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Background: Earthig is a contact with earth by several means that could cause influx of electron into the body with subsequent anti-inflammatory effect, immunity enhancement, anticoagulation, rising blood oxygenation, and possible antipyretic effect. All these effects of earthing might have a substantial role in the management of patients with COVID-19 infection without deleterious side effects of ordinary medications. Objective: to investigate the role of earthing in treatment and prevention of COVID-19 infection. Design: Observational study Setting: University of Basrah, College of Medicine, Iraq. Patients: The study included 59 cases with COVID-19 infection. Interventions: All patients conducted earthing through direct contact with earth or connecting apparatus for about 15 min-3 hours/day. Measurements and Main Results: The diagnosis was confirmed by PCR test with or without chest CT-scan. There was spectacular response in a severely ill patient who was unable to speak due to dyspnea with blood oxygen level 38% on continuous oxygen supply. On the second day of three hours daily earthing, his oxygen level raised to 95% with oxygen supply and 77% without oxygen supply. After 1-3 days of earthing, most patients revealed improvement of the following symptoms: fever, dyspnea, cough, weakness, headache, chest pain, taste and smell sense loss, anorexia, and body pain. Six people were in contact with COVID-19 patients that had performed preventive earthing. They contracted mild or short-lived illness although their household were severely affected. Conclusions: The outcome of patients with COVID-19 who had performed regular and sufficient earthing showing significant curing or preventive effects that more studies on larger sample size are advocated.
Prevention and treatment of COVID-19 infection by earthing
Haider Abdul-Lateef Mousa
MB ChB, MSc, Assistant professor
University of Basrah, College of Medicine, Iraq
The address of correspondence:
Dr. Haider Abdul-Lateef Mousa, MB ChB, MSc
PO Box 601, Post Code 42001, Ashar, Basrah, Iraq.
Telephone: 009647808595467
Keywords: COVID-19; COVID-19 treatment; COVID-19 prevention; Earthing; Grounding;
Cytokine storm
Word Count: 3,206
The author has no conflict of interest to declare.
Background: Earthig is a contact with earth by several means that could cause influx of
electron into the body with subsequent anti-inflammatory effect, immunity enhancement,
anticoagulation, rising blood oxygenation, and possible antipyretic effect. All these effects of
earthing might have a substantial role in the management of patients with COVID-19
infection without deleterious side effects of ordinary medications.
Objective: to investigate the role of earthing in treatment and prevention of COVID-19
Design: Observational study
Setting: University of Basrah, College of Medicine, Iraq.
Patients: The study included 59 cases with COVID-19 infection.
Interventions: All patients conducted earthing through direct contact with earth or
connecting apparatus for about 15 min-3 hours/day.
Measurements and Main Results: The diagnosis was confirmed by PCR test with or
without chest CT-scan. There was spectacular response in a severely ill patient who was
unable to speak due to dyspnea with blood oxygen level 38% on continuous oxygen supply.
On the second day of three hours daily earthing, his oxygen level raised to 95% with oxygen
supply and 77% without oxygen supply. After 1-3 days of earthing, most patients revealed
improvement of the following symptoms: fever, dyspnea, cough, weakness, headache, chest
pain, taste and smell sense loss, anorexia, and body pain. Six people were in contact with
COVID-19 patients that had performed preventive earthing. They contracted mild or short-
lived illness although their household were severely affected.
Conclusions: The outcome of patients with COVID-19 who had performed regular and
sufficient earthing showing significant curing or preventive effects that more studies on larger
sample size are advocated.
There is a lot of controversy in regard to medications for COVID-19 infection such as
hydroxychloroquine, steroid, and convalescent plasma. Vaccine development and production
is still ongoing without a significant breakthrough. At the current time, there is no approved
medication for COVID-19 [1,2,3]. There are many modalities of treatment although none of
them prevent complications and death. In regard to steroid use, there is no conclusive
evidence about safety. It was used as anti-inflammatory agent. Steroid administration in
patients with COVID-19 was associated with increased death rate, secondary bacterial
infections and complications such as, increased blood sugar, psychosis, delayed viral
clearance and raised mutation rate of the virus [4]. On the contrary, earthing has anti-
inflammatory effect and enhances immunity as well [5,6]. Studies on the efficacy of
chloroquine and hydroxychloroquine are inconclusive, that further studies are justified [7].
Several studies have demonstrated efficacy of certain antiviral agents to treat COVID‐19.
Remdesivir was found to be active in several COVID‐19 patients, preclinical studies of
SARS‐CoV and MERS‐CoV infections, and in mice by acting on the viral polymerase with
subsequent premature termination of viral replication [8,9,10].
The reason for death in COVID-19 infection is suspected to be the “cytokine storm”.
