Addressing Paediatric Post-Covid Sequelae with Individualised Homoeopathy : A Case Series

Addressing Paediatric Post-Covid Sequelae with Individualised Homoeopathy : A Case Series

(Referenced from The Homoeopathic Heritage, January 2025, Volume 50, No. 10)

ABSTRACT

Background : COVID-19 has resulted in long-term sequelae that persist well beyond the acute phase, known as long COVID. Emerging data highlight a significant prevalence of long COVID in paediatric populations, with symptoms that impact daily functioning and well-being. Despite recognition of long COVID in children, there remains limited consensus on management strategies. This case series examines the individualised homoeopathic management of post-COVID sequelae in three paediatric patients. 

Case Summaries: Three paediatric cases of post-COVID sequelae successfully treated with individualised homoeopathic medicine are reported. The first case involved a 9-year-old girl with recurrent dry cough and hoarseness post-COVID. The second case was an 8-year-old boy experiencing recurrent nasal discharge, sneezing, and behavioural changes following COVID-19. The third case, a 5-year-old boy, presented with post-COVID nocturnal enuresis and disturbed sleep, along with a history of recurrent tonsillitis. All cases were managed with individualised homoeopathic remedies, showing significant improvement within a few months under regular follow-up.

Results : All patients demonstrated improvement in primary symptoms and overall well-being. ORIDL scores increased progressively, indicating enhanced quality of life. Additionally, MONARCH scores supported a probable causative link between homoeopathic treatment and observed improvements, with scores reaching +9 or more, denoting a definite relationship.

Conclusion : Individualised homoeopathic management appears beneficial in alleviating post-COVID symptoms in children, providing a safe, non-invasive therapeutic approach. Further research with larger sample sizes is warranted to establish role of Homoeopathy in paediatric post-COVID care.

Keywords : COVID-19, homoeopathy, long COVID, paediatrics, post-COVID, sequelae

Abbreviations : COVID-19 : Coronavirus-associated acute respiratory disease called coronavirus disease 19, 

SARS-CoV-2 : Severe acute respiratory syndrome corona-virus type 2, 

MONARCH : Modified Naranjo Criteria for Homoeopathy, 

ORIDL : Outcome Related to Impact on Daily Living, 

WHO : World Health Organisation 

INTRODUCTION 

The challenges posed by coronavirus-associated acute respiratory disease, known as COVID-19, have extended beyond the acute phase to include various long-term sequelae. Since the onset of the SARS-CoV-2 pandemic, evidence has emerged showing that a substantial number of adults experienced lingering symptoms post-infection, with a reported long COVID prevalence of up to 80%.(1) Shortly after the pandemic’s onset, reports also began to surface of previously healthy individuals, including children, experiencing prolonged symptoms following SARS-CoV-2 infection. This prompted the WHO to define post-COVID in adults as a condition presenting in individuals with a probable or confirmed infection history, where symptoms persist or newly emerge three months after onset, lasting at least two months and not attributable to an alternate diagnosis.(2)

Recently, a research-based definition of long COVID in children has been developed through a Delphi process, aiming to address the unique presentation of post-COVID symptoms in paediatric populations (Figure 1).(2) Although the mechanisms underlying post-COVID conditions remain unclear, several pathogenesis models have been proposed, one of the most supported being the hypothesis of viral persistence or retention of viral components within the host.(3) In children, commonly reported post-COVID symptoms include fatigue, dyspnoea, headache, cognitive difficulties, myalgia, abdominal pain, anosmia, fever, cough, and diarrhoea.(4)

Figure 1 : Research Definition of Long COVID in children

The prevalence of long COVID sequelae in children has been further highlighted by studies such as the one conducted in Mexico, where 215 children with documented SARS-CoV-2 infection showed a dyspnoea prevalence of 8.8% two months after acute infection, decreasing to 2.3% at four months, with similar trends observed in symptoms like rhinorrhoea and dry cough.(5) Additionally, a CDC retrospective cohort study, based on healthcare insurance data, demonstrated a higher risk of severe post-COVID complications among children, including acute pulmonary embolism, myocarditis, cardiomyopathy, venous thromboembolic events, renal failure, and type 1 diabetes.(6)

Despite the growing understanding of long COVID in children, consensus on its management remains lacking, and guidelines specific to paediatric post-COVID conditions are still in development. While a few studies explore homoeopathic approaches to post-COVID syndrome in general, none specifically address paediatric cases.(7–10) This case series presents the individualised homoeopathic management of post-COVID sequelae in three cases, highlighting the potential of Homoeopathy as a viable therapeutic approach in managing this condition among children.

