BACKGROUND
COVID 19 is presently a global threat with over 169,268,157 confirmed cases and over 3,515,697 deaths worldwide as reported by WHO. Since no country, economy or healthcare delivery system was prepared to face calamity of this magnitude, there is still acute shortage of hospital beds and emergency services and here is where homoeopathy offers to help.
MATERIAL AND METHODS
Randomized controlled single blind study. Pre-diagnosed case of COVID 19 was taken up. The inclusion criteria for the study were COVID-19 RT-PCR, Rapid Antigen Test kit, HRCT Thorax.
RESULTS
The SpO2 level, symptoms and investigations of patient improved after Homoeopathic treatment.
CONCLUSION
Homoeopathy can be extremely effective in managing COVID 19 epidemic and serves as the first line of treatment.
KEYWORDS
COVID 19, homoeopathy.
ABBREVIATIONS
Corona virus disease 2019 – COVID 19, reverse transcription polymerase chain reaction – RT-PCR, high resolution computed tomography scan – HRCT scan, saturation of peripheral oxygen – SpO2, World Health Organization – WHO, creatinine – creat., serum uric acid – SUA, sodium – Na, potassium – K, chloride – Cl, serum glutamic oxaloacetic transaminase- SGOT, serum glutamic pyruvic transaminase – SGPT, lactate dehydrogenase – LDH, interleukin – IL, c-reactive protein – CRP.
INTRODUCTION
Since last 14-16 months, COVID 19 has kept the whole world on its toes. A Pandemic of this magnitude in 21st Century was far from being imaginable.
All the 219 countries and territories have followed different trajectories regarding number of cases and deaths. India, facing the second wave, stands next to USA and Brazil in maximum number of COVID cases.
India has to cater to a population of over 135 crores, there is approximately 1 doctor for 1445 Indians. For patients, such as this one, suffering from life threatening comorbidities, lack of hospital beds, poses additional challenge.
Therefore, in a country like India, homoeopathy has a larger role to play in prevention, treatment and management of COVID19.
CASE HISTORY
PATIENT DETAILS
Patients Name: Mr. M.A.
Age: 68 years.
Sex: Male.
Marital Status: Married.
Socio-economic group: Middle.
Religion: Muslim.
Occupation: Retired from job
Weight: 77 kg.
Height: 5’10”
Presenting complaints
Main complaints:
- Breathlessness < slightest exertion since 2 days. Initially slight breathlessness since last 6 days
- Cough with whitish expectoration since 4 days
- Swelling over both feet since 4 days
- Moderate fever since 7 days
- Excessive weakness
- Sensation of tightness in chest
History of presenting complaints
Few days back his daughter in law was tested positive for COVID. He was extremely worried for her. He himself developed moderate fever in next 2 days. He got himself checked with rapid antigen test kit for COVID which detected as positive. He started with the usual prescribed government protocol for COVID. On 5th day of taking Azithromycin tablets he started having breathlessness and his SpO2 started to drop gradually. His cough and congestion too worsened. He was advised oxygen intubation and hospital admission but since no beds were available his attendants decided to try homoeopathic treatment along with intermittent oxygen intubation at home.
Physical generals:
Appetite: Poor since onset of COVID. Otherwise he was eating normally. Craving: great desire for salty and spicy food ever since childhood.
Thirst: Intense and for large quantities.
Tongue:
Coated.
Urine: diminished in quantity, non-foamy, non-offensive.
Bowel: once, formed, unsatisfactory.
Sleep: disturbed due to breathlessness and cough.
Dreams: of future events (frequent in past)
Perspiration: mild on face and scalp. Non-offensive and non-staining
Palms
and soles: Dry and warm (no heat, burning or sweating).
Thermal: Chilly
Habits:
Non-vegetarian.
Addiction: Nil.
Physical constitution:
The patient was tall and slightly obese with pot belly. The skin was dry and smooth.
Past history:
- Hypertension since 20 years, controlled with medication
- Diabetes mellitus since 20 years. Taking medicines with poor control.
- Chronic renal failure since 5 years.
Physical Examination:
- Temperature : 100.4
- Blood pressure : 160/90
- Pulse rate : 98/min
- SpO2 : 86
- Random blood sugar : 287
- Respiratory rate: 28/minute
- Bilateral mild pitting pedal oedema
- No organomegaly was found.
- Rest of systemic examination was normal.
Family history
Mother – Diabetes mellitus
Father – Hypertension
Description of patient and life space investigations:
The patient was born and brought up under normal circumstances in a joint family which is why he always wanted to be surrounded by people and had anxiety on being alone. He was in a government job where he worked with honesty and dedication. He was mild and never quarrelled with anyone. But he is very faint hearted and cannot see anyone suffering and keeps on thinking about them.
