key: cord-0872379-u56se0ef authors: Zheng, Zhishui; Dong, Minglin; Hu, Ke title: A preliminary evaluation on the efficacy of ozone therapy in the treatment of COVID‐19 date: 2020-05-21 journal: J Med Virol DOI: 10.1002/jmv.26040 sha: 15ca73d08db3bb80b612c917d1cff139c1397ed8 doc_id: 872379 cord_uid: u56se0ef Currently, coronavirus disease 2019 (COVID‐19) is a global pandemic disease with significant morbidity and mortality. Ozone may exert its antiviral actions and ozone therapy has been demonstrated therapeutically usefulness in influenza and novel viruses. In this letter, two severe cases with COVID‐19 received ozone therapy were described. The results showed that ozone therapy may promote recovery of clinical condition and improvement of chest CT images, shorten the duration of viral shedding and length of hospital stay. This article is protected by copyright. All rights reserved. . After the written informed consent was obtained, MAH was given to patients once daily for 7 consecutive days. Each time, 100 ml of venous blood was collected and mixed with O 3 gas at the 1:1 ratio of oxygen-ozone to blood volume, with the final concentration of oxygen-ozone being 20μg/ml. The clinical study was approved by the Clinical Research Ethics Committee of Renmin Hospital of Wuhan University (WDRY2020-K020). A male of 53-year-old was admitted to Renmin Hospital of Wuhan University on 2020/2/20 due to mild fever and dyspnea for 7 days, accompanied by headache, runny nose, fatigue and loss of appetite. On admission, he presented a clear consciousness with a body temperature of 37.5℃. Chest CT imaging on 2020/2/19 revealed multiple small patchy shadows, linear interstitial changes and consolidation in both lungs. He was confirmed COVID-19 on 2020/2/21. Lymphopenia, elevated CRP and IL-6, mild hypoxemia were noted in laboratory tests. After admission, the patient was given antiviral therapy, antibiotics, immunoglobulin, omeprazole, supplemental oxygen of 3L/min. He was treated with O 3 -MAH on 2020/2/25, once daily for 7 consecutive days. With the treatment of MAH, his symptoms disappeared soon. Abnormal laboratory indicators within normal range were recorded (Table 1 ). Compared to baseline chest imaging, follow-up serial CT scans showed gradually absorbed bilateral lung lesions (Supplementary Figure 1) . The patient was discharged on 2020/3/14, after nuclei acid tests negative twice consecutively on nasopharyngeal swabs and meeting other discharge criteria [4] . No MAH-related adverse events were reported. This article is protected by copyright. All rights reserved. A male of 66-year-old was referred from a community clinic on 2020/2/5. He suffered from fever on 2020/1/22 accompanied by cough and sore throat, with the highest body temperature of 39.2℃. He had a history of chronic respiratory disease. For chest CT scan on 2020/1/23 showed "viral pneumonia-like changes", the patient was admitted to a community health center with "suspected COVID-19" and confirmed COVID-19 on 2020/1/25. However, antiviral therapy and antibiotics did not improve his condition, cough, hemoptysis and dyspnea occurred. Repeated chest CT scan revealed lesion progression, with multiple ground-glass opacities and interstitial changes in both lungs. After referred, he was given antiviral therapy, antibiotics, immunoglobulin, supplemental oxygen of 3L/min of. The patient was treated with O 3 -MAH since 2020/2/15, once daily for 7 consecutive days. After MAH treatment, he recovered rapidly with normal range of laboratory indicators. Compared to baseline chest imaging, follow-up CT scan showed obviously absorbed bilateral lung lesions ( Figure 2 ). After meeting the discharge criteria [4] , the patient left hospital on 2020/2/22. No MAH-related adverse events occurred. To show the advantages of this treatment, the two cases were compared with other two subjects without MAH, being age-and illness severity-matched. We found that the patients without MAH had longer duration of viral shedding and length of hospital stay. We present the possibility of ozone therapy as a treatment for COVID-19 in two severe confirmed cases. MAH was carried out to each patient for seven days. After treatment, two patients remitted symptoms and discharged with negative RT-PCR testing for SARS-CoV-2. Now casting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. NEJM Ozone therapy: an overview of pharmacodynamics, current research, and clinical utility National Health Commission of the People's Republic of China. Diagnosis and treatment of novel coronavirus infected pneumonia Rapid resolution of hemorrhagic fever (Ebola) in Sierra Leone with Ozone therapy Preliminary results of ozone therapy as a possible treatment for patients with chronic hepatitis C Oxygen-ozone immunoceutical therapy in COVID-19 outbreak: facts and figures A plausible "penny" costing effective treatment for corona virus-Ozone Therapy Table 1. Demographics, clinical and laboratory results of Cases with or without Ozone therapy