Each of the three cases in this series was managed with individualised homoeopathic medicines, selected according to the unique symptom profile of each child. The outcomes were assessed using the ORIDL questionnaire, which evaluates perceived changes in condition and overall well-being on a 7-point scale, ranging from -4 (disastrous deterioration) to 0 (no change) and up to +4 (cured/back to normal). Additionally, MONARCH was applied to assess the likelihood of a causal relationship between the homoeopathic treatment and observed outcomes.

CASE 1

A 9-year-old female was brought to the OPD  by her parents on 08/01/2022, presenting with a dry cough that began two days prior, along with complaints of occasional hoarseness.

History of Presenting Complaints

The patient tested RTPCR positive for COVID-19 on 13th June 2021 (Figure 2). During the acute phase, she experienced mild symptoms, including a dry cough, throat pain, mild fever, body aches, and fatigue, which resolved within a week. However, following her recovery, the cough resurfaced with every change of weather. The cough that was usually dry, always used to worsen when lying on the back, and was often accompanied with hoarseness. The child had been provided with allopathic medications to manage the cough, which offered temporary relief, though the recurrence persisted. Additionally, she reported generalised weakness and a decreased appetite since her COVID-19 recovery.

Past History

The patient had no significant medical history prior to her COVID-19 infection. She was generally in good health, with no known allergies, chronic conditions, or prior hospitalisations.

Family History

The patient’s mother had hypothyroidism, which was well-controlled with regular treatment. There was no family history of respiratory illnesses or post-viral complications.

Figure 2 : RTPCR Positive Report of Case 1

Physical Generals

Since her COVID-19 illness, the patient’s appetite was noticeably decreased. Her thirst remained adequate, with an average water intake of 2-2.5 litres daily, and her eliminations were regular. She had a strong preference for cold drinks (+++) and was described by her parents as highly chilly (+++). Sleep was generally sound and refreshing, typically lasting around 7-8 hours/night. 

Mental Generals

She was described as a lively and cheerful child who actively sought company and disliked being alone. Known for her vivacious nature, she was well-liked by friends and family. Upon observation, she appeared quite amiable, holding her pet kitten lovingly and kissing her. Her positive disposition and sociability helped her stay engaged in daily activities despite her lingering symptoms. 

General and Systemic Examination

On general physical examination, the patient presented with mild pallor, with no signs of icterus, cyanosis, clubbing, lymphadenopathy, abnormal pigmentation, or oedema. Vital signs were within normal limits. Her height was recorded at 132.8 cm, weight at 26.5 kg, and body type was ectomorphic.

On systemic examination, the patient’s vital signs were stable, and lung auscultation was unremarkable. She appeared physically stable, with no signs of respiratory distress or extreme fatigue.

Diagnostic Assessment

The patient exhibited symptoms indicative of post-acute sequelae of COVID-19, including a persistent dry cough and occasional hoarseness that resurfaced following her recovery from the initial COVID-19 infection. These symptoms have been recurring at every change of weather since more than six months, aligning with the criteria for post-COVID conditions, as described in Figure 1. The ICD-10-CM code U09.9 is applicable, as there were no alternate causes identified for her symptoms based on clinical history and examination.(11)

Therapeutic Intervention and Outcome Assessment 

The symptoms considered for the analysis and evaluation of the case were as follows:

  1. The patient was vivacious in nature
  2. She loved to be around people
  3. Appetite greatly diminished 
  4. Desire for cold drinks
  5. Thermal Reaction was chilly
  6. Tendency to get affected by change of weather
  7. Dry cough at every change of weather
  8. Cough aggravated by lying on the back
  9. Cough accompanied by hoarseness 
  10. Generalised weakness after recovery from acute COVID-19 

An individualised homoeopathic approach was adopted based on symptom similarity, with no adjunctive therapies utilised. The case was repertorised using RADAR OPUS 3.3.24 and the Synthesis Adonis Repertory, focusing on mental and physical generals as well as specific particulars (Figure 3).