The patient had been suffering from hypertension which was fairly controlled but his blood sugar remained uncontrolled despite taking medicines. 5 years back, he developed swelling over feet and on investigation it was found that his creatinine was 1.7 with moderate albuminuria.
DIAGNOSIS
This was the case of pre-diagnosed case of COVID19 J12.82 and pre-existing chronic renal failure N18.9, confirmed through investigations attached.[9]
Investigations:
HRCT THORAX (21-04-21): Viral aetiology likely COVID with CO RAD 5 highly suspicious for COVID 19. Extension of disease 35%. Severity index moderate 8/25.
BLOOD (21-04-21): Creat – 3.0, Urea-79.2, SUA-9.8, Na-149, K-4.17, Cl-109.6, SGOT-89.9, SGPT-78.4, LDH-728.4, D-Dimer-11,320, IL-6- 48.2, CRP-24.2.
BLOOD (06-05-21): Creat-2.0, Urea-59, Na-139, K-4.0, SUA-5.3
RT-PCR SARS CoV-2RNA (06-05-21): Negative
CASE ANALYSIS
Miasmatic analysis (Table 1)
| Symptom | Psora | Sycosis | Syphilis | |
| 1. | Anxiety alone | P | ||
| 2. | Anxiety others | P | ||
| 3. | Hypertension | P | ||
| 4. | Diabetes | P | ||
| 5. | Renal failure | P | P | |
| 6. | COVID | P | P |
Analysis and evaluation of symptoms (table 2)
| Chapter | Rubrics selected | Symptom | |
| 1. | Mind | Anxiety others | Mental General |
| 2. | Mind | Anxiety alone | Mental General |
| 3. | Mind | Sympathetic | Mental General |
| 4. | Mind | Mild | Mental General |
| 5. | Sleep | Prophetic Dreams | Mental General |
| 6. | Generalities | Food and drink, salt desire | Physical General |
| 7. | Generalities | Food and drink, spices desire | Physical General |
| 8. | Stomach | Thirst, unquenchable | Particular |
| 9. | Urine | Albuminous | Particular |
Repertorial analysis:
9 symptoms were selected for repertorial analysis and the medicines with maximum coverage were Phosphorus 9/22, Arsenicum album 6/16, Sulphur 7/14, Natrum muriaticum 6/13, Acidum nitricum 5/10. Out of these, Phosphorus was selected.
Justification for first prescription:
Phosphorus was selected as simillimum as it scores the maximum marks compared to all other medicines. The patient lacked the fastidiousness of Arsenicum album though he was fond of bathing, unlike Sulphur. He had no liking for fats ruling out Acidum nitricum and Sulphur, further. The patient also lacked the irritability of Natrum muriaticum and had been calm and composed throughout life under almost all circumstances. Therefore, there could not have been a simillimum better suited to the patient than Phosphorus.[4] (repertory chart attached)
| Date of follow up | Symptoms | Additional comments | Prescription |
| 19-04-21 | First Prescription | Phosphorus Q1.5 drops once every hour. | |
| 22-04-21 | The patients SpO2 rose from 86 to 90 with intermittent intubation, which was their main concern. His breathing was also better. Mild grade fever still persisted from 99 to 99.4F. Cough, expectoration, Tightness of chest were also better. | Since Dr Hahnemann said about 50 millesimal potency (Footnote 155 Aphorism 270) that unlike centesimal, while using 50 millesimal scale, the simillimum may be given for months, if necessary. (Aphorism 246). Since the patient was showing signs of improvement, the same medicine and potency was continued.[5] | Phosphorus Q1. Continued 5 drops once every hour. |
| 27-04-21 | All symptoms were better. There was no fever. SpO2 rose to a maximum of 92 without oxygen intubation. Same prescription was continued. | Since the patient showed signs of further improvement, the same medicine and potency was continued.[5] | Phosphorus Q1. Continued 5 drops once every hour. |
| 06-05-21 | The patient reported much improvement. SpO2 was now stable at 95. Since appetite returned to normal and weakness was also better, China officinalis 30 was stopped. It was assumed the Phosphorus might also bring down the liver enzymes further. The following prescription was continued. | BLOOD (06-05-21): Creat-2.0, Urea-59, Na-139, K-4.0, SUA-5.3 RT-PCR SARS CoV-2RNA (06-05-21): Negative The blood reports of the patient showed improvement and it was necessary to bring down the creatinine even further. The patient had already taken 0/1 potency for 17 days, it was decided to continue with next potency. Therefore, Phosphorus 0/2 was given.[5] | Phosphorus Q2. Continued 5 drops once every hour. |
| 16-05-21 | All symptoms were nearly normal. SpO2 now was 96 but reached 98 at times. | Since the patient showed signs of further improvement, the same medicine and potency was continued.[5] | Phosphorus Q2. Continued 5 drops once every hour. |
| 22-05-21 | The patient reported on phone that all his COVID symptoms were normal and his SpO2 was around 98 – 99 throughout the day | Since he wanted to continue treatment for albuminuria, raised creatinine, Phosphorus was continued and patient was advised to get his liver enzymes rechecked. He was advised to get creatinine and urinary albumin rechecked time to time..[5] | Phosphorus Q1. Continued 5 drops once every hour. |
General Management:
The patients was advised breathing exercises and to lie in prone position. He was asked to take light but nutritious food. All cold food, cold drinks, sour, oily and spicy food were restricted. Zinc and vitamic C tablets were asked to be continued. He was advised intermittent oxygen intubation whenever SpO2 level dropped below 92 or patient had any difficulty.
