Effect of naturopathy and yoga therapies as an adjuvant to conventional medicine in the management of COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) is the infectious disease affecting many countries globally. This case study was performed to evaluate the feasibility, safety, and effect of integrated naturopathy and yoga therapies (INYT) (i.e., conventional medicine + yoga and naturopathy) on the number of hospital stay and symptom score in a patient with COVID-19. A 39-year-old married male was diagnosed with COVID-19 on March 27, 2020. During the hospital stay, the patient underwent INYT. Adherence to INYT was good and the patient did not report any serious adverse effects during the intervention period. The length of hospital stay was 11 days. Which is less than the median hospital stay observed in previous studies and the symptom score reduced from 6 (day 1) to 0 (day 6). Thus, INYT might reduce the length of the hospital stay with symptoms and active infection and also is feasible and safe in a patient with COVID-19.

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© 2021 Yoga Mīmāsā | Published by Wolters Kluwer - Medknow 75
E󰘯ect of naturopathy and yoga therapies as an adjuvant
to conventional medicine in the management of
COVID-19
A. Mooventhan1, N. Manavalan2, Y. Deepa3, N. Mangaiarkarasi4, K. Kahlilsubramanian5, L. Nivethitha2
1Department of Research, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India, 2Department of Naturopathy,
Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India, 3Department of Manipulative Therapy, Government
Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India, 4Department of Yoga Therapy, Government Yoga and Naturopathy
Medical College, Chennai, Tamil Nadu, India, 5Department of Research, Government Yoga and Naturopathy Medical College, Chennai,
Tamil Nadu, India
INTRODUCTION
Coronavirus disease 2019 (COVID-19) is the infectious disease
caused by severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2). Severity of infection could be varied from
asymptomatic infection to critical disease. It is now aecting
many countries globally and thus the World Health Organization
declared that the epidemic is a public health emergency of
international concern. Although there is no specic drug for
COVID-19, symptomatic and supportive therapy is mainly
provided using conventional medicines (Bulut & Kato, 2020).
Because use of conventional medicine alone has its own adverse
eects, this case study was performed to evaluate the feasibility,
safety, and eect of integrated naturopathy and yoga therapies
(INYT) (i.e., conventional medicine + yoga and naturopathy) on
symptom score and the number of hospital stay in a patient with
COVID-19.
CASE REPORT
A 39-year-old married male was diagnosed with COVID-19 on
March 27, 2020. As described by him, the symptoms began with
Coronavirus disease 2019 (COVID-19) is the infectious disease a󰘯ecting many countries globally. This case study
was performed to evaluate the feasibility, safety, and e󰘯ect of integrated naturopathy and yoga therapies (INYT)
(i.e., conventional medicine + yoga and naturopathy) on the number of hospital stay and symptom score in a
patient with COVID-19. A 39-year-old married male was diagnosed with COVID-19 on March 27, 2020. During
the hospital stay, the patient underwent INYT. Adherence to INYT was good and the patient did not report any
serious adverse e󰘯ects during the intervention period. The length of hospital stay was 11 days. Which is less than
the median hospital stay observed in previous studies and the symptom score reduced from 6 (day 1) to 0 (day
6). Thus, INYT might reduce the length of the hospital stay with symptoms and active infection and also is feasible
and safe in a patient with COVID-19.
Key Words: Coronavirus disease 2019, medicine, naturopathy, yoga
Address for correspondence:
Dr. L. Nivethitha, Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai - 600 106,
Tamil Nadu, India.
E-mail: dr.nivethithathenature@gmail.com
Submitted: 21-Oct-2020 Revised: 05- May-2021 Accepted: 06-May-2021 Published: 21-Jul-2021
How to cite this article: Mooventhan A, Manavalan N, Deepa Y,
Mangaiarkarasi N, Kahlilsubramanian K, Nivethitha L. Effect of
naturopathy and yoga therapies as an adjuvant to conventional medicine
in the management of COVID-19. Yoga Mimamsa 2021;53:75-7.