Cytokine storm is an activation cascade of auto-amplifying cytokine production as a result of
dysregulated host immune response to different triggers among them are infections [11]. The
proinflammatory cytokine, Interleukin-6, is a major mediator in the acute inflammatory
response and with cytokine storm. It was reported to be elevated above the normal range in
patients with COVID-19 [12,13].
The earth’s surface has unlimited and constantly regenerated supply of free electrons. It is
electrically conductive, and its electron supply is renewed by the global atmospheric
electrical circuit [14,15]. It has been suggested that free or mobile electrons from the earth
could improve chronic inflammation by favoring as natural antioxidants [16]. The effect is
proposed by free electrons influx that absorbed into the body through direct contact with the
earth probably neutralizes free radicals and, that way, minimizes acute and chronic
inflammatory events [5].
This study was carried out to investigate the role of earthing in prevention and treatment of
COVID-19 infection. To the best of my knowledge, this is the first study that assess the
clinical outcome of COVID-19 infection after application of grounding.
Patients and Methods
The study was conducted at Basra province during the period of May 28, 2020 to November
5, 2020. An observational study that carried out on 59 patients with confirmed COVID-19
infection. The diagnosis was confirmed by positive PCR results, with or without chest CT-
scan. The research protocol was reviewed and approved by the Ethics Committee of the
College of Medicine, University of Basrah, Iraq, under the Institutional Review Board at
session number 15, 2020. Consent to participate was obtained from each patient or his or her
guardian. Approval to conduct the study from Ministry of Health has not been obtained yet
and it is still in processing state, therefore, the study included only cases who were managed
outside hospitals. There were many severely ill patients who had requested discharge from
hospitals upon their responsibility.
The patients were instructed to connect with earth by several feasible methods. The same
instruction were also provided for some people who were in contact with patients as
preventive measure. Earthing was carried out by walking bared feet on non-insulated ground,
preferably wet type, or insertion of conductive metallic bar in the earth that were connected
with conductive wire and plate to patient’s body. The body could be grounded by means of a
conductive patch or earthing sleep system on a bed’s mattress that is connected to a
building’s earthing system. Contact with green plants, where their roots directly inserted into
the earth, is also regarded as a good earthing resource. House floors covered with ordinary
construction cement, tiles, bricks, ceramic, granite, and marble are conductive, while wood,
plastic, or carpet are regarded as non-conductive. It is recommended to connect the body with
the earth directly or naturally, away from electrical interference from the building’s systems
or from electrical apparatus [6].
Questionnaires were provided for patients that included symptoms, temperature, Oxygen
blood level if available, method and duration of earth connection, subjective feeling after
earthing, and progress after earth connection during next few days, Supplement 1. Laboratory
investigations and chest CT- scan were also recorded for some patients. The progress of
disease was scrutinized on phone call follow up or direct patient visit.
After earth conducting, the patients were instructed to record the signs of improvement or
non-improvement such as temperature, Oxygen saturation, and other symptoms relief.
The patients were on medical treatment protocol according to severity of illness except 14
cases who were not taking any medicine when starting earthing. They were instructed to not
suspend any medication during grounding application and consult their physicians as usual.
The following medications were administered according to patient’s condition: Oxygen
supply, i.v. fluid, heparin, convalescent plasma, paracetamol, acetylsalicylic acid,
azithromycin, ceftriaxone, avifavir, oseltamivir, prednisolone, dexamethasone, vitamin C,
Zinc, and vitamin D.
Fifty-nine patients were studied. The age of patients range 32-88 years (mean 53 years). The
illness was severe in 20 cases, moderate in 28 cases, and mild in 11 cases, Figure 1. Six
patients with confirmed infection (age: 32, 58, 59, 47, 49, 38 yr.) experienced mild symptoms
or short duration illness after conducting regular earthing before contracting the illness as
preventive measure, Table 1. Of whom, three patients experienced mild fever, two patients
had productive cough, and one patient had body pain and loss of taste and smell sensation.
