COVID – 19 AND HOMOEOPATHIC TREATMENT

ABSTRACT :

The country first time experiences a pandemic due to a small creature, the corona virus.

INTRODUCTION :

The disease first originated in china and killing thousands of people worldwide and become  pandemic – ‘ COVID 19’. A coronavirus is a virus that is found in animals and, rarely, can be transmitted from animals to humans and then spread person to person.^[1]

Coronaviruses (CoVs) are the largest group of viruses belonging to the Nidovirales order, which includes Coronaviridae, Arteriviridae, and Roniviridae families.^[2]

VIRON STRUCTURE

Coronavirus virions are spherical with diameters of approximately 125 nm as depicted in recent studies by cryo-electron tomography and cryo-electron microscopy ^[3,4]. The most prominent feature of coronaviruses is the club-shape spike projections emanating from the surface of the virion. These spikes are a defining feature of the virion and give them the appearance of a solar corona, prompting the name, coronaviruses. Within the envelope of the virion is the nucleocapsid. Coronaviruses have helically symmetrical nucleocapsids, which is uncommon among positive-sense RNA viruses, but far more common for negative-sense RNA viruses.

Human Coronaviruses

these human coronaviruses are α-coronaviruses (HCoV-229E and HCoV-NL63) while the other two are β-coronaviruses (HCoV-OC43 and HCoV-HKU1).

These viruses are endemic in the human populations, causing 15–30% of respiratory tract infections each year. They cause more severe disease in neonates, the elderly, and in individuals with underlying illnesses, with a greater incidence of lower respiratory tract infection in these populations. HCoV-NL63 is also associated with acute laryngotracheitis (croup)^[5]

PATHOPHYSIOLOGY

CoVs are enveloped, positive-stranded RNA viruses with nucleocapsid. In CoVs, the genomic structure is organized in a +ssRNA of approximately 30 kb in length — the largest known RNA viruses — and with a 5′-cap structure and 3′-poly-A tail. Starting from the viral RNA, the synthesis of polyprotein 1a/1ab (pp1a/pp1ab) in the host is realized. The transcription works through the replication-transcription complex (RCT) organized in double-membrane vesicles and via the synthesis of subgenomic RNAs (sgRNAs) sequences. Of note, transcription termination occurs at transcription regulatory sequences, located between the so-called open reading frames (ORFs) that work as templates for the production of subgenomic mRNAs. In the atypical CoV genome, at least six ORFs can be present. Among these, a frameshift between ORF1a and ORF1b guides the production of both pp1a and pp1ab polypeptides that are processed by virally encoded chymotrypsin-like protease (3CLpro) or main protease (Mpro), as well as one or two papain-like proteases for producing 16 non-structural proteins (nsps). Apart from ORF1a and ORF1b, other ORFs encode for structural proteins, including spike, membrane, envelope, and nucleocapsid protein. ^[8]

Transmission

The virus transmit from the infected person to the health one through contact, with fluids, hand shake, transmission is believed occur through respiratory droplets from coughing sneezing,  and aerosol transmission. Using the article used by infected person is also a form of disease transmission.

Based on data from the first cases in Wuhan and investigations conducted by the China CDC and local CDCs, the incubation time could be generally within 3 to 7 days and up to 2 weeks as the longest time from infection to symptoms was 12.5 days ^[6]

Time period of COVID 19 on various surface  on plastic – 5 days, paper 4 -5 days, glass 4 days, wood – 4 days, steel 48 hours, surgical gloves 8 hours, aluminium 2 – 8 hours.

Differential diagnosis

The symptoms of the early stages of the disease are nonspecific. Differential diagnosis should include the possibility of a wide range of infectious and non-infectious (e.g., vasculitis, dermatomyositis) common respiratory disorders. 

