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Abstract

The age-old science of Ayurveda has many secrets hidden within. The coronavirus disease is a novel disease, as indicated by its nomenclature also. The plural medical system approach is being implemented to combat the disease. There are many references in the ayurvedic textbooks/classics/Samhitas about janapadodwamsa or epidemics in the age of gods and the management of such epidemics or janapadodwamsa can also be evidenced in the classics of Ayurveda. The principles of Ayurveda can be applied for both preventive and curative aspects of disease. The practical knowledge and the knowledge about the stage of the disease are essential to bridge the ayurvedic principles with the preventive and curative aspects of the disease. The efficiency of ayurvedic drugs is known by practice. However, new drugs can be formulated with a combination of drugs. The search for new drugs and new preventive practices in an integrated approach is what the approach is to be to tackle the novel virus. In this regard, the current paper aims to bridge the preventive aspects of COVID 19 with respect to various stages of disease in ayurvedic aspect.
© 2020 International Journal of Health & Allied Sciences | Published by Wolters Kluwer - Medknow S91
COVID 19 in ayurvedic perspective
V Kirthana, B Venkataiah1, M R Narayana Murthy
Abstract:
The age‑old science of Ayurveda has many secrets hidden within. The coronavirus disease is
a novel disease, as indicated by its nomenclature also. The plural medical system approach
is being implemented to combat the disease. There are many references in the ayurvedic
textbooks/classics/Samhitas about janapadodwamsa or epidemics in the age of gods and the
management of such epidemics or janapadodwamsa can also be evidenced in the classics of
Ayurveda. The principles of Ayurveda can be applied for both preventive and curative aspects
of disease. The practical knowledge and the knowledge about the stage of the disease are
essential to bridge the ayurvedic principles with the preventive and curative aspects of the
disease. The efficiency of ayurvedic drugs is known by practice. However, new drugs can be
formulated with a combination of drugs. The search for new drugs and new preventive practices
in an integrated approach is what the approach is to be to tackle the novel virus. In this regard,
the current paper aims to bridge the preventive aspects of COVID 19 with respect to various
stages of disease in ayurvedic aspect.
Keywords:
Ayurveda, COVID 19, health, prevention, public
Introduction
(Acharya Charaka in his treatise Charaka
samhita, Vimana sthana 3:6 quotes about
JANAPADODWAMSA or EPIDEMICS.)
The conversation between Atreya and
Agnivesha, which is documented
as Charaka samhita, a standard treatise
in the Ayurveda science quotes that all
though there are dissimilarities between
every individual, there are certain factors
which are similar among all. They are
AIR, WATER, DESHA (Place of living),
KALA (time/season). Vitiation among any
of these factors manifests diseases having
similar symptoms, which ultimately may
lead to the destruction of country. Such
manifested disease leading to destruction in
mass is termed as
JANAPADODWAMSA
or EPIDEMIC
.”
The history of such an epidemic outbreak
dates back to 3000 BC, where an epidemic
wiped out a whole village in China. The
archaeological site is now called “Hamin
Mangha.” The latest being CORONA VIRUS
PANDEMIC, named later as COVID‑19 or
NOVEL CORONA VIRUS DISEASE or nCoV,
which began in December 2019 in a Hubei
province of China called as Wuhan city.
The virus has affected 206 countries causing
40,777 confirmed deaths and 827,419
conrmed cases globally (as on April 1,
2020).[1] The situation is no less bad in
India with 1764 active Cases, 150 Cured/
Discharged, 50 deaths and 1 migrated case
as on April 2, 2020.[2]
The World Health Organization (WHO)
declared it as a pandemic on March 11,
2020.[1]
This pandemic has the following
symptoms:[3]
1. Fever– Usually high grade
2. Cough– Nonproducive/dry
3. Shortness of breath
4. Running nose
Address for
correspondence:
Dr. V Kirthana,
J P Nagar,
Mysore - 570 031,
Karnataka, India.