Based on the repertorial analysis and confirmation from the Materia Medica, a single dose of Phosphorus 200C was prescribed to be taken on an empty stomach, followed by placebo for two weeks. 

Figure 3 : Repertorisation Chart of Case 1

Follow-up and Outcome Assessment 

Follow-ups were conducted initially at two-week intervals and then transitioned to one-month intervals as the patient showed improvement. The follow-up timeline is detailed in Table 1, where the patient’s progress and changes in intervention are documented.

The ORIDL score was assessed at each follow-up visit to monitor progress, with separate evaluations for the Main Complaint and Overall Well-being, as shown in Table 1.

Additionally, to establish the causal relationship between the homoeopathic intervention and clinical improvement, MONARCH was applied, yielding a score of +9, indicating a definite relationship between the treatment and observed outcomes (Table 2).

Table 1 : Follow-up Timeline and Outcome Assessment of Case

Follow-up Date

Symptomatology 

Prescription 

ORIDL – MC

ORIDL – OWB

08/01/2022

On the basis of repertorial analysis and confirmation from the Materia Medica. 

Phosphorus 200C, single dose. Placebo for two weeks.

N/A

N/A

15/01/2022

Episodes of cough subsided significantly, and fatigue showed slight improvement.

Placebo continued for 2 weeks. 

+2

+1

29/01/2022

Cough – absent.

Appetite improved. Fatigue was much reduced 

Placebo continued for 2 weeks. 

+3

+3

12/02/2022

Reappearance of dry cough since 2 days, though milder than before.

Phosphorus 200C/1 dose/empty stomach.

Placebo for 2 weeks. 

-1

+3

05/03/2022

Cough subsided within a day after the repeated dose. The patient’s overall health was stable, with no signs of fatigue or loss of appetite.

Placebo continued for 1 month. 

+3

+3

02/04/2022

Mild sore throat since one day after having a cold drink (also sudden weather change). 

Phosphorus 1M, single dose. 

Placebo continued for 1 month. 

+2

+3

07/05/2022

Continued improvement noted with no respiratory complaints, sore throat, or fatigue. Appetite remained good, and overall vitality was stable.

Placebo continued for 1 month. 

+3

+4

11/06/2022 

No symptoms of cough, sore throat, or fatigue despite further weather transitions.

Placebo was advised to be taken once weekly. 

+4

+4

25/12/2022 

No visits after 11/06/2022. Mother came for her treatment and reported no recurrence of complaints in the child. 

+4

+4

[ORIDL: Outcome in Relation to Impact on Daily Living, MC: Main Complaint, OWB: Overall Well-Being] 

Table 2 : Causal Assessment of Case 1 by Modified Naranjo Criteria for Homoeopathy

S. No.

Domains

Yes

No

Not sure or N/A

1.

Was there an improvement in the main symptom or condition for which the homoeopathic medicine was prescribed?

+2

  

2.

Did the clinical improvement occur within a plausible time frame relative to the drug intake?

+1

  

3.

Was there an initial aggravation of symptoms? (need to define in glossary)

0

  

4.

Did the effect encompass more than the main symptom or condition, i.e., were other symptoms ultimately improved or changed?

+1

  

5.

Did overall wellbeing improve? (suggest using validated scale)

+1

  

6.A. 

Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease?

  

0

6.B.

Direction of cure: Did at least two of the following aspects apply to the order of improvement of symptoms

From organs of more importance to those of less importance

From deeper to more superficial aspects of the individual

From the top downwards

   

7.

Did “old symptoms” (defined as non seasonal and non cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement?

 

0

 

8.

