According to the NHS Long COVID plan for 2021/22: The term ‘Long COVID’ (LC) includes both ongoing symptomatic COVID-19 (5-12 weeks after onset) and Post-COVID-19 Syndrome (12 weeks or more). LC is a multi-systemic debilitating condition that affects increasing number of people of any age impacting physical, psychological, and cognitive health.

We propose that Ozone autohemotherapy as a safe an effective therapeutic strategy to treat LC. Data suggest that ozone is an effective for COVID associated pneumonia, either as a monotherapy or, as an adjunct to standard treatment regimens [1], [2]. “Systemic ozone therapy has several positive effects, such as control of inflammation, stimulation of immunity, low antiviral activity and protection from acute coronary syndromes and ischemia reperfusion damage.” [1] Evidence also suggests that ozone administration via autohemotherapy at small doses can decrease oxidative stress  [1], [2].

A multicenter, randomized, controlled, open-label clinical trial testing using ozone auto-hemotherapy in hospitalized patients with Covid-19 pneumonia was performed in Spain [3]. In this protocol, patients in the ozone auto-hemotherapy group received treatment mixing 100-200ml of blood with ozone at a concentration of 40 μg / mL with a gas volume of 200 ml. Preliminary report of this trial showed that ozonated autohemotherapy was associated with a significantly faster clinical improvement [4].

There are several biological plausible mechanisms of action for ozone autohemotherapy, including virucidal activity and reduction of oxidative stress. Oxidative stress, understood as the imbalance between the generation of so-called free radicals, and their elimination by the antioxidant defense systems is considered an emerging risk factor for LC [5]. Oxidative stress is associated with several diseases, such as cardiovascular diseases, neuro-degenerative disorders, metabolic disorders, and numerous other chronic-degenerative diseases [5].

We propose a clinical trial for LC based on perfectly executed autohemotherapy (according to the guidelines by the Italian Society for Oxygen-Ozone Therapy, SIOOT).  Levels of oxidative stress will be used as a scientific metric for ozone dosage and treatment evolution. This is significant since treatment would be tailored to each individual (personalized medicine approach) based in the oxidative balance determined by reactive oxygen metabolites (d-ROMs) and the Plasma Antioxidant Test (PAT) [5]. Determination of biological antioxidant potential will be used to evaluate treatment progression.

If we consider oxidative stress as a metric for the multifactorial pathogenesis caused by LC, we should be able to use personalized ozone autohemotherapy as an efficient treatment strategy for LC. Ozone improves the ability of the blood to supply oxygen to the tissues: this results in a reactivation of the microcirculation and peripheral oxygenation, clearly associated with LC. Also, many other chronic diseases (allergies, immune deficiency diseases, rheumatic diseases, cardiovascular diseases, headaches, neurosis, etc.), could benefit from this therapeutic approach.



S. G. C. B. T. L. S. C. M. S. L. A. a. F. G. D. R. Francesco Cattel, "Ozone therapy in COVID-19: A narrative review," Virus Res. , no. 291, 2021.


L. C. M. J. A. S. H. A. G. A. S. Z. B. E. M. K. N. J.-J. M. A. R. J. S. F. H. N. M. E. Morteza Izadi, "Ozone therapy for the treatment of COVID-19 pneumonia: A scoping review," International Immunopharmacology, vol. 92, 2021.


I. d. B. d. G. D. J. Trueta, "Ozone Auto-hemotherapy for COVID-19 Pneumonia (COVID-OZONE)," 2020. [Online]. Available: https://clinicaltrials.gov/ct2/show/NCT04370223. [Accessed 23 July 2021].


M. V. A. P. F. V. P. J. P. D. N. W. S. D. B. a. M. V. Alberto Hernández, "Ozone therapy for patients with COVID-19 pneumonia: Preliminary report of a prospective case-control study," Int Immunopharmacol , vol. 90, 2021.


E. N. P. A. S. P. O. A. G. L. A. Z. a. R. A. Z. B. V. Chernyak, "COVID-19 and Oxidative Stress," Biochemistry (Mosc), vol. 85, no. 12, p. 1543–1553., 2020.