E-mail: kirthana.vdoc@
gmail.com
Received: 12-05-2020
Revised: 24-05-2020
Accepted: 13-05-2020
Published: 04-06-2020
Department of Community
Medicine, JSSMC,
1Dr. BRKR Government
Ayurveda College,
Hyderabad, Telangana,
India
Perspective
Access this article online
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Website:
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DOI:
10.4103/ijhas.IJHAS_110_20
How to cite this article: Kirthana V, Venkataiah B,
Murthy MR. COVID 19 in ayurvedic perspective. Int
J Health Allied Sci 2020;9:S91-6.
This is an open access journal, and articles are
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S92 International Journal of Health & Allied Sciences - Volume 9, Supplement 1, 2020
5. Gastrointestinal disturbance– Diarrhea/nausea
6. Headache.
The symptoms get exhibited within 2–14 days of
exposure to virus.[3]
Acharya Charaka, in his treatise has widely explained
the etiology, signs/symptoms, and treatment protocol
for aagantuja jwara.
(Charaka samhita. Chikitsa sthana. 3:4)
Acharaya Charaka has mentioned that Jwara is that
which causes distress to Deha (Body), Indriya (Sense
organs), manas (Mental faculty), that which disease
which produces greater discomfort among all diseases
and that which takes a lot of Bali is termed as Jwara
and that is explained by Acharyas initially owing to its
importance in its destructive capacity.
Mentioning various types of Jwara’s, he also mentioned
about Aagantuja jwara, that which is caused by external/
foreign bodies or Germs.
The Current Pandemic Can Be Grouped
Under Aagantuja Jwara
Ayurveda categorizes diseases and treatment in terms
of Doshas vitiated (Dushyas), Prakriti of the individual
(Body constitution), Adhishthana of disease (Target
organ of disease).
However, the treatment of a disease includes much
more aspects like Roga marga (Pathway of disease), Kala
(Time/Season of disease manifested).
Trying to understand COVID 19 in Ayurveda perspective:
Doshas Involved– Vata, Pitta
Since the disease produces dryness (Dry Cough) and
shortness of breath, it can be considered that vitiation
of Vata dosha is present.
The presence of high‑grade fever annotes vitiation of
pitta dosha.
Roga Marga– Abhyantara
Since the disease involves phupusa (lungs), the pathway
of the disease can be considered as internal.
Adhishtana– Phupusa
The target organ for the disease manifestation is phupusa
or lungs.
Type of Vyadhi– Agantuja Jwara
That which is caused by Virus (Foreign body).
Kala– Time of Vyadhi– In Indian
Context– Summer
Most of the cases started by the end of February and
the beginning of March, i.e., end of Shishira ritu and
beginning of Vasantha ritu.
The period was Ritusandhi, i.e., junction period of
two ritus, where it is said that the time is apt for the
occurrence of any disease as the immunity of individuals
would have reduced.
Transmission– Droplet
Ayurveda way of treatment
The treatment aspect of Ayurveda can be understood in
three categories–
1. Ahara
2. Vihara
3. Aushada.
a. Abhyantara
b. Bahya.
Aushada– Abhyantara aushadi
Acharya Charaka in his treatise, has explained that Tikta
rasa aushadi should be given during Jwara kala.
(Bitter taste dominant medications)
Accordingly, considering the prakriti of the individual,
roga and rogi bala, kala and adhisthana of roga the
treatment of different type of jwara is to be decided.