Are there alternate causes (other than the medicine) that with a high probability could have caused the improvement? (consider known course of disease, other forms of treatment, and other clinically relevant interventions)

 

+1

 

9.

Was the health improvement confirmed by any objective evidence? (e.g., lab test, clinical observation, etc.) 

+2

  

10.

Did repeat dosing, if conducted, create similar clinical improvement?

+1

  

Total score: +9 (maximum score: +13, minimum score: – 6)

 

CASE 2

An 8-year-old male was brought to the OPD by his parents with complaints of watery nasal discharge and frequent sneezing, persisting for the last 3.5 months.

History of Presenting Complaints 

The patient tested RTPCR positive for COVID-19 on 1st July 2021 (Figure 4), with symptoms including high fever, mild respiratory issues, throat pain, and body aches, all of which resolved within five days. However, one month after recovering from the acute COVID-19 symptoms, he began experiencing episodes of watery nasal discharge accompanied by sneezing. These episodes usually start with sneezing, followed by nasal discharge, and are occasionally accompanied by itching in the nose. Although he took allopathic medication, the symptoms have not fully resolved and continue to recur.

Past History

One year back, the patient had typhoid fever, for which he received allopathic treatment.

Family History

The family history revealed that the father had cholelithiasis, while the mother suffered from bronchial asthma. No other significant familial medical issues were reported.

Physical Generals

Since the COVID-19 illness, the patient’s appetite has significantly reduced, with a marked craving for extra salt in his food. His thirst remained adequate, with an average daily water intake of 2-2.5 litres. The patient had experienced repeated episodes of severe constipation, characterised by hard stools that occasionally required mechanical removal. He was ambithermal, exhibiting no specific preference or discomfort in either hot or cold environments. His sleep was generally sound and refreshing, averaging 8 hours per night.

 

Mental Generals

The patient was answering in monosyllables during case taking and often avoided eye contact. As reported by the parents, following his COVID-19 illness, he exhibited noticeable changes in his behaviour towards those around him. He became withdrawn, losing interest in activities he previously enjoyed. Additionally, he displayed irritability over trifles, getting upset over minor interruptions during play or simple requests to assist with chores. This behavioural change prompted his parents to speak with his teachers, who noted similar changes in his interactions at school. The once outgoing and cheerful boy had become taciturn and reluctant to engage in conversations, only responding when absolutely necessary.

General and Systemic Examination

On general physical examination, the patient appeared lean and thin, with a weight of 25 kg and height of 129.9 cm. There were no signs of pallor, icterus, cyanosis, clubbing, lymphadenopathy, abnormal pigmentation, or oedema. Vital signs were within normal limits, and he appeared physically stable, with no signs of respiratory or acute distress.

On systemic examination, his abdomen was soft but tender to palpation, particularly in the lower quadrants, where he reported mild discomfort due to constipation.

Diagnostic Assessment 

The complaints of watery nasal discharge and frequent sneezing began one month after the patient recovered from COVID-19 and were absent prior to the infection. Vital signs were normal, and the examination revealed signs of nasal congestion. Tenderness in the abdomen was noted, likely due to constipation. Differential diagnoses, including viral rhinitis and allergic rhinitis, were considered; however, the timeline and symptomatology indicated that these symptoms were consistent with post-COVID conditions. As the symptoms have persisted for over three months, they meet the criteria for post-acute sequelae of COVID-19 (Figure 1). The ICD-10-CM code U09.9 is applicable, as no alternate causes were identified based on clinical history and examination.(11)

Therapeutic Intervention and Outcome Assessment 

The symptoms considered for the analysis and evaluation of the case were as follows:

  1. The patient was answering in monosyllables during case taking 
  2. He used to get irritated over trifles. 
  3. He was uncommunicative and reserved. 
  4. Diminished appetite 
  5. Desire for extra salt in food
  6. Stool was hard, difficult and painful to pass. 
  7. Stool was so hard that it required mechanical removal. 
  8. Recurrent watery nasal discharge from both nostrils. 
  9. Nasal discharge accompanied with itching in nose and sneezing. 