The most striking outcome was observed in 56 year old patient. He was admitted to hospital
because of dyspnea, cough, fever, and blood Oxygen level 74%. PCR for COVID-19 was
positive. The patient was given continuous Oxygen supply, antiviral Avifavir, i.v. fluid,
Prednisolone, Azithromycin, i.v. Ceftriaxone, and convalescent plasma infusion. There was
no improvement during staying in the hospital for one week. The patient requested discharge
from the hospital upon his responsibility. At home the patient had continued on prescribed
medical treatment and continuous Oxygen supply. By the end of second week of acquiring
the infection, he was extremely deteriorated. He was unable to speak any word because of
severe dyspnea. The Oxygen level on oximeter measurement while the patient on continuous
Oxygen administration was 38%. Chest CT scan showed more than 70% involvement of
lungs. As the patient could not sit or leave his bed to perform earth contact, the patient’s son
was instructed to perform earthing to the patient by means of wire and plate that connected
him to ground. Substantial improvement was noticed on the second day after two sessions
earthing (3 hr/day). Oxygen level increased to 95% while the patient on Oxygen supply and
77% without Oxygen administration. Full recovery established after three days on 3 hr daily
earthing that he was just complaining from weakness and exhaustion for further one week. A
65-year old woman was severely dyspneic who admitted to hospital for oxygen supply and
discharged for continuous Oxygen therapy at home. She was also improved after 40 minutes
earthing session after which she required intermittent Oxygen supply. Forty-three year old
man who was admitted twice in the hospital for Oxygen supply. He conducted earthing for 30
minutes daily at home after discharge from the hospital. He acquired complete improvement
after three days of earthing. A 68-year old man with severe illness, who had hypertension
and diabetes mellitus. He died in the hospital as a result of cerebrovascular accident (CVA)
that was demonstrated as ischemic stroke on brain CT- scan. He was on medical treatment in
addition to implementation of twice brief earthing for 15 min/day on every other day which
was commenced on the 12th day of illness. Two women with severe illness were not
improved on full protocol of medications and earthing instruction. Afterward, they were lost
follow up. The other 14 patients with severe illness were improved on regular medications
and sufficient earthing without any complications. Another 73 year aged patient with severe
illness who was complaining from critical dyspnea. He was on continuous Oxygen supply
and prescribed medications. He refused applying earthing apparatus to his body. He died on
the next day as a result extreme hypoxemia while he was at the second week of illness. Sixty-
seven year aged diabetic patient at 3rd week of moderate illness who was complaining from
continuous fever, body pain, anorexia, and loss smell and taste sensation. A significant
improvement on the second day by approximately 2 hr daily grounding. There was settlement
of fever, and recovery of smell and taste sensations. All other patients with moderate or mild
illness were improved significantly within one to three days after 15 min. -3 hours daily
earthing. Complete recovery in patients who started early earthing (within the first five days
of the illness) ranged from 1-16 days (mean 8 days), Table 1. The following symptoms were
recorded to be improved after earthing: fever, dyspnea, cough, sore throat, weakness,
headache, chest pain, taste and smell sense loss, anorexia, and body pain. Nine patients with
risks factors were also improved after earthing, Table 2.
The outcome of most patients in the present study revealed significant improvement after one
to three days of earthing. Nine patients with risk factors were improved on earthing
procedure. Moreover, 17 severely affected patients out of 20 with or without risk factors were
improved following earthing as well. It is well known that an overwhelming inflammatory
response is the cause of human deaths from influenza infections [17]. Severe acute
respiratory syndrome COVID-19-induced infection can be associated with a coagulopathy,
findings concordance with infection-induced inflammatory changes as noticed in patients
with disseminated intravascular coagulopathy [18]. Best way to avoid the suppression of anti-
viral immune response is to choose selective instead of broad immunosuppressive drugs.
Corticosteroids and other immunosuppressive therapies have anti-inflammatory effect
although they hamper the immune system. On the other hand, anticoagulation by
acetylsalicylic acid might enhance metabolic acidosis which could deteriorate patient’s
condition who has respiratory acidosis. Earthing has revealed anti-inflammatory effects [5]
and improvements in the immune response [19] and both effects have been shown to be
mandatory for influenza treatment [6]. In addition, earthing was shown to promote immune
response following vaccination by increasing gamma globulin level [19]. Connection with
earth has also been shown to reduce red blood cells (RBCs) aggregation, and blood
coagulation by increasing the zeta potential of RBCs. The zeta potential is a parameter that
indicates the number of electrons on RBC surface. A greater number of zeta potential is
associated with a higher ability of the RBCs to repel each other. Subsequently, the higher
surface RBC negative charge is, the blood has less tendency to coagulate. Grounding has
been demonstrated to enhance the surface negative charge on RBCs and thus decreasing
blood viscosity and clumping [20,21]. Hypoxemia is another major cause of mortality in
patients with COVID-19 infection. A Randomized controlled trial study revealed that
earthing had caused decreased blood oxygenation during 40 minutes grounding, followed by
a dramatic increase in blood oxygen level after ungrounding [22]. Therefore, earthing could
improve blood oxygenation significantly in COVID-19 patients with hypoxemia. From a
historical point of view, American Indians have had a faith in the healing ability of the earth.