• Adenovirus
• Influenza
• Human metapneumovirus (HmPV)
• Parainfluenza
• Respiratory syncytial virus (RSV)
• Rhinovirus (common cold) [7]

HOW TO PROTECTET OURSELF

Clean your hands often

• Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place or after blowing your nose, coughing, or sneezing.
• If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
• Avoid touching your eyes, nose, and mouth with unwashed hands.

• Avoid close contact with people who are sick
• Put distance between yourself and other people if COVID-19 is spreading in your community.
• Stay home if you are sick, except to get medical care.
• Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
• Throw used tissues in the trash.
• Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
• If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. .
• If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
• Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
• If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection.

SYMPTOMSOF COVID 19

Most common symptoms are

• Fever
• Dry cough
• Fatigue
• Coughing up sputum, or thick phlegm, from the lungs
• Shortness of breath
• Bone or joint pain
• Sore throat
• Headache
• Chills
• Nausea or vomiting
• Stuffy nose
• Diarrhea
• Coughing up blood
• Swollen eyes[10]

HOMOEOPATHIC CONCEPT OF TREATMENT OF COMMUNICABLE DISEASE

Homoeopathy on the other hand, has had a good reputation in the field of prophylaxis, especially against acute infectious diseases. Ever since the founder, Dr. Samuel Hahnemann advised the use of Belladonna in the prevention of scarlet fever, homoeopathic medicines have done excellent service in the field of prophylaxis in many infectious diseases epidemics.

DIAGNOSIS

The detection of viral nucleic acid is the standard for noninvasive diagnosis of COVID-19. However, the present detection of SARS-CoV-2 nucleic acid was high in specificity and low in sensitivity, so that there might be false negatives and the testing time could be relatively long. The Novel Coronavirus Pneumonia Diagnosis and Treatment Plan (5^th trial version) took “suspected cases with pneumonia imaging features” as the clinical diagnostic criteria in Hubei Province.^[14]

Rubrics Selected : ( Main Symptoms )
1.Generalities; weakness; fever; during
2.Cough; dry; fever; during
3.Fever, heat; zymotic fevers
4.Respiration; difficult; fever; during
5.Generalities muscles pain, fever during
6.Chest; inflammation; lungs, pneumonia; influenza, in or after
7.Kidneys; suppression of urine, anuria; fever, during
Repertorial Result :
Ars
Bry

Analysis of the remaining less common symptoms :

1. Cough; loose; fever, during Ars, Bry
2. Expectoration; bloody, spitting of blood Ars, Bry
3. Head; pain, headache; fever; during Ars, Bry
4. Rectum; diarrhea; fever; during Ars, Bry
5. Nose; coryza; fever, during Ars, Bry
6. Throat; pain; fever, during Ars

The rubric THROAT PAIN(Sore) –Accompanied by Coryza – MERC, NIT ACID, NUX VOM, PHOS, phyt, calcphos, lach,carb an.

Probable remedies with differentiation

Arsalb

Thin watery excoriating coryza, with weakness and exhaustion. Throat sore with Difficulty to SWALLOW (Often reporting with covid cases). RESTLESSNESS WITH WEAKNESS is the characteristic…THIRSTY For warm drinks. Excoriating coryza with splinter like pain in throat – Nit acid (Tremendous ANXIETY)

Merc sol

Coryza is watery not acrid. METALLIC TASTE, SALIVATION.Characteristic. Offensive breath, non-relieving sweat too.

Nuxvom

 Stuffy cold stuffiness with sneezing will be prominent. Hypersensitivity to smell. If there are abdominal symptoms with an ineffectual urge to stool, we can confirm nux.   

Fever Stage

Now the symptoms will be more established, with sore throat, GI symptoms , headache, Myalgia, weakness etc.

Look for the most striking feature of the case. The remedy selected should have that symptom as prominent

If weakness overruns the symptoms which has been the scenario in many cases the rubric GENERALS- Weakness fever during comes which has ARS, CUPRUM, PHOS, NUX, VERAT as 3 mark, and Bapt, Bry, Gels, Mur acid, Ac phos, Rhustox, Eupat, Stannum

If the debility is so marked with the typical description PATIENT SLIDES DOWN IN THE BED with patient even needs to lift them up frequently, with involuntary diarrhoea – ACID MUR.

