Study of ozone therapy as a complementary treatment in SARS-CoV-2 infection. Summary of the doctoral thesis in medical sciences. 321.19 –Anesthesiology and Intensive Care

Abstract

Relevance and importance of the research. Ozone therapy is a complementary treatment with a wide range of therapeutic applications. It can be used as a standalone therapy or as an

adjunct to existing treatment protocols for patients with novel coronavirus disease 2019 (COVID- 19). Evidence suggests that this therapy has led to improvements in the clinical picture,

biochemical markers, and radiological signs of inflammation, with no reported side effects [1]. Ozone therapy, known for its antioxidant, anti-inflammatory, and antithrombotic properties, may be crucial in addressing hyperinflammation, immunodeficiency, hypercoagulability, and poor response to conventional therapies associated with COVID-19. Early studies suggest that ozone therapy could serve as a promising adjunctive treatment for mild to severe cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Therefore, ozone therapy could be an effective option, either as an alternative (standalone) treatment or, more realistically, as a valuable adjunct to standard therapies for COVID-19 patients, including those experiencing severe respiratory failure [2, 3, 4]. Evidence from the specialized literature suggests that introducing the ozone therapy into

treatment protocols may help reduce morbidity and accelerate recovery in patients with COVID- 19. However, randomized, controlled clinical trials are required to validate ozone therapy as a

viable adjunctive treatment for COVID-19, to guide its clinical application, and evaluate its impact on the progression of SARS-CoV-2 infection [5]. Based on the forementioned information, this study aims to evaluate the clinical efficacy of ozone therapy (major autohemotherapy with ozone) in patients with SARS-CoV-2. To achieve this goal, the following research objectives have been defined: 1. To assess the mortality rate in COVID-19 patients treated with intravenous ozone therapy versus those receiving standard care. 2. To estimate the impact of intravenous ozone therapy on the oxygenation index in patients with SARS-CoV-2 infection. 3. To determine the impact of intravenous ozone therapy on the profile of inflammatory markers in COVID-19 patients. 4. To conduct a comparative analysis of the incidence and duration of non-invasive and invasive mechanical ventilation in the study cohorts. 5. To evaluate the influence of intravenous ozone therapy on the length of stay in the Intensive Care Unit and the overall length of hospital stay. Scientific novelty and originality. The scientific relevance of this study lies in the assessment of all the effects of ozone therapy on the intensity of the inflammatory process and respiratory parameters in COVID-19 patients, which play a decisive role in clinical progression and survival rates. In this way, the study provides opportunities for improving the condition of these patients. Scientific problem solved. The scientific problem addressed consists in evaluating the

efficacy of major ozonated autohemotherapy in the clinical progression of patients with SARS- CoV-2.

The theoretical significance and practical value of this research lies in how the results complement and substantiate treatment methods for patients with COVID-19. A comparative analysis was conducted on the clinical and evolutionary aspects of SARS-CoV-2 infected patients

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with and without the adjunctive use of intravenous ozone therapy. Thesis results approval. The study results were presented and discussed at the following national and international scientific forums:

1. The 5th International Conference on Nanotechnologies and Biomedical Engineering, ICNBME- 2021. November 3-5, 2021, Chișinău, Republic of Moldova.

2. The 48th Congress of the Romanian Society of Anesthesia and Intensive Care (SRATI), May 11-15, 2022, Sinaia, Romania. 3. The 7th International Conference on Covid-19 Studies, September 5-6, 2022, Ankara, Turkey.