They have a tradition to bury patients from all types of illnesses in the earth up to their necks
for some hours. A mud bath is valuable in producing rheumatic pain or joints pain relief
caused by injuries, while mud packs have beneficial effects in fever reduction, treatment of
influenza, measles, and scarlet fever [23]. People in rural areas with predominant earth or
green plants contact may obtain prevention from COVID-19 infection that might be
explained by lower number of cases in rural than cities areas. Furthermore, the high incidence
rate of CIVID-19 in certain cities in developed world might be related to character of the
houses floor which are made from non-conductive materials such as woods, marble,
porcelain, ceramic or plastic. Most people in the cities are used to wear insulated shoes
without earth contact. The detachment from earth might lead to accumulation of positive
body charges or free radicles that could interfere with normal immune response and the cells
of the immune system that has to be investigated by further studies. Grounding might convert
unregulated cascade of host immune response into a regulated one that prevent cytokine
storm and death.
Therefore, the anti-inflammatory, anticoagulation, immunity enhancement, blood
oxygenation promotion, and fever reducing effects of earthing could have vital role in
COVID-19 infection cure and prevention. The healing effects of earthing on COVID-19
infection deserve extensive investigations. It might have a major impact globally. It is a cost-
free treatment that could save thousands of lives. It could conserve a significant budget that
spent for medications, vaccines and other more healthcare resources as well.
The limitations of the present study were small sample size, the study carried out on non-
hospitalized patients, many patients were on usual treatments, and there was no control group
without earthing for outcome comparison. Further studies are required that involve large
sample size, hospitalized patients, and more patients with severe illness.
Earthing or grounding might have significant impact in the management of patients with
COVID-19. The main complications of the illness are hypoxemia, coagulopathy,
inflammation, and immune defect which endanger the patient’s life. All these complications
could be relieved by earthing without the deleterious side effects of the drugs and without
cost as well. It is advised to perform sufficient and regular earthing for at least 40 minutes
daily for prevention or treatment of COVID-19 infection. Earthing could be applied at any
stage of the illness although earlier is better. It is more effective when conducted on wet
muddy earth type. It might be effective for other respiratory viral infections such as influenza.
Even under the circumstances of vaccine availability, it could be employed after viral
mutation or future new pandemic emergence that the manufactured vaccines cannot work
anymore. In addition, vaccines demand prolong time for development and continuous
revision in case of viral mutation whereas resistance to antiviral medications might be
developed at any stage of the pandemic.
It is recommended to apply earthing as adjuvant to current medical treatment protocol and
preventive measure for COVID-19 infection though not replacing the approved medications
or prospective vaccines in management or prevention of the illness.
After searching the electronic databases, no previous study is found that investigates the role
of earthing in prevention and treatment COVID-19 infection. For the first time, the current
investigator (Mousa 2016, Mousa 2017) has recommended earthing as a mean for prevention
and treatment of respiratory viral infections [6,17].
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option for the COVID‐19. Travel Med Infect Dis 2020; 101615.
9. Agostini ML, Andres EL, Sims AC et al. Coronavirus susceptibility to the antiviral
remdesivir (GS‐5734) is mediated by the viral polymerase and the proofreading
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Figure legend
Figure 1. The outcome of 59 patients with COVID-19 infection. Flowchart showing the
outcome of 59 patients with COVID-19 infection after conducting earthing procedure.
Twenty patients had severe illness of whom 17 got improvement without any complications.
One patient died who did not perform adequate earthing. Two patients had lost follow up.
The other 39 patients with moderate and mild illness acquired complete recovery after
Figure 1. The outcome of 59 patients with COVID-19 infection.
Severe illness 20
Moderate illness 28
Mild illness 11
59 patients conducted earthing
Improved 17
Lost follow
up 2
Died 1 (Brief
Improved 28
Table 1. Duration of illness in patients who performed prophylactic or early earthing within the first five
days of disease.
Age/Sex Complaints Earthing duration Illness Duration/day
*32 F Fever ½ hr/day for 7 days 5
*58 M Fever Prophylaxis 1 hr/day for 35 days 1
*59 M Productive cough Prophylaxis 2 hr/day for 60 days 14
*47 F Fever Routine daily bared feet walking 2
*49 M Productive cough, runny nose Routine daily bared feet walking 15
*38 M Body pain, loss of taste & smell sensation Prophylaxis 15 min daily bared feet walking 4
42 F Body pain, headache weakness, 3 hr/day for 12 days 16
anorexia, sore throat
45 M Headache, weakness ½-3 hr/day for 10 days 12
61 F Fever, body pain 1 hr/day for 5 days 7
45 M Fever, headache, body pain, anorexia, 1 hr/day for 4 days 6
sore throat
50 F Fever, headache, cough 45 min/day for 3 days 7
40 F Fever, chest pain, cough, dyspnea, weakness 2 hr/day for 10 days 12
67 F Fever, headache, runny nose, loss of smell 2 hr/day for 11 days 10
and taste sensation
41 F Fever, dyspnea, sore throat, body pain ½- 1hr/day for 9 days 13
57 M Fever, weakness 1hr/day for 3 days 5
85 F Fever, body pain 40 min/day for 3 days 6
88 M Fever 40 min/day for 3 days 4
35 M Fever, headache, body pain, weakness 40 min/day for 2 days 7
55 F Fever, dyspnea, weakness 3-4 hr /day for 3 days 6
65 F Dyspnea required oxygen supply 40 min/day for 3 days 10
43 M Dyspnea required oxygen supply ½ hr/day for 3 days 9
61 F Cough, dyspnea, loss of smell and 20 min/day for 7 days 12
taste sensation, weakness
*They were implementing prophylactic earthing. Mean: 8 Days
Table 2. The outcome of nine patients with risk factors after application of earthing.
