Fatigue in post-acute sequelae (long covid) of SARS-CoV2 treated with oxygen-ozone autohemotherapy

Background

Long COVID, formally known as post-acute sequelae of SARS-CoV-2 infection (PASC), leaves a substantial share of people who have recovered from COVID-19 with persistent symptoms. Fatigue is consistently reported as one of the most disabling and common of these symptoms, often accompanied by pain and reduced quality of life. Because no established medical treatment for PASC-related fatigue yet exists, researchers in Italy set out to examine whether oxygen-ozone autohemotherapy - a systemic ozone therapy in which a small volume of the patient's own blood is mixed with a medical oxygen-ozone gas mixture and then re-infused - could help relieve this fatigue.

Study design

The study, led by U. Tirelli and colleagues, followed 100 adults who had previously tested positive for COVID-19 and were experiencing PASC-related fatigue. Participants were recruited from two clinics in Italy and treated with oxygen-ozone autohemotherapy over a course of two to three weeks. Fatigue was measured before and after treatment using the Fatigue Severity Scale (FSS), a validated seven-point self-report questionnaire. This was a prospective, single-arm observational case series - there was no control or placebo group, and both patients and assessors were aware treatment was being given.

Findings

On average, patients' fatigue scores fell by 67% following treatment, a statistically significant change (p < 0.0001). Around 40% of participants reported near-complete recovery from their fatigue symptoms. The improvement was seen consistently across the group regardless of sex or age.

What the authors concluded

The authors concluded that oxygen-ozone autohemotherapy was associated with meaningful relief from PASC-associated fatigue in this group of patients, describing the results as preliminary evidence that supports further investigation into the mechanisms behind the effect.

Limitations of this study

This was an uncontrolled case series rather than a randomised or placebo-controlled trial, so the improvement cannot be separated with certainty from natural recovery over time, placebo response, or other factors. Fatigue was assessed using a self-reported scale, which is inherently subjective, and there was no long-term follow-up to establish whether the improvement was sustained. The sample was drawn from only two clinics in Italy, which may limit how well the findings generalise to other populations. Larger, controlled studies are needed before firm conclusions can be drawn about the effectiveness of oxygen-ozone autohemotherapy for long COVID fatigue.