An individualised homoeopathic approach was adopted based on symptom similarity, with no adjunctive therapies utilised. The case was repertorised using RADAR OPUS 3.3.24 and the Synthesis Adonis Repertory, focusing on mental and physical generals as well as specific particulars (Figure 5).

Based on the repertorial analysis and confirmation from the Materia Medica, a single dose of Natrium muriaticum 200C was prescribed to be taken on an empty stomach, followed by placebo for one week. 

Figure 5 : Repertorisation Chart of Case 2

Follow-up and Outcome Assessment 

The first follow-up was conducted at a one-week interval due to the presence of acute complaints. After these complaints settled, the follow-up frequency was adjusted to two-week intervals and gradually transitioned to one-month intervals as the patient continued to improve. The follow-up timeline is detailed in Table 3. 

The ORIDL score was assessed at each follow-up visit to monitor progress, with separate evaluations for the Main Complaint and Overall Well-being, as shown in Table 3.

Additionally, to assess the causal relationship between the homeopathic intervention and clinical outcomes, MONARCH was applied, yielding a score of +10, which indicates a definite relationship between the treatment and the observed improvements (Table 4).

Table 3 : Follow-up Timeline and Outcome Assessment of Case 2

Follow-up Date

Symptomatology

Prescription 

ORIDL – MC

ORIDL – OWB

07/11/2021

On the basis of repertorial analysis and confirmation from the Materia Medica. 

Natrum muriaticum 200C, single dose. Placebo for two weeks.

N/A

N/A

20/11/2021

Increase in nasal discharge and sneezing, prompting an early visit. 

Placebo continued. 

-2

0

01/12/2021

Slight improvement in appetite. Stool – satisfactory since 3 days. Mood showed slight improvement, with the patient responding better during OPD visits. 

Placebo continued for 2 weeks. 

+1

+1

17/12/2021

Further improvement in appetite. Patient willingly started playing with friends in the evening, indicating better mood. 

Placebo continued for 2 weeks. 

+2

+2

22/12/2021

Episode of severe constipation 2 days back requiring mechanical intervention. Mild difficulty while passing stool since yesterday. 

Natrium muriaticum 200/1 dose/empty stomach

Placebo for 2 weeks. 

-1

+2

05/01/2022

Continuous improvement in appetite, mood, and constipation noted. The patient appeared more engaged and responsive.

Placebo continued for 2 weeks. 

+2

+3

19/01/2022

Continuous improvement 

Placebo continued for 1 month. 

+3

+3

02/03/2022

Watery nasal discharge reappeared since 2 days after a family trip to the mountains. 

Natrum muriaticum 200C/single dose/empty stomach. Placebo continued for 1 month. 

-1

+3

27/04/2022

Sustained improvement. 

Placebo continued for 1 month. 

+3

+3

30/06/2022

Reported after 2 months, with no new symptoms. Social engagement and mood consistently positive.

Natrium muriaticum 200/single dose/ SOS

Placebo continued. 

+3

+4

01/09/2022

SOS dose not taken. Continued remission of symptoms. 

Placebo continued. Patient advised to visit only in case of recurrence. 

+4

+4

[ORIDL: Outcome in Relation to Impact on Daily Living, MC: Main Complaint, OWB: Overall Well-Being] 

Table 4 : Causal Assessment of Case 2 by Modified Naranjo Criteria for Homoeopathy

S. No. 

Domains

Yes

No

Not sure or N/A

1.

Was there an improvement in the main symptom or condition for which the homoeopathic medicine was prescribed?

+2

  

2.

Did the clinical improvement occur within a plausible time frame relative to the drug intake?

+1

  

3.

Was there an initial aggravation of symptoms? (need to define in glossary)

+1

  

4.

Did the effect encompass more than the main symptom or condition, i.e., were other symptoms ultimately improved or changed?

+1

  

5.

Did overall wellbeing improve? (suggest using validated scale)

+1

  

6.A. 

Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease?

  

0

6.B.

Direction of cure: Did at least two of the following aspects apply to the order of improvement of symptoms

From organs of more importance to those of less importance

From deeper to more superficial aspects of the individual

From the top downwards

  

0

7.