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DOI:
10.4103/ym.ym_22_20
Abstract
Case Report
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Mooventhan,
et al
.: Naturopathy and yoga for COVID-19
76 Yoga Mīmāsā | Volume 53 | Issue 1 | January-June 2021
mild sore throat on March 19, 2020, and gradually (day by day)
increased to sever sore throat associated with dysphagia and sever
fever (103° Fahrenheit) on March 26, 2020. The patient was referred
to undergo COVID-19 tests. As suggested, he gave his pharyngeal
swab, nasal swab, and blood samples for COVID-19 at the nearby
government medical college hospital, South India. After he gave
samples, the physician advised him to undergo conventional
medication (azithromycin, hydroxychloroquine, and paracetamol)
for symptomatic relief. Simultaneously, the patient was kept
isolated in a separate room till the test results had come. On March
27, 2020, his test for COVID-19 has become positive and thus he
was diagnosed as having COVID-19 and got admitted in the same
medical college hospital, Chennai, for further treatments. On March
28, 2020, the patient underwent the entire COVID-19 test mentioned
above for the 2nd time and the result was positive for COVID-19
again and thus advised to continue the treatment in the same hospital.
Intervention
During the hospital stay, the patient underwent integrated IYNT
(conventional medicine + naturopathy and yoga). Conventional
medicines such as azithromycin, hydroxychloroquine, paracetamol,
oseltamivir, and vitamin supplementations for 1 week followed by
only vitamin and zinc supplementations were provided. A detail
of the INYT treatments is provided in Table 1.
Outcome measures
Length of hospital stay with active infection and symptoms,
safety, and feasibility of INYT were assessed using a daily log.
Symptom scores were assessed daily based on the common
COVID-19 symptoms (Ozma et al., 2020). Each symptom carries
4 points from 0 to 3 (0 = no symptom, 1 = mild symptoms without
inconvenience, 2 = moderate symptoms with inconvenience but
no disruptions in normal routine, and 3 = severe symptoms with
disruptions in normal routine). The total score ranges from 0 to 30,
where 0 indicates no symptoms and 30 indicates severe symptoms
(Mooventhan, Khode, & Nivethitha, 2014). Pharyngeal swab,
nasal swab, and blood tests for COVID-19 were done on 1st and
2nd day followed by 8th, 9th, and 10th days.
RESULTS AND DISCUSSION
The patients’ length of stay at hospital was 11 days; of 11 days,
8 days (5 days with mild symptoms [symptom score = 6] and
3 days without symptoms [symptom score = 0]) he was staying
with active infection. Since 9th and 10th day investigations showed
negative results, he was considered as a COVID-19 negative
case and after 1-day (11th day) observation, he was discharged
(12th day) from the hospital and advised to continue vitamins
and zinc supplementations at home for 2 weeks. The length
of hospital stays in our study was 11 days, which is less than
the median length of hospital stay reported in the literature,
i.e., 17 days (interquartile range: 15–20) for COVID-19 patients
(Mishra et al., 2020). Symptoms have reduced gradually (symptom
score 6, 5, 3, 1, 1, 0 on day-1 to day-6 respectively) and there
was no further symptom from the 6th day to till discharge Table 2.
Stress-induced immune dysregulation reduces the immune
response, delays wound healing, reactivates latent viruses,
and enhances the risk for more severe infection. Yoga has
been shown to downregulate the hypothalamic–pituitary
adrenal axis by reducing stress and improve immune functions
(Sengupta, 2012). Pranayama has shown to reduce mucosal
Table 1: The details of the naturopathy and yoga therapies received by the study patient
Timing Activities Frequency Rationale
6:00 am‑7:00 am Enema Daily Fever management
7:00 am‑8:00 am Yoga: Om Chanting, Kapalbhati, Vajrasana,
Padmasana, Dhyana veerasana, Gomukasana,
Ushtrasana, Hridhaya mudhra, Prana mudra, Chin
mudra, Yoni mudra
Daily Reduce stress and improve immunity
and cardiopulmonary functions
9:00 am‑9:30 am Breakfast (vegetarian diet) Daily Hospital routine diet
10:00 am‑10:30
am
Porridge made up of mixed cereals (200 ml) and
herbal decoction (50 ml)
Daily Improve immunity against viral infection
11:00 am‑12:00 n Yoga: Bhastrika pranayama (5 min), Bhramari
pranayama (10 min), and
Nadi shodhana
pranayama
(15 min)
Daily Reduce stress and improve immunity
and cardiopulmonary functions