Since the COVID is vatapittaja vyadhi,
i. Kirata– Swertia chirata– Gentianaceae:
The anti‑pyretic activity of kirata is documented by
RL Singh, Pankaj singh, Anju agarwal that both the
crude and puried extracts signicantly inhibited
cell proliferation and induced apoptosis. It may cure
infectious diseases, tonsilitis, bronchitis, pneumonia,
whooping cough, acute enteritis, gastritis, urethritis,
nephritis, tuberculosis, gall bladder infection,
influenza and high blood pressure. Besides, the
anti‑helmintic, hypoglycemic and antipyretic
antifungal and antibacterial properties there are
amarogentin (most bitter compound), swerchirin,
swertiamarin and other active principles of the herb.[4]
The plant also has hypoglycaemic property and hence
should be administered carefully
A study by Bhargava et al. reported the anti‑pyretic
activity of kirata by studying Antipyretic Potential
of Swertia chirata Buch Ham. Root Extract. They
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reported that the antipyretic effect of the extract was
comparable to that of paracetamol (150 mg kg − 1
body weight, p. o.), a standard antipyretic agent.[5]
(ii) Amrita– Tinospora cordifolia– Menispermaceae
The antipyretic activity of amrita is very well
known and documented. However, its anti‑pyretic
activity is studied by Upadhyaya et al. reported that
traditionally T. cordifolia is known for its jwarahara
activity (antipyretic activity). The water‑soluble
fraction of 95% ethanolic extract of T. cordifolia
plant has shown signicant antipyretic activity. In
another experimental study, antipyretic effects have
been reported in the hexane‑and chloroform‑soluble
portions of T. cordifolia stems. Various studies show
remarkable anti‑infective and antipyretic properties
of T. cordifolia. Pre‑treatment with T. cordifolia was
shown to impart protection against mortality induced
by intra‑abdominal sepsis following coecal ligation in
rats and signicantly reduced mortality from induced
by Escherichia coli –induced peritonitis in mice[6]
A study by Neha rawat and Rakesh Roushan reported
that Guduchi is highly rich in anti‑oxidants. It also
has anti‑pyretic, anti‑viral, and wound healing
properties.[7]
(iii) Katu rohini– Picrorhiza kurroa‑Plantaginaceae
A study by Masood et al. documented that the plant
is considered as an important medicinal plant which
is mostly used in the traditional medicinal system
for asthma, jaundice, fever, malaria, snake bite, and
liver disorders. Different pharmacological activities
of P. kurroa include anti‑microbial, anti‑oxidant,
anti‑bacterial, anti‑mutagenic, cardio‑protective,
hepato‑protective, anti‑malarial, anti‑diabetic,
anti‑inflammatory, anti‑cancer, anti‑ulcer, and
nephro‑protective activities were recorded from this
plant[8]
A study by Krupashree et al. reported that the study
demonstrates antioxidant and protective effects
of Picrorhiza kurroa against oxidative damage of
macromolecules such as DNA, protein, and lipids.[9]
(iv) Musta– Cyperus rotundus– Cyperaceae
A review by Nagarajan et al. suggested that both
Aconitum heterophyllum and Cyperus rotundus are
reported to possess anti‑inammatory, antipyretic,
antibacterial and antidiarrheal properties, while
anti‑inammatory and antibacterial activities are
attributed to C. scariosus.[10]
(v) Vasa– Adathoda vasica– Acanthacea
A potential drug with highly used in Kasa (Cough),
Swasa (Respiratory distress/Asthma/Bronchitis) is
reviewed by Ankit Gupta and P. K. Prajapati and
reported that Highly signicant (P < 0.001) results on
Shwasakashtata (Difculty in respiration) were found
in all the test drug groups except in Vasa Ghrita,
which was only signicant (P < 0.05). The effect on
Kasa (Cough) was also highly signicant (P < 0.001)
in all groups, whereas it was insignicant (>0.10) in
the Vasa Ghrita (Medicated ghee prepared with Vasa)
group.[11]
(vi) Usage of Ginger, Turmeric, Long pepper, Clove,
Garlic, Cumin, Coriander, Cinnamon, Basil
leaves (Tulsi) in excess either along with food or
alone
(vii) Ushna jalapana (Frequent intake of hotwater)– Can
be added with Mint leaves and Coriander leaves,
Fennel, Ajwain.
Aushada– Bahya– Urdhwagata shodana
i. Nasya– Medicated Nasal drops can be instilled into
both the nostrils every day and night. Since the
pathway of disease is upper respiratory track, Nasya
can be benecial to combat the disease and to keep
the channel clear for breathing
ii. Kavala graha– Keeping the medicated oil or kashaya
(decoction) in the mouth for some time until the eyes
starts watering
This keeps the oral cavity clean, strengthens the gums,
and, most importantly, clears the mucus plugs if
adhered in the channel.
iii. Gandusha– Gargling
The procedure helps to clear the sinuses and keeps
the channel patent
iv. Swedana– Sudation
Frequent inhalation of steam with addition of
bronchodilating drugs like Vasa (Adathoda vasica),
Bharangi (Clerodendrum Serratum) depending on roga
and rogi bala.