Did “old symptoms” (defined as non seasonal and non cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement?

   

8.

Are there alternate causes (other than the medicine) that with a high probability could have caused the improvement? (consider known course of disease, other forms of treatment, and other clinically relevant interventions)

 

+1

 

9.

Was the health improvement confirmed by any objective evidence? (e.g., lab test, clinical observation, etc.) 

+2

  

10.

Did repeat dosing, if conducted, create similar clinical improvement?

+1

  

Total score: +10 (maximum score: +13, minimum score: – 6)

CASE 3

A 5-year-old male was brought to the OPD by his parents  with complaints of involuntary urination during sleep, ongoing for the past 4 months, and sleep disturbances persisting for the last 2.5 months.

History of Presenting Complaints

The patient tested RTPCR positive for COVID-19 on 23rd June 2021 (Figure 6), experiencing mild symptoms, including sneezing, coryza, and mild fever, which resolved in about a week. However, within a week after recovery, he had an episode of involuntary urination during sleep. These episodes continued, occurring approximately 1-3 times per week, since last 4 months. 

Around 1.5 months after the onset of these episodes, he developed persistent sleep disturbances, marked by frequent tossing and turning throughout the night. Notably, his episodes of involuntary urination are more likely to occur on nights when his sleep is comparatively deeper. 

Figure 6 : RTPCR Positive Report of Case 3

Past History

The patient had a history of recurrent tonsillitis, starting from around 1 year of age, for which he received intermittent treatment.

Family History

The family history was notable for respiratory conditions, with the patient’s father and paternal grandfather both diagnosed with bronchial asthma. The maternal grandmother passed away due to hepatocellular carcinoma. 

Physical Generals

Since his COVID-19 illness, the patient’s appetite had decreased, although he drank a good amount of water (around 2.5-3 litres daily). His bowel movements were regular, but his perspiration had a noticeably strong odour. He avoided bathing whenever he could, disliked the cold, and preferred warm environments. His sleep was disturbed, often tossing through the night, with involuntary bedwetting occurring 1-3 times a week.

Mental Generals

The patient was generally well-behaved and had a natural desire for amusement, often requesting TV, music, or other forms of entertainment. No significant behavioural changes were observed following his COVID-19 illness, although he did become irritable when unable to sleep. Typically, he enjoyed engaging activities and showed a preference for playful interactions.

General and Systemic Examination

On general physical examination, the patient appeared ectomorphic with a slender build, weighing 16.5 kg and measuring 106.6 cm in height. His skin appeared dry with a mild pallor, and there were no signs of icterus, cyanosis, clubbing, lymphadenopathy, abnormal pigmentation, or oedema. Vital signs were within normal limits, and he exhibited no signs of respiratory distress. However, slight fatigue was noted, likely due to his disturbed sleep patterns. No abnormalities were detected on systemic examination. 

Diagnostic Assessment 

The patient’s symptoms of involuntary urination and sleep disturbances began shortly after his recovery from COVID-19, suggesting a correlation between the two. Primary nocturnal enuresis and urinary tract infections were considered as potential diagnoses but were ruled out due to the specific timing of symptom onset immediately following the COVID-19 infection. The persistent nature of these symptoms, coupled with their emergence post-COVID, aligns with the criteria of Post-COVID-19 sequelae as defined in Figure 1. Therefore, the symptoms are classified under ICD-10-CM code U09.9, reflecting the post-COVID condition.(11)

Remedial Analysis and Therapeutic Intervention 

The symptoms considered for the analysis and evaluation of the case were as follows:

  1. Irritability due to disturbed sleep
  2. Desire for amusement and sources of entertainment 
  3. Diminished appetite 
  4. Offensive perspiration 
  5. Dislike for bathing
  6. Thermal reaction was chilly
  7. Disturbed sleep with restlessness at night
  8. Recurrent episodes of involuntary urination at night 
  9. Past History of tonsillitis 

An individualised homoeopathic approach was adopted based on symptom similarity, with no adjunctive therapies utilised. The case was repertorised using RADAR OPUS 3.3.24 and the Synthesis Adonis Repertory, focusing on mental and physical generals as well as specific particulars (Figure 7).