He was asked to continue his previous medication he was taking for hypertension and diabetes.
He was regularly counseled on phone to maintain positivity as many of his friends of his age group had died.
Conclusion
The global death rate of COVID is 3.9% but the pandemic has assumed Frankenstein proportions as no country in the world was prepared to accommodate so many patients at the same time.
Just as this case, homoeopathy offers ray of hope to almost all stages of patients of COVID19. It has been found to be extremely useful in prevention of COVID, in the initial stages of disease where there are mild symptoms, in the later stages where there are breathing troubles such as this one, in cases which are critical and hospitalized and those having post-covid illnesses.
We need more cases being treated by homoeopaths to be documented and published so that homoeopathy can be established as first line of treatment rather than alternate or complementary. The burden of healthcare on the hospitals of modern medicine, especially in these times, can definitely be reduced by timely intervention of homoeopathy.
References
- WHO Coronavirus (COVID19) Dashboard (Live) World Health Organisation (Internet). (cited 28 May 2021) Available from: https://covid19.who.int/
- Covid 19 in Numbers (Live) Business Standard (Internet). (cited 28 May 2021) Available from: https://www.business-standard.com/coronavirus
- Coronavirus Update (Live): Deaths from Covid19 Virus Pandemic – Worldometer (Internet). (cited 28 May 2021) Available from: https://www.worldometers.info/coronavirus/
- Homoeopathic Repertorium (Mobile Application Software) Version 3.9.5.7. Soft Solutions 22-12-2015.
- Patil J D, Hahnemann’s final direction on dose and repetition. Homoeobook (Mobile Application Software) Version 6. Avaanet Media. 12-04-12
- Boericke W., Boerick’s Pocket Manual of Homoeopathic Materia Medica and Repertory, B Jain Publishers Pvt Ltd, Reprint Edition 2000, page 65-66, 94.
- Ubiratan Cardinalli Adler 1, Maristela Schiabel Adler 2, Livia Mitchiguian Hotta 3, Ana Elisa Madureira Padula 4, Amarilys de Toledo Cesar 5, José Nelson Martins Diniz 6, Crislaine Aparecida Antonio Mestre 7, Katia Regina Spiller 8, Lidiamara Soares 8, Helen de Freitas Santos 9, Edson Zangiacomi Martinez 10. Homoeopathy for Covid-19 in Primary Care: A structured summary of a study protocol for a randomized controlled trial. (Internet). Cited 28-05-2021. Available from https://pubmed.ncbi.nlm.nih.gov/33522951/
- D. Kalliantas,1,2 M. Kallianta,3 and Ch. S. Karagiannil. Homoeopathy combat against coronavirus disease (Covid-19). (Internet). Cited 28-05-2021. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272237/
- Thomas CKwee , Robert M. Kwee. Chest CT in COVID-19: What the Radiologist Needs to Know. (Internet). Cited 23-10-20 https://pubs.rsna.org/doi/full/10.1148/rg.2020200159
About the authors
- Dr Lubna Kamal, Asstt Professor , Department of Materia Medica, State Jawahar Lal Nehru Homoeopathic Medical College, Kanpur.
- Dr Mohan Singh, MD, Nano Homoeopathy Pvt Ltd, New Delhi, Lucknow, Haldwani, Haridwar.
- Dr Vandana Mishra, Asstt Professor , Department of Materia Medica, State Jawahar Lal Nehru Homoeopathic Medical College, Kanpur.
Reports Before
Reports After
About Author:
Dr Lubna Kamal, Dr Mohan Singh, Dr Vandana Mishra