ARS ALB

 Characteristic – weakness, restlessness and thirst, usually for warm drinks in sips .Highly anxious and insecure. (Hearing all the news about people dying from the disease, the very same feeling looms constantly in their mind thereby becoming restless and at the same time they are weak too. so this alternation is the key for ARS ALB along with thirst. Don’t hesitate to prescribe even if they are thirsty but in large quantities. Ars can also have desire for cold drinks. If the stomach doesn’t tolerate cold water well (exact opposite of Phos) and vomits it out Ars can be indicated. 

PHOSPHOROUS.

 Weakness plus .Characterised by the THIRST for COLD water.(But if normal water itself is there we can take it, because in our society taking cold water during the sickness is considered as wrong. Cold water is vomited out as soon as it gets warm in stomach (Pyrogen). Phosphorous doesn’t tolerate warm water well). Respiratory symptoms will be prominent. So the Thirst with great desire to be magnetized. (They need someone besides their bed always) . Though anxious they are easily reassured (Ars not). Pain in the chest while coughing, pain in abdomen while coughing are marked symptoms in Phos (not all cases will be bryonia) 

NUX VOM

Weakness plus .Stuffy nose, GI symptoms. With great sensitivity to smell, noise etc. 3. The three I’s a) IRRITABILITY (Aversion to be disturbed as in Bryonia) b) IMPATIENCE and  c) INEFFECTUAL URGE TO STOOL can confirm NUX. 

CUPRUM MET

 WEAKNESS ,  When cough and throat pain are prominent continuous paroxysmal, spasmodic dry cough which gets relieved by drinking cold (Causticum, Ipecac, Coccus Cacti); difficulty to swallow due to spasm(which some patients were expressing) . Coppery taste in mouth (might describe as Metallic taste) . Accompanied with SPASM or CRAMPS ANYWHERE. 

VERATRUM ALBUM

 Rapid sinking with great prostration. RESTLESSNEES, CHILL YET THIRST FOR ICY COLD WATER. COLD PERSPIRATION on Forehead or on any other places. GI symptoms especially diarrhoea with cold sweat (great desire for refreshing drinks, lemonade (Belladonna)). Delirium with rage.COVID 19 is slow progressing so medicines like BRYONIA, BAPTISIA and GELSEMIUM also can be indicated

BRYONIA

Slow progression. DRYNESS with great thirst, AGG MOTION. Mentally irritated..Wants to be left alone, because motion agg is there in all levels.

BAPTISIA AND GELSEMIUM

Both are slow progressing/sleepy.

Baptisia

OFFENSIVENESS .Delirium strong though onset is slow. RAPID PROSTRATION>>>with OFFENSIVE DISCHARGES (mouth, stool, Sweat) .Brown strip in the centre of tongue.

Gelsemium

WEAKNESS AND TREMBLING .chilliness .EYELIDS HEAVY DROOPING 4. Headache relieved by URINATION. 

ACID PHOS

PROSTRATION .GREAT DESIRE FOR REFRESHING THINGS.^[11]

HOMOEOPATHIC CONCEPT

Homoeopathic medicine can also used as a prophylactic , master Hahnemann in §4 says  “He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health”^[12]

From the older days homoeopathic medicine was use for preventive purpose for , in 1805  for scarlet fever. Our master Hahnemann was a great hygienist; he advocated the concept of cleaning before 200 years. And gave strict instructions for care of public in infection and contagious disease. In the chapter, FRIEND OF HEALTH (1792, 1795), in the lesser writing of master, clearly give an idea about it. ^[13]

Physicians:

The physicians should wash their hands with vinegar and warm water after seeing the patients. But nowadays it can be substituted by antiseptic solutions. The physicians have a major role in checking for epidemics in birth itself. Common people may be careless but it is the duty of a physician to care the patient with an epidemic too. The physician should wear oil cloaks on each and every visit to the patient. This in modern day it is replaced by neatly washed and disinfected aprons. The physician, when coming to the wards should check both the internal and external condition of the patient. The physician has also a duty to supervise the environment of the patient. He should advise the nurses how a patient should be taken care of. It is the sole duty of a physician to visit the patient twice a day without fail.