Based on the repertorial analysis and Materia Medica, a single dose of Psorinum 200C was prescribed, to be taken on an empty stomach, followed by placebo for two weeks. 

Figure 7 : Repertorisation Chart of Case 3


Follow-up and Outcome Assessment 

Follow-ups were conducted initially at two-week intervals and subsequently transitioned to one-month intervals as the patient showed improvement. The follow-up timeline in Table 5 outlines the patient’s progress along with the adjustments made to the intervention.

The ORIDL score was assessed at each follow-up visit to monitor progress, with separate evaluations for the Main Complaint and Overall Well-being, as shown in Table 5.

Additionally, to assess the relationship between the homoeopathic treatment and the observed improvements, MONARCH was applied, resulting in a score of +11, indicating a definite relationship between the treatment and the improvements noted (Table 6).

Table 5 : Follow-up Timeline and Outcome Assessment of Case 3

Follow-up Date

Symptomatology 

Prescription

ORIDL – MC

ORIDL – OWB

10/11/2021

On the basis of repertorial analysis and confirmation from the Materia Medica. 

Psorinum 200C/single dose/empty stomach. Placebo for 2 weeks. 

N/A

N/A

24/11/2021

Slight improvement in sleep noted. Other complaints same as before. 

Placebo continued for 2 weeks. 

+1

+1

08/12/2021 

Improvement in appetite and a reduction in episodes of involuntary urination at night. Sleep disturbances reduced. 

Placebo continued for 2 weeks. 

+2

+2

22/12/2021

2 episodes of bedwetting in the last week. Sleep disturbed since 3 days. 

Psorinum 200C/single dose/empty stomach.

Placebo for 2 weeks. 

-1

+2

06/01/2022

Complaints same as before. 

Placebo continued for 2 weeks. 

-2

0

18/01/2022

Child appeared irritable. No improvement in complaints. 

Psorinum 1M/single dose/empty stomach

Placebo for 2 weeks. 

-2

-1

09/02/2022

No episodes of bedwetting. Sleep highly improved. 

Placebo continued for 2 weeks. 

+2

+2

18/02/2022

Reported early due to sore throat and inflamed tonsils since 2 days. 

Reappearance of old symptoms. Placebo continued for 2 weeks. 

+2

+2

30/03/2022

Tonsillitis resolved on its own. Improvement in sleep and urination continues steadily.

Placebo continued for 1 month. 

+3

+3

04/05/2022

Consistent remission of symptoms. 

Placebo continued for 1 month. 

+3

+4

06/07/2022

No new episodes of bedwetting. Appetite is stable, and sleep remains undisturbed.

Placebo continued. 

+4

+4

06/12/2022 (Telephonic Follow-up) 

Sustained improvement with no return of symptoms.

+4

+4

[ORIDL: Outcome in Relation to Impact on Daily Living, MC: Main Complaint, OWB: Overall Well-Being] 

 

Table 6: Causal Assessment of Case 3 by Modified Naranjo Criteria for Homoeopathy

S. No. 

Domains

Yes

No

Not Sure or N/A

1.

Was there an improvement in the main symptom or condition for which the homoeopathic medicine was prescribed?

+2

  

2.

Did the clinical improvement occur within a plausible time frame relative to the drug intake?

+1

  

3.

Was there an initial aggravation of symptoms? (need to define in glossary) 

+1

  

4.

Did the effect encompass more than the main symptom or condition, i.e., were other symptoms ultimately improved or changed? 

+1

  

5.

Did overall wellbeing improve? (suggest using validated scale)

+1

  

6.

Direction of cure: did some symptoms improve in the opposite order of the development of symptoms of the disease? 

+1

  

7.

Direction of cure: Did at least two of the following aspects apply to the order of improvement of symptoms

From organs of more importance to those of less importance

From deeper to more superficial aspects of the individual

From the top downwards 

  

0

8.

