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 Table of Contents  
CASE REPORT
Year : 2021  |  Volume : 15  |  Issue : 3  |  Page : 237-244

Safe and effective management of COVID-19 through ayurveda intervention: A case series


1 Department of Panchakarma, All India Institute of Ayurveda, Sarita Vihar, New Delhi, India
2 Department of Panchakarma and Tanuja Nesari is Director, All India Institute of Ayurveda, Sarita Vihar, New Delhi, India

Date of Submission07-Dec-2020
Date of Decision08-Mar-2021
Date of Acceptance25-Mar-2021
Date of Web Publication25-Sep-2021

Correspondence Address:
Kavita Kumari
Department of Panchakarma, All India Institute of Ayurveda, Sarita Vihar, New Delhi - 110 076
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_308_20

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  Abstract 


Introduction: COVID-19/SARS-CoV-2 has become a major concern for whole humanity, it is rising rapidly and the condition is worsening. With a huge transmission rate, it has become an important requirement of this times to hatch out a safe and effective treatment for COVID-19. Main clinical findings–All the 5 cases of Doctors pursuing MD education in Ayurveda at All India Institute of Ayurveda were having varied variety of symptoms fever, sore throat, fatigue being common along with rest others like dyspnea, hemoptysis, cough, palpitations, pain in abdomen and calf muscles. Diagnosis: All the cases were diagnosed as COVID-19 positive. Intervention: All of the cases were given Ayurveda treatment chiefly comprising of SamshamniVati, AYUSH Kwatha, Chyawanprash along with Steam Inhalation with Ajwain (Tachyspermumammi) and nasal application of Anu Taila along with a specific daily (Dinacharya) and dietary (Ahara ) regimen. Outcome: All the patients recovered completely without any post-complications assessed after a follow-up period of 1 month. Conclusion: It was found that Ayurveda is a safe and effective treatment for mild to moderate COVID-19 patients. A lead can be taken from these cases and Ayurveda can be conjugated with the main stream modern medical treatment modalities for curing this pandemic with an integrated approach.

Keywords: Ayurveda, Dinacharya, Ahara, COVID-19 management


How to cite this article:
Bhatted SK, Kumari K, Malhotra N, Nesari T. Safe and effective management of COVID-19 through ayurveda intervention: A case series. J Ayurveda 2021;15:237-44

How to cite this URL:
Bhatted SK, Kumari K, Malhotra N, Nesari T. Safe and effective management of COVID-19 through ayurveda intervention: A case series. J Ayurveda [serial online] 2021 [cited 2021 Dec 1];15:237-44. Available from: http://www.journayu.in/text.asp?2021/15/3/237/326713




  Introduction Top


Coronavirus disease-2019 (COVID 19) has become a common term in today's scenario from December 2019 events of respiratory infections from Wuhan city[1] to February 2020 when the WHO reported it as COVID-19,[2],[3],[4] the WHO has declared this outbreak as public health emergency of international concern.[5] As of now, there is no specific cure found for COVID 19 in modern medicine, As per the latest report of WHO, it has spread to 185 countries and regions, with more than 16,341,920 confirmed cases including 650,805 deaths as of July 28, 2020,[6] there has been an immense pressure on health-care systems to come out with a safe and effective solution that could provide a minimum or no residual complaints. It is the most relevant time to amalgamate all our health-care systems to harness a way out. As of now, traditional system of medicine is being highly used by different countries and their promising results have been seen. However, there are no rigorous data to illustrate its scientific basis, but the efficacy of some traditional medicines for COVID-19 is being continuously tested.[7] Analogously in India as well, there has been a lot of capitalization shift to Ayurveda along with other indigenous systems among this pandemic situation. Ongoing trials with a large sample size are being conducted to develop a standard protocol for the treatment of COVID-19; constantly, there has been an increase in the use of one or the other Ayurveda medicines that may be for preventive, prophylactic, or therapeutic purpose.[8]

There are few cases which are worth sharing as it can give a potent breakthrough knowledge in curing this pandemic, thereby decreasing the morbidity and mortality related to this disease. This case series is a collection of 5 cases of doctors pursuing MD education in Ayurveda at All India Institute of Ayurveda who all happened to came in close contact with COVID-positive patients while carrying out their duties and subsequently developed certain sign and symptoms of COVID-19.