The procedure helps to clear the airways and aids
smooth respiration.
v. Dhupana– Fumigation
Fumigating the house and surroundings periodically
with drugs like guggulu (Commiphora mukul),
Nimba (Azadirachta indica), Vacha (Acorus calamus)
The efciency and mode of action of dhoopana drugs
are documented by Shrestha et al. in their work
Dhoopana Karma: A review through Brihatrayi[12]
A study by Tillu et al. further noted the medical
benefits of both bahya and abhyantara chikitsa.
He further states that immunomodulators such as
Ashwagandha, Guduchi, Yashtimadhu, Shatavari,
and Amalaki can be provided to diseased persons to
enhance their immunity. They further recommend
clinical research of the same.[13]
Vihara
i. Avoid unnecessary gathering
ii. Maintain distance from each other
iii. Maintain isolation
iv. Avoid sleeping during the daytime
v. Avoid excessive physical activity including excessive
walking or jogging Among individuals under
observation, to combat mental stress and anxiety.
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Application of lukewarm oil on anterior fontanelle
is known to reduce anxiety
Shirodhara– A panchakarma procedure is known
to reduce mental stress and anxiety can be
performed
A good sleep.
Yogasana can be practiced for positive health:
1. Pranayama– Particularly bastrika and kapalabhaati
can be performed for 10 min each
2. Asanas like– Bhujangasana, Vajrasana, and
Padaangushtasana, can be performed for respiratory
wellness.
Ritusandhi
Ritusandhi refers to the junction of two ritus. It is said
that the disease during this period occurs because of
change in kala i.e., shifting one one ritu to another (the
last 15 days of previous ritus and initial 15 days of
successive ritu) and that the human body fails to adjust
for such changes. Hence to combat the disease during
this period, the achara (regime) and ahara (diet) during
this period should gradually change from the previous
ritu to successive ritu.
In the current scenario, since the COVID outbreak in
India started in ritusandhi kala, the diet and regime
should be followed carefully.
The diet and regime of both Shishira and Vasantha ritu
should be followed.
Shishira Ritu
Mid‑January to mid‑March (approximately) is considered
as Shishira Ritu (winter). During this season, the
environment remains cold. The strength of the person
becomes less, deposition of the Kapha Dosha and digestive
capacity remains in a higher state. Foods having
Amla (sour) as the predominant taste are preferred.
Cereals and pulses, wheat/gram our products, new
rice, corn, are advised. Ginger, Garlic, Pippali (fruits of
Piper longum), Sugarcane products, Turmeric, Clove,
Cinnamon, Cumin are to be taken in more quantity.
Vasantha Ritu
The approximate time is from mid‑March to mid‑May.
Strength of the person remains in a medium degree,
vitiation of Kapha Dosha occurs and Agni remains in
Manda state.
One should take easily digestible foods. Among cereals,
old barley, wheat, rice are preferred. Among pulses, lentil,
Mugda, and others, can be taken. Food items tasting Tikta
(bitter), Katu (pungent), and Kashaya (astringent) are to
be taken.
A study by Ravi Philip Rajkumar has identified a
potential psychoneuroimmuno modulator mechanism
for the interventions suggested by the government.
He has stated that “A potential psychoneuroimmune
mechanism was identified for five of the proposed
methods, via neurobiological mechanisms such as
modulation of monoamine function, stress axis response
and autonomic activity, as well as reduction of anxiety,
depression and perceived stress in human subjects.”[14]
Ayurveda and Public Health
Acharya Sushruta has depicted different modes of
communicable disease transmission while explaining the
treatment model for Kushta roga (type of skin disease)
in his classical treatise Sushruta Samhita.
He says through excess of all forms of contact (Prasanga),
physical contact (Gatrasamsparsat), expelled
air (Nihsvasat), eating with others in the same plate (Saha
bhojanata), sharing a bed (Sahashayyasanat), using clothes,
garlands or ornaments of infected individuals (Vastra
malaanuepanat) infectious diseases spread from person
to person.