Age Sex Symptoms and signs (Risk factors) Earthig Outcome
56 M Dyspnea, (severe illness, blood Oxygen 38%, 3 hr./day On 2nd day, dyspnea improved, blood Oxygen increased up to 95%
Lung CT-scan involvement > 70%)
67 M Fever, body pain, anorexia, loss of smell and 2 hr./day On 2nd day, fever settlement, recovery of
taste sensations (Diabetes mellitus) smell and taste sensations, and appetite improvement
32 F Fever (asthmatic on prednisolone maintenance ½ hr./day Immediate fever reduction after earthing, complete
10 mg /day) recovery within five days
85 F Fever, headache, (old age) 40 min./day Recovery from all symptoms after six days
88 M Fever and weakness (old age) 40 min./day Recovery after four days
75 F Fever, headache, runny nose, loss of smell 1 hr./day Improve all symptoms after three days except intermittent
and taste (diabetes, hypertension, old age) mild fever.
68 M Five days of high fever, weakness, body pain 1 hr./day Fever subside after one session earthing
(severe illness)
65 F Fever, dyspnea, cough, required hospitalization 40 min/day Reduced oxygen supply into intermittent one after one session
(severe illness required continuous Oxygen supply) earthing
43 M Dyspnea, cough, fever (severe illness required ½ hr./day Improved after three days that Oxygen supply was not
intermittent Oxygen supply and hospitalization) required any more
... The importance of moistening the skin and the surface of the ground outdoors to obtain good biological grounding has been highlighted by Sokal & Sokal [18]. With regard to recovery from COVID-19, Mousa [10] reports that biological grounding has the greatest efficacy when undertaken on "wet muddy earth". ...
... Improved pain relief and reduced inflammation resultant from biological grounding after exercise were additionally reported for grounded versus sham-grounded testsubjects in research by others [54,55]. Increased pain relief has also been reported in COVID-19 patients after grounding [10]. ...
... Reducing exposure to air pollution is the most effective way to preclude the onset and progression of respiratory diseases [69], and reduces risk of neurodegenerative disease and all-cause mortality [70]. Improved electromagnetic hygiene measures can help reduce the incidence of diseases [11,12,38], including SARS-CoV-2 [10,60]. ...
Full-text available
There are a growing number of studies investigating how grounding (earthing) the body may benefit biological performance and aid the treatment of non-communicable diseases. Research also indicates how biological grounding initiatives can sometimes be compromised, or inappropriate, and the need to take additional factors into account as potential contributory factors, or confounders, to expected results. It is proposed that expanding electromagnetic hygiene measures beyond biological grounding alone may help reduce spread of communicable diseases, incidence of respiratory conditions, neurodegenerative disease and all-cause mortality. Identifying potential synergies that exist could enable multilevel interventions to further increase the efficacy of measures. It is hoped that this review will help act as a catalyst to inspire and inform multi-disciplinary research within these topic areas, best practices and policies to help drive medical innovation, reduce health burdens, improve bioelectromagnetic-based therapies, and influence the general design of the built environment and next-generation technologies.
... Dr. Haider Abdul-Lateef Mousa performed an observational study to examine the effects of grounding on 71 Covid-19 subjects [12]. Grounding was done either in nature or via a device that connects to the ground via an electric outlet. ...
... Sixty-nine of these subjects improved following grounding for 15 min to 6 h per day, while 2 people did not survive. Improvements included a reduction of dyspnea and fever and improved blood oxygen levels, among others [12]. This preliminary study supports previous reports suggesting that grounding, possibly via its anti-inflammatory effect and increased pH in the respiratory tract, may be beneficial against Covid-19 [13,14]. ...
... In 28 with moderate illness, all improved; and in 11 with mild illness, all improved and no deaths were reported. Mousa concluded that grounding demonstrated significant preventative as well as curative aspects in the treatment of Covid-19 [ 12]. ...
