Yoga Mimamsa

CASE REPORT
Year
: 2021  |  Volume : 53  |  Issue : 1  |  Page : 75--77

Effect 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 Kahlilsubramanian1, L Nivethitha2,  
1 Department of Research, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
2 Department of Naturopathy, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
3 Department of Manipulative Therapy, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
4 Department of Yoga Therapy, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India

Correspondence Address:
L Nivethitha
Department of Naturopathy, Government Yoga and Naturopathy Medical College, Arumbakkam, Chennai - 600 106, Tamil Nadu
India

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.



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;53:75-77


How to cite this URL:
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 [serial online] 2021 [cited 2021 Sep 19 ];53:75-77
Available from: https://www.ym-kdham.in/text.asp?2021/53/1/75/322043


Full Text



 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 affecting 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 specific 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 effects, 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 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 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].{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].{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 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 flavonoids. 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 effect 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 effects during the intervention period. Thus, INYT might be effective 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 effect.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.[10]

References

1Abishek, K., Bakshi, S. S., & Bhavanani, A. B. (2019). The efficacy of yogic breathing exercise bhramari pranayama in relieving symptoms of chronic rhinosinusitis. International Journal of Yoga, 12(2), 120-123. doi:10.4103/ijoy.IJOY_32_18.
2Bulut, C., & Kato, Y. (2020). Epidemiology of COVID-19. Turkish Journal of Medical Sciences, 50(SI-1), 563-570. doi:10.3906/sag-2004-172.
3Chang, J. S., Wang, K. C., Yeh, C. F., Shieh, D. E., & Chiang, L. C. (2013). Fresh ginger (Zingiber officinale) has anti-viral activity against human respiratory syncytial virus in human respiratory tract cell lines. Journal of Ethnopharmacology, 145(1), 146-151. doi:10.1016/j.jep.2012.10.043.
4Cinatl, J., Morgenstern, B., Bauer, G., Chandra, P., Rabenau, H., & Doerr, H. W. (2003). Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet (London, England), 361(9374), 2045-2046. doi:10.1016/s0140-6736(03)13615-x.
5Mishra, V., Burma, A. D., Das, S. K., Parivallal, M. B., Amudhan, S., & Rao, G. N. (2020). COVID-19-hospitalized Patients in Karnataka: Survival and stay characteristics. Indian Journal of Public Health, 64(Supplement), S221-S224. doi:10.4103/ijph.IJPH_486_20.
6Mooventhan, A., Khode, V., & Nivethitha, L. (2014). Effect of yogic breathing techniques in new sputum positive pulmonary tuberculosis. International Journal of Preventive Medicine, 5(6), 787-790.
7Ophir, D., & Elad, Y. (1987). Effects of steam inhalation on nasal patency and nasal symptoms in patients with the common cold. American Journal of Otolaryngology, 8(3), 149-153. doi:10.1016/s0196-0709(87)80037-6.
8Ozma, M. A., Maroufi, P., Khodadadi, E., Köse, Ş., Esposito, & I., & Ganbarov, K., … Kafil, H. S. (2020). Clinical manifestation, diagnosis, prevention and control of SARS-CoV-2 (COVID-19) during the outbreak period. Le Infezioni in Medicina, 28(2), 153-165.
9Sengupta P. (2012). Health impacts of yoga and pranayama: A state-of-the-art Review. International Journal of Preventive Medicine, 3(7), 444-458.
10Zhang, L., & Liu, Y. (2020). Potential interventions for novel coronavirus in China: A systematic review. Journal of Medical Virology, 92(5), 479-490. doi:10.1002/jmv.25707.