A total of 92 patients were enrolled: SoC + O3-AHT (48 patients) were compared to the SoC treatment (44 patients). The two groups differed in steroids therapy administration (72.7% in SoC arm vs. 50.0% in O3-AHT arm; p = 0.044). Steroid therapy was routinely started when it was subsequently deemed as effective for the treatment of COVID-19 disease. No significant differences in mortality rates, length of hospital stay, mechanical ventilation requirement and ICU admission were observed. Clinical improvement in patients with pneumonia was assessed according to a specifically designed score (decrease in SIMEU class, improvement in radiology imaging, improvement in PaO2/FiO2, reduction in LDH and requirement of oxygen therapy ≤ 5 days). Score assessment was performed on day-3 (T3) and day-7 (TEnd) of O3-AHT treatment. A significant increase in the score was reported at TEnd, in the O3-AHT treatment arm (0 [0-1] in the SoC arm vs. 2 [1-3] the O3-AHT arm; p = 0.018). No adverse events related O3-AHT treatment was observed. CONCLUSION: In mild-to-moderate pneumonia due to SARS-CoV-2, adjuvant oxygen/ozone therapy did not show any effect on mortality, or mechanical intubation but show a clinical improvement a day 7 from randomization in a composite clinical endpoint. Larger Randomized prospective studies alone or in combination with steroids are needed to confirm our results.

Dynamics of Amphan Cyclone and associated changes in ocean, land meteorological and atmospheric parameters

The low-pressure system developed in the Bay of Bengal and the Andaman Sea during March-October, often forms tropical cyclones, depending upon the intensity widespread destruction occurs in the areas where landfall takes place along the Indian coastal region. On 20 May, 2020, tropical cyclone Amphan hit the Indian coast at Bakkhali, West Bengal, in the afternoon (1330 IST). On 19 May, 2020, the intensity strengthened into a super cyclonic storm, with a strong wind speed up to 220 km/h. This cyclone affected a large population of India and Bangladesh. More than twenty-two thousand houses were damaged and millions of people were shifted to a safe place and due to the spread of COVID-19, the rescue missions were quite challenging. The cyclone affected most of the eastern states of India, heavy rainfall occurred causing floods along the track of cyclones. Using multi-satellite, ground and Argo floats data, we have analyzed meteorological and atmospheric parameters during May 2020. Our detailed analysis shows pronounced changes in atmospheric (CO mole fraction, total ozone column) and ocean parameters (chlorophyll concentration, dissolved oxygen, salinity, sea surface and sub-surface temperature) before and after the cyclone. Changes in ocean parameters such as caused by the cyclone Amphan along its track and the atmospheric and meteorological parameters change as the cyclone moves over the land.