Full-text available
Grounding or earthing could be the anti-inflammatory antidote for modern man. It is one of the greatest kept secrets when it comes to our health and aliveness and only a small part of the scientific community really understands the concept. Once health professionals and others realize that grounding is especially important in preventing inflammatory illness, an incredible effect on public health will be realized. The breath of validation from previous published data and real-life testimonials is a testimony of the earth’s dramatic impact on healing the human body. Health information is constantly changing as a result of new research in various approaches to treating a multitude of inflammatory conditions. Sometimes, even with the most relevant published data, it is difficult to choose which advice is most conducive for healing. For example, it has been noted that perhaps one-third of the medical literature could be fraudulent.. Understanding absolute versus relative risk can also be confusing even for health professionals. And when data is reported in relative risk, only a fraction of the real science is revealed. However, one small established fact that conveys universal agreement is the simple correlation that inflammation is the root cause of almost all diseases!
In the current issue of the Biomedical Journal a special section introduces the influence earthing (or lack thereof) has on the human body. A variety of enlightening articles elaborate how electromagnetic hygiene involving earthing may lower the occurrence of various diseases, reduce inflammation, improve sleep and help maintain a well-functioning circadian rhythm. Another article has a closer look at the connection between sunspot extrema and pandemics, and the relief grounding may exert on the main complications encountered in COVID-19 infection. This issue furthermore contains articles about the principles and safety of COVID-19 mRNA vaccines, the use of lidocaine against the cytokine storm triggered by SARS-CoV-2, and hypocalcemia as predictive marker in COVID-19. The reader learns about two miRNAs playing a role in colorectal cancer, diffusion characteristics of cerebrospinal fluid, and an approach of rotational radiography leading to a lower radiation exposure. The final articles present the use of dynamic arthroscopy to refine diagnosis of the origin of shoulder pain, the application of traditional Chinese medicine in analysis of chronic kidney disease, and an exchange concerning neuroimaging abnormalities in pediatric COVID-19 cases.
Full-text available
The research on grounding or earthing summarized here is providing valuable clues about why chronic and autoimmune diseases are rampant, simple and reliable help for those with these health issues, and promising paths forward. During the period when this research was getting started, approximately 2000 to the present, scientists from around the world were establishing connections between inflammation and virtually all chronic diseases (Table I) using the c-reactive protein assay developed by Ridker and his colleagues at Harvard Medical School. This article reviews Earthing, a safe therapy that optimizes (balances) each person’s unique physiological functions; and that provides relief from the major diseases of the aging population; and that may slow the aging process itself. This statement is made because of the recognition that cumulative damage by reactive oxygen species (ROS), sometimes referred to as free radicals, is one of the most widely studied theories of the cause of aging. Because the continuous semiconducting fabric of the body reaches into every part of the body, including the interiors of all cells and their nuclei, mobile electrons in the grounded or earthed person are thought to be capable of rapidly neutralizing ROS produced by oxidative metabolism taking place in every cell and tissue.
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Severe acute respiratory syndrome coronavirus (SARS‐CoV)‐2, a novel coronavirus from the same family as SARS‐CoV and Middle East respiratory syndrome coronavirus, has spread worldwide leading the World Health Organization to declare a pandemic. The disease caused by SARS‐CoV‐2, coronavirus disease 2019 (COVID‐19), presents flu‐like symptoms which can become serious in high‐risk individuals. Here we provide an overview of the known clinical features of and treatment options for COVID‐19. We carried out a systematic literature search using the main online databases (PubMed, Google Scholar, MEDLINE, UpToDate, Embase and Web of Science) with the following keywords: ‘COVID‐19’, ‘2019‐nCoV’, ‘coronavirus’ and ‘SARS‐CoV‐2’. We included publications from 1 January 2019 to 3 April 2020 which focused on clinical features and treatments. We found that infection is transmitted from human to human and through contact with contaminated environmental surfaces. Hand hygiene is fundamental to prevent contamination. Wearing personal protective equipment is recommended in specific environments. The main symptoms of COVID‐19 are fever, cough, fatigue, slight dyspnoea, sore throat, headache, conjunctivitis and gastrointestinal issues. Real‐time PCR is used as a diagnostic tool using nasal swab, tracheal aspirate or bronchoalveolar lavage samples. Computed tomography findings are important for both diagnosis and follow‐up. To date, there is no evidence of any effective treatment for COVID‐19. The main therapies being used to treat the disease are antiviral drugs, chloroquine/hydroxychloroquine and respiratory therapy. In conclusion, although many therapies have been proposed, quarantine is the only intervention that appears to be effective in decreasing the contagion rate. Specifically designed randomized clinical trials are needed to determine the most appropriate evidence‐based treatment modality. Abstract
