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.

Efecto del ultrasonido terapéutico pulsátil de baja intensidad sobre la regeneración del cartílago articular en pacientes con gonartrosis de segundo y tercer grado / Effect of low-intensity pulsed ultrasound on regeneration of joint cartilage in patients with second and third degree osteoarthritis of the knee

Objetivo Indagar si la aplicación del ultrasonido terapéutico pulsátil de baja intensidad (USTPBI) produce cambios favorables en la regeneración del cartílago articular, así como beneficios clínicos en pacientes que tienen gonartrosis grado 2 o 3 según la clasificación de Kellgren y Lawrence. Diseño Éste es un estudio observacional, tipo antes y después, sin grupo control, en el que se estudiaron 10 pacientes (11 rodillas) con gonartrosis grados 2 y 3 (según la clasificación de Kellgren y Lawrence), a los que se les aplicó ultrasonido terapéutico a una intensidad de 0,3W/cm2 pulsátil al 50%, que otorgó un total de energía de 36J/cm2 por sesión durante 36 sesiones. Las mediciones se realizaron previas al inicio del tratamiento y posteriores al término de éste (3 meses después), y consistieron en: grosor del cartílago articular mediante el análisis de imágenes tomadas por resonancia magnética (RM) por 2 reumatólogos y un experto radiólogo; dolor mediante escala visual analógica (de uno a 10cm), y el índice de gravedad de Lequesne. Se utilizaron pruebas estadísticas no paramétricas de Wilcoxon y pruebas de correlación de Spearman, y se definió un valor de p<0,05 como estadísticamente significativo. Resultados Se observó una disminución en la intensidad de dolor (basal media de 7,09±2,54; final media de 4,18±2,22; p=0,005) y una mejoría en cuanto a la funcionalidad (basal media de 10,55±5,42; final media de 5±4,45; p=0,008) después del tratamiento con USTPBI. Con respecto al grosor medido en la RM, no se obtuvieron mediciones consistentes entre los observadores, por lo que se concluyó que el método de medición no fue reproducible, lo que hizo difícil definir si hubo un incremento o no en el grosor del cartílago articular. Conclusiones El USTPBI tiene un efecto benéfico sobre la disminución del dolor y la mejoría de la funcionalidad. Desafortunadamente, en este estudio no se cuenta con un método de medición reproducible para arrojar una conclusión válida en cuanto al efecto del USTPBI sobre el grosor del cartílago articular (AU)

Objective To determine if the application of low intensity pulsed ultrasound (LIPUS) therapy has a positive effect over the cartilage repair, functional status and reduction of pain in patients with grade 2 or 3 osteoarthrosis of the knee. DesignT his trial was an observational, before and after study without a control group, in which 10 patients (eleven knees) were studied. We applied LIPUS therapy with an intensity of 0.3W/cm2, duty cycle of 50%, giving a total of 36J/cm2 per session during 36 sessions (three months). The clinical measures were obtained before the first session and at the end of the 36th session, and were: cartilage thickness by the analysis of magnetic resonance images (MRI) measured by two rheumatologists and a radiology specialist, pain by a visual analog scale (1–10cm) and function/severity by the Lequesne index. We used the non parametric tests of Wilcoxon for comparing medians and the Spearmans rho for the correlation of the inter observer cartilage thickness measurements defining a p value of<0.05 as significant. Results We observed an effect on pain (VAS mean before 7.09+−2.54 mean after 4.18+−2.22 p 0.005) and on the function/severity index (Lequesne mean before 10.55+−5.42 mean after 5+−4.45 p 0.008). There was poor consistency regarding the cartilage thickness measures by resonance imaging between the three observers (2 rheumatologists and 1 radiologist) so we were not able to define the presence or absence of effect on cartilage thickness augmentation. Conclusions LIPUS has a benefic effect over pain and functionality/severity in patients with Kellgren and Lawrence grade 2 and 3 osteoarthritis of the knee. Unfortunately in this study we did not count with a reliable measure method to conclude on its effect over cartilage thickness measured by MRI (AU)

[Effect of low-intensity pulsed ultrasound on regeneration of joint cartilage in patients with second and third degree osteoarthritis of the knee]. / Efecto del ultrasonido terapéutico pulsátil de baja intensidad sobre la regeneración del cartílago articular en pacientes con gonartrosis de segundo y tercer grado.

OBJECTIVE: To determine if the application of low intensity pulsed ultrasound (LIPUS) therapy has a positive effect over the cartilage repair, functional status and reduction of pain in patients with grade 2 or 3 osteoarthrosis of the knee. DESIGN: This trial was an observational, before and after study without a control group, in which 10 patients (eleven knees) were studied. We applied LIPUS therapy with an intensity of 0.3W/cm(2), duty cycle of 50%, giving a total of 36J/cm(2) per session during 36 sessions (three months). The clinical measures were obtained before the first session and at the end of the 36th session, and were: cartilage thickness by the analysis of magnetic resonance images (MRI) measured by two rheumatologists and a radiology specialist, pain by a visual analog scale (1-10cm) and function/severity by the Lequesne index. We used the non parametric tests of Wilcoxon for comparing medians and the Spearmans rho for the correlation of the inter observer cartilage thickness measurements defining a p value of<0.05 as significant. RESULTS: We observed an effect on pain (VAS mean before 7.09+-2.54 mean after 4.18+-2.22 p 0.005) and on the function/severity index (Lequesne mean before 10.55+-5.42 mean after 5+-4.45 p 0.008). There was poor consistency regarding the cartilage thickness measures by resonance imaging between the three observers (2 rheumatologists and 1 radiologist) so we were not able to define the presence or absence of effect on cartilage thickness augmentation. CONCLUSIONS: LIPUS has a benefic effect over pain and functionality/severity in patients with Kellgren and Lawrence grade 2 and 3 osteoarthritis of the knee. Unfortunately in this study we did not count with a reliable measure method to conclude on its effect over cartilage thickness measured by MRI.