12:30 pm‑1:00 pm Steam inhalation Daily Improve immunity against viral infection
1: 30 pm‑1:00 pm Any one of the following fruits a day (100‑200
g): apple, orange, banana, and Indian gooseberry
Daily Improve immunity
2:00 pm‑3:00 pm Lunch (sambar rice + curd rice + green leafy
vegetables)
Daily Hospital routine diet
4:00 pm‑5:00 pm Any one of the following boiled food items (100
g): green gram, Bengal gram, and groundnut
Daily Hospital routine diet
5:00 pm‑6:00 pm Yoga: JB (3 min) and SN (12 min) Daily JB: Improve vital energy in the neck
region including throat
SN: Improve physical fitness
6:00 pm‑7:00 pm One apple Daily Improve immunity
7:00 pm‑8:00 pm Yoga: Yoga Nidra (45 min) Daily Reduce stress
8:00 pm‑9:00 pm Dinner (vegetarian diet) Daily Hospital routine diet
10:00 pm‑6:00 pm Sleep Daily Daily routine
Timings that we did not mention in this table is meant for the participants’ resting time. SN: Surya namaskara; JB: Jalandhra bandha
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et al
.: Naturopathy and yoga for COVID-19
Yoga Mīmāsā | Volume 53 | Issue 1 | January-June 2021 77
edema, dislodge the mucous from sinuses and ventilate it,
improve nasal mucosal temperature and humidification,
and prevent microbes and allergens from settling down
(Abishek, Bakshi, & Bhavanani, 2019). According to naturopathy,
accumulation of morbid matter (including metabolic wastes) is the
main cause of disease; thus, enema (colon irrigation) is one of the
fundamental treatments of naturopathy provided in all kinds of
fever management. The patient received enema with 900–1000 ml
of drinking water in the morning. The participants received
vegetarian diet including fruits and vegetables, nuts, and legumes
that are rich in vitamins, minerals, and phytochemicals including
Vitamin-A, Vitamin-C, zinc, selenium, and avonoids. Vitamin-A
(anti-infective vitamin) plays a vital role in body’s defenses against
infection (Zhang & Liu, 2020). He had received herbal drinks
consisting of ginger and licorice root. Ginger is known to stimulate
mucosal cells to secrete IFN-β to counteract with viral infection
(Chang, Wang, Yeh, Shieh, & Chiang, 2013). Glycyrrhizin
(a major component of licorice root (Glycyrrhiza glabra L.) has
been reported to induce interferon activity and augment NK cell
activity and acts as a potent inhibitor of replication of the viruses
and is highly sensitive to SARS-CoV (Cinatl et al., 2003). Steam
inhalation produces hyperthermia and enhances general and local
host defense mechanisms and potentiates the antiviral activity of
interferon as well as its immunoregulatory eect on suppressor
cells (Ophir & Elad, 1987). This literature support the results of
this study, i.e., yoga and naturopathy treatments might have been
used for the management of COVID-19. Moreover, adherence to
INYT was good and the patient did not report any serious adverse
eects during the intervention period. Thus, INYT might be
eective in reducing the length of the hospital stay with symptoms
and active infection and also is feasible and safe in a patient with
COVID-19. However, the validity and reliability of this result
may vary because of a single case. Hence, randomized controlled
trials are required with large sample size and advanced techniques
to validate our results.
CONCLUSION
INYT is safe, feasible, and may be considered as an adjuvant
in the management of COVID-19. However, further studies are
required to warrant this eect.
Financial support and sponsorship
Nil.
Conicts of interest
There are no conicts of interest.
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Table 2: Symptom and its score along with conventional medication provided to the patients
Date Symptoms Symptom score Conventional medications
March 27, 2020 Fever 3 Azithromycin, chloroquine
Sore throat 3 Paracetamol
March 28, 2020 Fever 2 T. chloroquine
Sore throat 3T. oseltamivir
March 03, 2020 Sore throat 3T. azithromycin
March 03, 2020 Sore throat 1T. paracetamol
March 03, 2020 Difficulty in breathing 1T. multi vitamins
April 1, 2020 ‑ ‑ T. Vitamin C
April 04‑2020 ‑ ‑ T. Zinc was added along with the previous day medications
April 3 2020 to April 7, 2020 ‑ ‑ T. Multi Vitamins, T. Vitamin C, T. Zinc
Symptom score (1: Mild symptoms without inconvenience; 2: Moderate symptoms with inconvenience but no disruptions in normal routine, and 3: Severe symptoms
with disruptions in normal routine). T: Tablet
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