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Rapid diagnostics, vaccines and therapeutics are important interventions for the management of the 2019 novel coronavirus (2019-nCoV) outbreak. It is timely to systematically review the potential of these interventions, including those for Middle East respiratory syndrome-Coronavirus (MERS-CoV) and severe acute respiratory syndrome (SARS)-CoV, to guide policymakers globally on their prioritization of resources for research and development. A systematic search was carried out in three major electronic databases (PubMed, Embase and Cochrane Library) to identify published studies in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Supplementary strategies through Google Search and personal communications were used. A total of 27 studies fulfilled the criteria for review. Several laboratory protocols for confirmation of suspected 2019-nCoV cases using real-time reverse transcription polymerase chain reaction (RT-PCR) have been published. A commercial RT-PCR kit developed by the Beijing Genomic Institute is currently widely used in China and likely in Asia. However, serological assays as well as point-of-care testing kits have not been developed but are likely in the near future. Several vaccine candidates are in the pipeline. The likely earliest Phase 1 vaccine trial is a synthetic DNA-based candidate. A number of novel compounds as well as therapeutics licensed for other conditions appear to have in vitro efficacy against the 2019-nCoV. Some are being tested in clinical trials against MERS-CoV and SARS-CoV, while others have been listed for clinical trials against 2019-nCoV. However, there are currently no effective specific antivirals or drug combinations supported by high-level evidence.
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Novel Coronavirus (2019-nCoV) is an emerging pathogen that was first identified in Wuhan, China in late December 2019. This virus is responsible for the ongoing outbreak that causes severe respiratory illness and pneumonia-like infection in humans. Due to the increasing number of cases in China and outside China, the WHO declared coronavirus as a global health emergency. Nearly 35,000 cases were reported and at least 24 other countries or territories have reported coronavirus cases as early on as February. Inter-human transmission was reported in a few countries, including the United States. Neither an effective anti-viral nor a vaccine is currently available to treat this infection. As the virus is a newly emerging pathogen, many questions remain unanswered regarding the virus’s reservoirs, pathogenesis, transmissibility, and much more is unknown. The collaborative efforts of researchers are needed to fill the knowledge gaps about this new virus, to develop the proper diagnostic tools, and effective treatment to combat this infection. Recent advancements in plant biotechnology proved that plants have the ability to produce vaccines or biopharmaceuticals rapidly in a short time. In this review, the outbreak of 2019-nCoV in China, the need for rapid vaccine development, and the potential of a plant system for biopharmaceutical development are discussed.
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Middle East respiratory syndrome coronavirus (MERS-CoV) is the causative agent of a severe respiratory disease associated with more than 2468 human infections and over 851 deaths in 27 countries since 2012. There are no approved treatments for MERS-CoV infection although a combination of lopinavir, ritonavir and interferon beta (LPV/RTV-IFNb) is currently being evaluated in humans in the Kingdom of Saudi Arabia. Here, we show that remdesivir (RDV) and IFNb have superior antiviral activity to LPV and RTV in vitro. In mice, both prophylactic and therapeutic RDV improve pulmonary function and reduce lung viral loads and severe lung pathology. In contrast, prophylactic LPV/RTV-IFNb slightly reduces viral loads without impacting other disease parameters. Therapeutic LPV/RTV-IFNb improves pulmonary function but does not reduce virus replication or severe lung pathology. Thus, we provide in vivo evidence of the potential for RDV to treat MERS-CoV infections. Remdesivir (RDV) is a broad-spectrum antiviral drug with activity against MERS coronavirus, but in vivo efficacy has not been evaluated. Here, the authors show that RDV has superior anti-MERS activity in vitro and in vivo compared to combination therapy with lopinavir, ritonavir and interferon beta and reduces severe lung pathology.
Currently, there is no approved therapy for COVID-19. The World Health Organization therefore endorse supportive care only. However, frontline clinicians and researchers have been experimenting with several virus-based and host-based therapeutics since the outbreak in China. China's National Health Commission has issued the first COVID-19 Treatment Guideline with therapy suggestions (7th edition attached) which inspired following clinical studies worldwide. Major therapeutics are evaluated in this review. Key evidence from in vitro researches, animal models and clinical researches in emerging coronaviruses are examined. Antiviral therapies remdesivir, lopinavir/ritonavir and umifenovir, if considered, could be initiated before the peak of viral replication for optimal outcomes. Ribavirin may be beneficial as an add-on therapy and is ineffective as a monotherapy. Corticosteroids use should be limited to indicating comorbidities. IVIG is not recommended due to lack of data in COVID-19. Xuebijing may benefit patients with complications of bacterial pneumonia or sepsis. The efficacy of interferon is unclear due to conflicting outcomes in coronavirus studies. Chloroquine and hydroxychloroquine have shown in vitro inhibition of SARS-CoV-2, and the studies on clinical efficacy and whether the benefits outweigh the risk of dysrhythmias remain inconclusive. For patients who developed cytokine release syndrome, interleukin-6 inhibitors may be beneficial.