Did “old symptoms” (defined as non seasonal and non cyclical symptoms that were previously thought to have resolved) reappear temporarily during the course of improvement?

+1

  

9.

Was the health improvement confirmed by any objective evidence? (e.g., lab test, clinical observation, etc.)

+2

  

10.

Did repeat dosing, if conducted, create similar clinical improvement? 

+1

  

Total score: +11 (maximum score: +13, minimum score: – 6)

DISCUSSION 

This case series highlights the potential of individualised homoeopathy in addressing post-COVID sequelae in paediatric patients, a topic which remains largely unexplored in current medical literature. As noted, post-COVID symptoms in children can vary widely, with manifestations such as respiratory, gastrointestinal, and neurocognitive complaints persisting long after the acute phase. Existing studies primarily focus on post-COVID in adults, leaving a gap in understanding and treating these sequelae within the paediatric population.(7–10) 

The cases in this series also highlight the psychological impact of post-COVID sequelae on children, with symptoms such as irritability, social withdrawal, and diminished engagement in activities being prominent. This aligns with findings from larger studies on paediatric post-COVID conditions, which report neurocognitive and behavioural changes among affected children.(12–15) Addressing these symptoms holistically through individualised remedies that consider both mental and emotional aspects might offer a unique advantage in managing paediatric post-COVID cases. The improvement in social behaviour, mood, and engagement observed in these cases suggests that homoeopathy may not only alleviate physical symptoms but also enhance emotional well-being. 

Each case was managed by individualised homoeopathic prescriptions derived from the symptomatology and personality traits of the paediatric patients, taking into account both mental and physical attributes. Phosphorus, Natrum muriaticum and Psorinum, the prescribed remedies, were chosen based on each child’s symptom profile, corroborated by repertorisation and reference to the Materia Medica. 

The assessment of outcomes using the ORIDL score and MONARCH criteria provided a structured framework to evaluate the effectiveness of homoeopathic intervention. In all cases, there was a marked improvement in both primary symptoms and overall well-being, as indicated by positive changes in the ORIDL scores. Additionally, the MONARCH scores of +9 and above for each case suggest a definite relationship between the homoeopathic treatments and observed outcomes, supporting the causal association between the prescribed remedies and clinical improvements.

Further research, with larger sample sizes and controlled study designs, is warranted to more definitively establish the role of  Homoeopathy and its efficacy in addressing post-COVID conditions in paediatric populations.

 

CONCLUSION 

This case series suggests that individualised Homoeopathy may be a viable therapeutic approach for managing post-COVID sequelae in paediatric patients. The observed improvements in both physical and emotional domains in these cases warrant further exploration through controlled studies. As the long-term impact of COVID-19 on children continues to unfold, homoeopathy offers a complementary approach worth considering, especially in settings where conventional treatment options are limited or insufficient.

Declaration of Patient Consent

The author certifies that the appropriate consent forms for all three patients have been obtained. For the two patients aged 9 and 8, assents were obtained from the children, with consents provided by their respective guardians. For the 5-year-old patient, consent was provided solely by the guardian. The guardians have agreed to the use of the laboratory reports and other clinical information for publication in this journal. The names and initials of the patients are not included in the manuscript, and every effort has been made to maintain their anonymity, although complete confidentiality cannot be guaranteed.

Acknowledgement

I express heartfelt gratitude to Dr. Annu Kapoor (Former Principal and HOD of NHMC & Hospital), for her invaluable support and encouragement throughout this work. Special thanks to my mentor Dr. Rakesh Taneja for his valuable guidance and suggestions. Sincere appreciation goes to the parents of the patients for their trust and cooperation. 

Financial support and sponsorship – Nil.

Conflicts of interest – None declared. 

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Author

Dr. Sweksha Yadav,

M.D. (Hom), Department of Organon of Medicine and Homoeopathic Philosophy, Nehru Homoeopathic Medical College and Hospital (New Delhi).

About the author

Dr. Sweksha Yadav

M.D. (Hom), Department of Organon of Medicine and Homoeopathic Philosophy, Nehru Homoeopathic Medical College and Hospital (New Delhi).