Beds:
Every bed should be provided with linen mattresses stuffed with straw. Each mattress should be covered with a linen sheet. Beneath the linen sheet oil cloth of three feet length should be spread, where the nates and back of the patients lie. Each patient should be provided with two linen sheets. Every week one sheet should be given to wash while the patient uses the second sheet that is provided. ^[13]

HOMOEOPATHIC APPROACH- Disease – (in the sense lack of ease; inconvenience): any deviation from or interruption of the normal structure or function of any part ,organ, or system(or combination thereof)of the body that is manifested by a characteristic set of symptom and sign and whose aetiology, pathology and prognosis may be known or unknown.

In aphorism 73 he explain about different types of acute diseases as individual, sporadic, epidemic diseases. In his attempt to explain the epidemic disease he states,“ these disease generally become infectious (contagious) when they prevail among thickly congregated masses of human being”.

BIBILIOGRAPHY

1.https://familydoctor.org/condition/coronavirus/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369385/

3. Neuman BW, Adair BD, Yoshioka C, Quispe JD, Orca G, Kuhn P, Milligan RA, Yeager M, Buchmeier MJ. Supramolecular architecture of severe acute respiratory syndrome coronavirus revealed by electron cryomicroscopy. Journal of virology. 2006;80(16):7918–7928. 

4. Barcena M, Oostergetel GT, Bartelink W, Faas FG, Verkleij A, Rottier PJ, Koster AJ, Bosch BJ. Cryo-electron tomography of mouse hepatitis virus: Insights into the structure of the coronavirion. Proceedings of the National Academy of Sciences of the United States of America. 2009;106(2):582–587. 

5.van der Hoek L, Sure K, Ihorst G, Stang A, Pyrc K, Jebbink MF, Petersen G, Forster J, Berkhout B, Uberla K. Croup is associated with the novel coronavirus NL63. PLoS Med. 2005;2(8):e240. 

6. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KSM, Lau EHY, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, Liu T, Zhao J, Li M, Tu W, Chen C, Jin L, Yang R, Wang Q, Zhou S, Wang R, Liu H, Luo Y, Liu Y, Shao G, Li H, Tao Z, Yang Y, Deng Z, Liu B, Ma Z, Zhang Y, Shi G, Lam TTY, Wu JTK, Gao GF, Cowling BJ, Yang B, Leung GM, Feng Z. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N. Engl. J. Med. 2020 Jan 29; 

7. https://www.ncbi.nlm.nih.gov/books/NBK554776/

8. Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis. Nat. Rev. Microbiol. 2009 Jun;7(6):439-50. 

9. https://www.webmd.com/lung/news/20200310/know-the-symptoms-of-covid19

11. COVID-19  And its Possible Homoeopathic Prophylaxis. Dr.K.Saji. MD(Hom)

https://www.homeopathy360.com/2020/03/11/covid-19-and-its-possible-homoeopathic-prophylaxis/

12.organon text

13. THE LESSER WRITINGS OF SAMUEL HAHNEMANN TRANSLATED BY R.E. DUDGEON.2017 (13 IMPRESSION) B JAIN PUBLISHERS, NEW DELHI. Dudgeon R.E., The Lesser writings of Samuel Hahnemann, B. Jain Publishers, 11^th impression, pg no 203-210.

14. PRC NHCot. The Novel Coronavirus Pneumonia Diagnosis and Treatment Plan (5th trial version). 2020.

About Author:

Dr.Amrutha Manoharan,

B.H.M.S,  M.D(Hom.), Diploma In Yoga