Owing to the reference and evidencing the current
scenario, it can be said that role of Ayurveda in
maintaining Public Health is highly inuential.
The very aim of Ayurveda is treating the diseased and
Pretecting the health of the healthy
(Charaka samhita. Sutra sthana. 30:26)
i.e., Protecting the health of healthy and reducing the
ailment of diseased.
The aim of Ayurveda and Public health seems to be in
line with each other.
Integrating the age‑old practice of Ayurveda with
modern problems provides a better alternative for the
problems.
The Ayurvedic practice is not just for those who are
diseased but also for those who are healthy to protect
their health status. The iceberg phenomenon can be
understood with Shatkriya Kalas of the Ayurvedic
concept.
Ayurveda explains the stages of disease in 6 stages, i.e.,
1. Sanchaya– Stage of accumulation– This is the rst stage
of any disease where the doshas (Responsible for
disease formation) are increased in their own site.
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This can be analyzed with the aversion toward food
or activities or a feeling of uneasiness before the onset
of Vyadhi (Disease‑CoVID 19)
2. Prakopa– Stage of provocation– With the advancement
in disease, the increased doshas tends to leave its site
of origin and tries to move to other site. The stage
of vyadhi (Disease– CoVID 19) when doshas start
producing respiratory symptoms
3. Prasara– Stage of propogation– The doshas having
a tendency to leave their site of origin to site of
disease expression (Target organ) will start moving
from their site of origin. This is the stage of when
all the symptoms of vyadhi (CoVID 19) starts
exhibiting (cough, gastro‑intestinal disturbances,
Fever, Running nose, Myalgia)
4. Sthanasamshraya– Stage of localization– The vitiated
doshas starts localizing in such areas which are prone
to respective disease. The virus producing CoVID 19
is prone to producing respiratory symptoms and the
target organ is lungs. This stage can be considered
as the premonitory stage of the disease. Once the
infection has occurred the above stages may occur
simultaneously depending on the severity of infection
and susceptibility of the individual
5. Vyakta– Stage of manifestation– The doshas localized
in the target organs starts exhibiting the symptoms.
This is the visible stage of the disease. The vyadhi
(CoVID 19) is exhibited with all the signs and
symptoms in its full form
6. Bheda– Stage of complicationThe dosha vitiation will
be completed by fth stage. If the treatment is not
available at disease manifested stage, then the disease
may further aggravate to produce complications. The
vyadhi (CoVID 19) may produce renal complications
and pneumonia leading to death of the individual.
It is up to the stage of sthanasamsraya (Stage of
localization) the disease is not clear in its manifestation
and can be compared to the iceberg hidden in the water.
The stages after sthanasamsraya are perceivable to eyes
and are being treated.
The concept of prevention can be applied at each level
of kriyakala.
The primordial prevention can be applied at stage 1 and
stage 2:
The act of social distancing and preventing unnecessary
movement within or outside the unaffected countries.
The primary prevention can be applied at stage 3 and
stage 4:
Prophylacyic medications can be started in such
countries where the disease has started a slow raise.
Health education to all classes of people is the need of
the hour. Bursting the myths and wrong messages being
spread in the community should be stopped and should
be replaced with correct information. Providing adequate
specic protection measures like supply of masks, hand
sanitizers to those who are in need.
The secondary prevention can be applied at stage 4 and
stage 5:
The countries which have already developed clusters of
diseases with community transmission should accelerate
the process of disease detection and adequate treatment
for the same. The disease should be identied at stage 4
in order to prevent the community spread. The people
should be educated to the extent such that the chain
of infection is broken by their non‑participation in the
epidemiological triad.
The tertiary prevention can be applied at stage 6:
The people who are at the verge of losing life due to
CoVID 19 are to be given supportive care to prevent to
aid the process of respiration.
A study by Sanjeev Rastogi, Deep Narayan Pandey,
Ram Harsh Singh suggested disease stage‑wise
categorization of patients into unexposed asymptomatic,
exposed symptomatic, with mild symptoms and with
moderate‑to‑severe symptoms and treatment protocol
to be assigned depending on the disease stage.[15]
Conclusion
COVID 19, a new strain of virus causing mortality all
over the world, can be prevented with appropriate food
intake, hygiene, and social distancing.