  Methodology Top


All five cases were taken into consideration and were studied meticulously as per the recovery rate, serious complications, and residual symptoms. A case study with a complete time frame in accordance with the sign and symptoms, reverse transcription–polymerase chain reaction (RT-PCR) or rapid antigen test, and time taken for complete recovery was taken.

Most of the treatment adopted was as per preventive measure guidelines and COVID-19 management guidelines issued by the Ministry Of AYUSH, Government of India [Table 1] and [Figure 1], compromising oral Ayurvedic medicines, external therapies, and dietary regimen.
Table 1: Treatment adopted

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Figure 1: Ayurveda treatment protocol

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The following Ayurvedic medicines were also given as per the sign and symptoms and its severity.









  1. Tablet Laghumalinivasant 125 mg bd after food with honey if a patient had mild respiratory symptoms (breathlessness on exertion and heaviness in the chest) and tablet Swarna malini vasant 125 mg bd after food with honey if a patient had moderate-to-severe respiratory symptoms (breathlessness with hemoptysis, drop in Spo2 level ≤92, and pneumonia)
  2. Kantakariavaleha 10 g bd after food with lukewarm water was given for persistent cough
  3. Avipattikar churna 5 g bd before food with lukewarm water was given for gastrointestinal symptoms like pain in the abdomen.


All patients after being tested nonreactive for COVID-19 were found to be physically fit and were discharged from quarantine, as per the Delhi government guidelines, they were discharged after a quarantine period of 14 days. All of them quarantined at their own rented apartments, though case no. 4 had a symptom of mild weakness with no other serious illness. All patients did not have any residual complications after the negative COVID report and even after a follow-up period of 1 month.


  Observation and Results Top


All the cases of COVID-19 infection [Table 2] were treated with Ayurvedic medicines [Table 2]. All of them had varied symptoms ranging from fever, dry cough, sore throat, abdominal pain, diarrhea, anosmia, pain in flanks and calf, heaviness in the chest, dyspnea, hemoptysis, arrhythmia, etc., but none of them proved to be fatal considering the fact that three cases out of five were known case of hypertension and hypothyroidism. Cases 1, 2, and 4 can be categorized into severe COVID-19 positive and cases 3 and 5 can be categorized into mild COVID-19 positive.[9] It is an important point to record that cases 1, 2, and 4 were females and all of them had a cluster of cardiovascular and respiratory symptoms but were easily resolved without any complication with Ayurveda medicines. All therapeutic measures adopted by five doctors were assessed and were plotted on [Graph 1] where AyushKwata, ShamshamniVati, Chyavanprasha , Anu taila Nasya (nasal instillation), Pathyaahara (light freshly prepared food), steam inhalation with Ajwain (Trachyspermum ammi), drinking warm water intermittently, turmeric milk, and yoga for 30 min were adopted by all five cases. Herbo-mineral medicines such as Laghumalinivasant, and Swarna malini vasant and Kantakariavaleha were also included for cases 1, 2, and 4 as they had respiratory and cardiovascular symptoms, as it has ingredients such as Swarna Bhasma and Maricha which were found to be effective against certain strains of viruses [Table 3]. It was observed that in cases 1, 2, and 4 all respiratory and cardiovascular symptoms subsided within 3–4 days after adding Laghumalini Vasant and Swarna malini Vasant [Graph 2], [Graph 3], [Graph 4] and Kantakariavaleha. Similarly, gastrointestinal symptoms also subsided after adding Avipattikarchurna, as it has Trikatu and Amla which were found to be effective in digestive functioning [Table 3]. The time for subsiding of symptoms on an average was found to be 20–21 days. Similarly, the average time for nonreactive nasopharyngeal RT-PCR/rapid antigen swab test was found to be 20 days. However, it showed to be reactive or indeterminate twice, specifically in cases 3 and 5, postulating the detectable viral load, although there were no serious symptoms in both the cases other than fever, cough, abdominal pain, and fatigue. In all cases, symptoms such as fever [Graph 5], cough, sore throat, and abdominal pain gradually came down in starting phase only. Anosmia and weakness was the only feature which was found for a longer run. It was observed that all cases recovered completely with in a period of 3 weeks. After a follow-up of 1 month, all cases were normal with no residual sign and symptoms or complications. Maximum days for which symptoms persisted were 22 days; considering these 5 cases, graphs were plotted for temperature [Graph 5], Spo2 [Graph 2], respiration rate [Graph 3], pulse rate [Graph 4], breathlessness [Graph 6], and fatigue [Graph 7] with symptoms on y-axis and days on x-axis. Graphs 6 and 7 are plotted on the basis of [Table 4]. Treatment measures taken by all five cases were also plotted in Graph 1 as per their usage.
Table 2: Case presentation