The SARS-CoV-2 coronavirus (COVID-19) induced infection can be associated with a coagulopathy, findings consistent with infection induced inflammatory changes as observed in patients with disseminated intravascular coagulopathy (DIC). The lack of prior immunity to COVID-19 has resulted in large numbers of infected patients across the globe and uncertainty regarding management of the complications that arise in the course of this viral illness. The lungs are the target organ for COVID-19; patients develop acute lung injury which can progress to respiratory failure, although multiorgan failure can also occur. The initial coagulopathy of COVID-19 presents with prominent elevation of D-dimer and fibrin/fibrinogen degradation products, while abnormalities in prothrombin time, partial thromboplastin time, and platelet counts are relatively uncommon in initial presentations. Coagulation test screening, including the measurement of D-dimer and fibrinogen levels, is suggested. COVID-19 associated coagulopathy should be managed as it would be for any critically ill patient, following the established practice of using thromboembolic prophylaxis for critically ill hospitalized patients, and standard supportive care measures for those with sepsis-induced coagulopathy or DIC. Although D-dimer, sepsis physiology, and consumptive coagulopathy are indicators of mortality, current data do not suggest the use of full intensity anticoagulation doses unless otherwise clinically indicated. Even though there is an associated coagulopathy with COVID-19, bleeding manifestations, even in those with DIC, have not been reported. If bleeding does occur, standard guidelines for the management of DIC and bleeding should be followed.
Importance Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. Risk factors for the clinical outcomes of COVID-19 pneumonia have not yet been well delineated. Objective To describe the clinical characteristics and outcomes in patients with COVID-19 pneumonia who developed acute respiratory distress syndrome (ARDS) or died. Design, Setting, and Participants Retrospective cohort study of 201 patients with confirmed COVID-19 pneumonia admitted to Wuhan Jinyintan Hospital in China between December 25, 2019, and January 26, 2020. The final date of follow-up was February 13, 2020. Exposures Confirmed COVID-19 pneumonia. Main Outcomes and Measures The development of ARDS and death. Epidemiological, demographic, clinical, laboratory, management, treatment, and outcome data were also collected and analyzed. Results Of 201 patients, the median age was 51 years (interquartile range, 43-60 years), and 128 (63.7%) patients were men. Eighty-four patients (41.8%) developed ARDS, and of those 84 patients, 44 (52.4%) died. In those who developed ARDS, compared with those who did not, more patients presented with dyspnea (50 of 84 [59.5%] patients and 30 of 117 [25.6%] patients, respectively [difference, 33.9%; 95% CI, 19.7%-48.1%]) and had comorbidities such as hypertension (23 of 84 [27.4%] patients and 16 of 117 [13.7%] patients, respectively [difference, 13.7%; 95% CI, 1.3%-26.1%]) and diabetes (16 of 84 [19.0%] patients and 6 of 117 [5.1%] patients, respectively [difference, 13.9%; 95% CI, 3.6%-24.2%]). In bivariate Cox regression analysis, risk factors associated with the development of ARDS and progression from ARDS to death included older age (hazard ratio [HR], 3.26; 95% CI 2.08-5.11; and HR, 6.17; 95% CI, 3.26-11.67, respectively), neutrophilia (HR, 1.14; 95% CI, 1.09-1.19; and HR, 1.08; 95% CI, 1.01-1.17, respectively), and organ and coagulation dysfunction (eg, higher lactate dehydrogenase [HR, 1.61; 95% CI, 1.44-1.79; and HR, 1.30; 95% CI, 1.11-1.52, respectively] and D-dimer [HR, 1.03; 95% CI, 1.01-1.04; and HR, 1.02; 95% CI, 1.01-1.04, respectively]). High fever (≥39 °C) was associated with higher likelihood of ARDS development (HR, 1.77; 95% CI, 1.11-2.84) and lower likelihood of death (HR, 0.41; 95% CI, 0.21-0.82). Among patients with ARDS, treatment with methylprednisolone decreased the risk of death (HR, 0.38; 95% CI, 0.20-0.72). Conclusions and Relevance Older age was associated with greater risk of development of ARDS and death likely owing to less rigorous immune response. Although high fever was associated with the development of ARDS, it was also associated with better outcomes among patients with ARDS. Moreover, treatment with methylprednisolone may be beneficial for patients who develop ARDS.
Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/L (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/L could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.