The stage of the disease in the community needs to be
decided, and the administration of medicine can be done
by ascertaining the roga bala and rogi bala.
Prophylactic measures can be applied by administering
anti‑pyretic drugs like Amrita, Kirata inappropriate
and required form and dosage. Intake of Ginger, Garlic,
Cumin, Coriander, Cinnamon, Clove, and Turmeric in
excess quantity for its prevention.
Distancing one from the affected individuals is the key.
Respiratory and personal hygiene is to be followed in
order to protect oneself from the disease.
Following the recovery, the individuals should not resort
to daily routine activities until the individual regains
strength and his agni bala (digestive capacity) is normal.
Ayurveda not only aims to heal the diseased but also to
protect the health of the healthy individuals; hence, the
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S96 International Journal of Health & Allied Sciences - Volume 9, Supplement 1, 2020
measures applied for the treatment of disease should
also be followed by healthy individuals to prevent the
disease occurrence.
“PREVENTION IS BETTER THAN CURE”
Financial support and sponsorship
Nil.
Conicts of interest
There are no conicts of interest.
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... In the present era, the indescribable COVID-19 disease is emerging in the world. In December 2019 the outbreak of the Coronavirus begun in Wuhan city, China.Covid19 is the disease caused due to Novel Corona Virus2, now named as SARS CoV-2 Rastogi et al., 2020;Kirthana et al., 2020). The irst case of the COVID-19 in India was reported in Kerala State, on 30th January 2020, and was amongst the passengers from China (Stella et al., 2020). ...
... On 11 March 2020 WHO declared it as a pandemic.COVID-19 has the following symptoms: High-grade fever, Cough-Nonproductive, Breathlessness, running nose, gastrointestinal disturbances-Diarrhea/nausea, Headache. The manifestation of symptoms is seen within 2-14 days of exposure to the virus (Kirthana et al., 2020). In Ayurveda Classics, the Jwara(fever) is described as the major disease. ...
... Vyaghriharitaki, DashmoolKadha, Talisadi, Sitopaladichurnaand drugs like Ardrak(GingiberOf icinalis) (Kirthana et al., 2020), Tulsi(Oscimum Sanctum), Yashtimadhu(GlycyrrhizaGlabra), can be given (Rastogi et al., 2020). ...
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As the corona pandemic has emerged, researchers around the globe are working on finding specific treatment for it. But till date, no conclusive specific treatment has been found, and we are following the protocols with symptomatic management. Ayurveda is an ancient science of healing, with highly sophisticated literature about diseases, their pathogenesis, clinical features, and management. The evaluation of different modalities for treating COVID-19 pandemic patients is the foremost aim of the study. For review, we used the knowledge of the ancient classics and past literature regarding human treatment guidelines mentioned in Ayurveda classics, for prevention and treatment of communicable diseases, to provide appropriate direction in the prevention of COVID-19. The thorough review has been done, of literature, Samhitas(Ayurveda Classics), and research articles which were published between January and June 2020 by PubMed, Google Scholar, WHO, Ministry of AYUSH. The opinions of experts have also been referred to. As individuals with lower immunity have a higher risk of COVID-19, so the herbal Rasayana(Rejuvenating) drug, which has proven immunomodulatory activity, is also included in the given study. The Review for Ayurveda formulations, which might help in preventing the progression of COVID-19, has also been made. The Indian herbs are widely utilized in the preparation of Ayurvedic medicines or formulations or in the form of drinks to manage various respiratory disorders such as cough, cold, and flu. Hence, these drugs are formulated by using active parts of the plants, which are used for preventing and treating the COVID-19. These formulations are immunity modulators and they prevent the spread of the virus, by intruding at a different stage of virus multiplication in the infected person.
... " He highlighted Aagantuja jwara, which is produced by external/ foreign substances or germs, when discussing several forms of Jwaras. [36] Guduchyadi kwatham is a well-known Ayurvedic composition that is used by Ayurvedic doctors all across India to treat influenza and viral illnesses. In traditional Ayurvedic literature, it is used to treat Pitta and Kapha exacerbated illnesses, as well as Jwaram (fever) and gastrointestinal disorders. ...