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Table 3: Potent ayurvedic drugs that can be effective against COVID-19

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Table 4: Severity grade of breathlessness and fatigue

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  Discussion Top


As per the WHO data, 81% of the COVID-19 cases show only mild symptoms, 14% develop severe illness requiring oxygen therapy, and only 5% of the critical cases require intensive care.[10] Further, the prognosis of the disease makes it clear that the immune response of the patients has a crucial role to play in early recovery. The immune response is needed in a precise regulation to eliminate the virus; otherwise, it may lead to immunopathology due to uncontrolled immunoresponse.[11] Ayurvedic treatment with symptomatic management will also enhance the immunity (Rasayana)[12] ensuring early recovery and minimal complications. It provides us a clear insight that almost 81% of cases showing mild symptoms can be easily managed with Ayurvedic treatment. With the incorporation of Ayurveda in the COVID-19 management, we can even prevent 14% of the cases to enter into severe illness condition thus in total reducing an estimated 95% of the current health-care sector burden due to COVID 19 and the remaining 5% critical cases can be potentially managed through an integrated plan of Ayurveda and allopathy system of medicine. In all the above cases, drugs played a significant role in enhancing immunity and in fighting COVID-19 infection. Ingredients of AYUSH Kwatha (Tulsi, Dalchini, Sunthi, and Marich) are known for its antimicrobial, antiviral, and anti-inflammatory [Table 4] action in general and enhances the digestion and metabolism which indirectly plays a significant role in maintenance of healthy immune system and overall strength of the individual.[13] Tablet Shamshamnivati has Guduchi (Tinospora cordifolia) as the main content. Guduchi has been studied to have immunomodulation activity, anti-inflammatory, antipyretic, anti-infective, antioxidant, antineoplastic, hepatoprotective, antihyperglycemic, and cardioprotective activity.[14] Chyavanprasha is one of the time-tested Ayurveda formulations that has been used since ancient times to enhance strength and immunity.[15] Amalaki (Emblica officinalis) is the main ingredient of Chyavanprasha known for its higher concentration of Vitamin C which is considered as the best constituent in the prevention and management of COVID-19 infection.[16] All the drugs being used have such ingredients which exhibit antviral, antimicrobial, anti-inflammatory, analgesic, immunomodulatory, and antioxidant activity. Anu Taila[17] if applied in nostrils, it acts as a barrier for entry of virus. Anu taila Nasya has only a few scientific studies till now; there is no study focused on its immunity-boosting and nourishing effect, etc.[18] Steam inhalation (Swedana) is indicated in Urahstambhana (stiffness and tightness of the chest, which is an important symptom of COVID-19) as it helps to overcome vitiation of kapha and vata due to ushna-tikshna properties of swedana[19] with an add on antiviral effect of Thymol,[20] an active component of Ajwain (Trachyspermum ammi).

Limitation

Due to the highly contagious nature of COVID-19, immediate isolation is required, these cases were quarantined at home in their respective separate rooms and due to which they had a limited access to other laboratory investigations which could have given more strength to the above postulations. From the above cases, we can take some lead and conduct this study with a large sample size for a much better statistical analysis.

Strength

First, there is already an anticipated fear of getting infected with COVID-19 in the society and then culminating into hospital alone. However, if there are mild–moderate symptoms then being home quarantined, the Ayurveda management under strict medical supervision can assure safe and early results without any adverse effects and simultaneously preventing any further complications. This can save a person from financial burden in this critical times apart from ensuring early and safe recovery.

All the five cases did not develop any fatal or critical complications. From the above case series, it can be concluded that stand-alone Ayurveda intervention in the form of drugs, formulations, therapies, dietary modifications, specific preventive measures, and personal and social code of conduct are safe and effective in the management of sign and symptoms of COVID 19 as evidenced by improvement in both subjective and objective parameters including Spo2, breathlessness, temperature, and RT-PCR and rapid antigen test. Hence, this case series provides a lead to conduct large sample studies on the management of COVID 19 through Ayurveda intervention and subsequently to include as a mainline of treatment in national policies and guidelines for COVID-19 management.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
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