... Several herbs including Tulsi (Ocimum sanctum) and Haldi (Curcuma longa-turmeric) used as Ayurvedic medicines are well known for their immunomodulatory properties [20][21][22][23][24]. Ayurvedic treatment has also been found to be effective in other COVID-like illnesses such as influenza [25][26][27] and chikungunya [28]. Several studies have been conducted to understand the COVID-19 pandemic and the conditions that it causes from the perspective of Ayurveda [29][30][31][32][33][34][35]. Based on these observations and the study of classical Ayurveda texts, several experts have proposed the use of Ayurveda for both prophylactic [36][37][38][39][40][41][42][43][44][45][46][47][48][49] and therapeutic purposes [34, 38-41, 43, 44, 50-58] in COVID-19. ...
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Background We report a high-risk case of a coronavirus disease 19 (COVID-19)-positive patient with comorbidities including diabetes mellitus (DM), hypertension (HTN), hypothyroidism and chronic kidney disease (CKD), treated successfully using an integrative therapy plan based on Ayurveda and Yoga, along with government-mandated compulsory modern western medicine (MWM) treatment. Recently, some evidence has been emerging on the use of Ayurveda for treatment of COVID-19. The classical texts of Ayurvedic medicine such as Charaka Samhita and Sushruta Samhita contain descriptions of pandemics of similar proportions and describe them as Janapadoddhvansa , meaning the destruction of communities, along with their causes and treatment. Case presentation The case reported herein is a 55-year-old man from Delhi, India, with confirmed (tested) COVID-19, who first took MWM for 7 days before seeking integrative therapy. The patient has comorbidities including DM, HTN, hypothyroidism and CKD and had developed symptoms including fever (which was resolved by the time integrative therapy was started), sore throat, dry cough, body aches, weakness, bad taste and smell, and heaviness in the abdomen. Based on the patient’s symptoms and comorbidities, a treatment plan including Ayurvedic medicines, Yoga protocol, dietary recommendations and lifestyle modifications was prescribed by a registered Ayurveda doctor and a Yoga consultant. The patient started experiencing improvement in all the symptoms within 2 days after starting the treatment; he reported approximately $$75\%$$ 75 % relief from the symptoms after 5 days, and almost complete relief within 9 days. Also, the blood sugar levels (both fasting blood sugar [FBS] and postprandial blood sugar [PPBS]) exhibited significant improvement after 5 days, and decreased to within the normal range within 12 days. Besides relief in symptoms, the patient’s real-time reverse transcription polymerase chain reaction (RT-PCR) test done on the 19th day returned negative results. Conclusions Integrative therapy was found to be effective in mitigating the symptoms of COVID-19 in this patient with multiple comorbidities. Moreover, a significant improvement in blood sugar levels (not under control with modern medicine) was also achieved. Integrative therapy based on the classical texts of Ayurveda and Yoga may offer a promising and scalable treatment option for COVID-19 patients. A case series or a suitably designed randomized controlled trial is needed to assess its efficacy.
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World community is facing an unprecedented pandemic of novel corona virus disease (COVID-19) caused by Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV- 2). The disease has spread globally with more than 1.43 million confirmed cases and 82,100 deaths as of April 8, 2020. Despite worldwide efforts to contain it, the pandemic is continuing to spread for want of a clinically-proven prophylaxis and therapeutic strategy. The dimensions of pandemic require an urgent harnessing of all knowledge systems available globally. Utilization of Traditional Chinese Medicine in Wuhan to treat COVID-19 cases sets the example demonstrating that traditional health care can contribute to treatment of these patients successfully. Drawing on the Ayurveda classics, contemporary scientific studies, and experiential knowledge on similar clinical settings, here we propose a pragmatic plan for intervention in India. We provide a plan for graded response, depending on the stage of infection among individuals, in a population. Notwithstanding the fact that no system of medicine has any evidence-based treatment for COVID-19 as yet, clinical interventions are required to be put in place. Therefore, pragmatic strategy proposed here for Ayurveda system of medicine requires immediate implementation. It will facilitate learning, generate evidence and shall be a way forward.
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