One of the article published in NCBI This paper reports for the first time, the outcomes of Ayurvedic intervention in a COVID-19 patient with severe hypoxia requiring supportive oxygen therapy.
Patient developed fever, severe cough, loss of smell, loss of taste, nasal block, anorexia, headache, body ache, chills, and fatigue and was hospitalised when she developed severe breathing difficulty. Later, she tested positive for COVID-19 by RT PCR. The patient sought Ayurvedic treatment voluntarily when her SPO2 remained at 80% even after being given oxygen support.
With COVID-19 being self limiting in majority of patients, it is not possible to draw definite conclusions about efficacy of any medical intervention with data from a single patient. However, this case points out the potential for Ayurveda to be considered as a first line and cost effective intervention even in COVID-19 patients with severe hypoxia. The oxygen saturation of the patient remained at 80% even after providing oxygen and Allopathic medications. After administration of Ayurvedic medicines, the oxygen saturation of the patient normalised within a day and oxygen support could be gradually withdrawn. The patient was clinically symptom free after just two days of Ayurvedic treatment. The remaining one week of her stay in the hospital was uneventful. On the basis of this observation, we propose that Ayurvedic treatment may be considered even in moderately severe COVID-19 patients on oxygen support and its role in preventing the progress of the disease to more severe stage should be investigated by conducting larger studies. The classical indications of the medicines administered to this patient point to their relevance in the management of COVID-19. As discussed in the section on diagnosis, the patient presented with symptoms indicating vātakaphapradhānasannipātajvara with indications of increasing pitta dominance. The patient was administered ṣaḍaṅgapānīyaṃ (medicated herbal water made of six herbs) for dīpanapācana (stimulating digestion and metabolism). Guḍūcī (Tinospora cordifolia) was added to make the combination balanced in addressing the imbalance of all three doṣas. Ṣaḍaṅgapānīya has a specific action on pitta in fevers  while guḍūcī can also additionally act on vāta and kapha apart from pitta . Considering the fast progression of breathlessness and hypoxia, with the subjective experience of inability to breathe, the blockage/covering (avarana) of vāta in the āmāśaya (upper gastrointestinal tract) was considered. Breathlessness and cough are mentioned as symptoms of this condition termed as āmāśayagatavāta and ṣaḍdharaṇacūrṇa has been specifically indicated in this context [12,13]. Breathing difficulty caused by obstruction of vāta by kapha has also been clearly mentioned in the texts to be originating in the āmāśaya . On the basis of this clinical judgement, ṣaḍdharaṇacūrṇa was administered for seven days. Sūkṣmatriphalā, which is a combination of triphalā with kajjalī (combination of mercury and sulphur) is a rasāyana (immunity bolstering agent). It is widely used in management of upper and lower respiratory tract. This medicine was administered to prevent infection and support the immune system of the patient. Kanakāsavam was also administered for relief from dyspnoea, which is a main indication of this formulation. It works as an expectorant and dilates the airways . The above medicines were given in divided small doses at short intervals (see Table 1) based on the principle of frequent drug administration (muhurmuhur) in poisoning, vomiting, thirst, hiccough, dyspnoea and cough. Indukāntaṃ kaṣāyaṃ was administered for strengthening the digestion and metabolism, to control and prevent recurrence of fever and also to enhance the strength of the patient . Indukāntaṃ kaṣāyaṃ is indicated in diseases with dominance of vāta, depletion (kṣaya), intermittent fever (nimnonnatajvara) and especially for improving strength (bala). A previous study exploring the effects of Indukāntaṃ Ghrtaṃ (the same decoction cooked in ghee) as an adjuvant in cancer chemotherapy reported it to be capable of inducing leukopoiesis as well as activation of non-specific and specific immune mechanisms of the host . Ayurveda recognises the causative role of a virus as an external agent in diseases like COVID-19. COVID-19 could be classified as an āgantukajvara (fever of exogenous origin) caused by bhūtābhiṣaṅga (bhūta also means virulent microbes), the contact with virulent microorganisms . However, the focus of Ayurvedic treatment is on strengthening host factors like agni (digestive and metabolic functions) and bala (innate strength of body and mind) as well as restoring the balance of the doṣas (restoring functional integrity of the body) to overcome the infection and recover from the disease.
Types of intervention (modern pharmacological) On admission (21 June 2020, around 8 pm), she was prescribed the following medicines.
1. Azee (Azithromycin) 625 mg 1-0-0
2. Cefexime 200 mg 1-0-1
3. T. Dexamethasone 6 mg 1-0-0
4. T. Acetaminophen 650 mg SOS
5. T. Vitamin C 500 mg 1-0-1
6. T. Pantoprazole 40 mg 1-0-0
7.C. Becosule (Vitamin B Complex) 1-0-0
8.Syp. Grilinctus (Guaifenesin, Chlorpheniramine maleate and Ammonium chloride) 2 tsp 1-1-1
The doctors suggested the option of starting Fabiflu, but the patient declined to take this medicine. She stopped taking all the above prescribed medicines after starting the Ayurvedic treatment (22 June 2020 by 7 pm). Only Vitamin C and oxygen support was continued.
Types of intervention (Ayurveda) On the evening of the second day of hospitalisation, she opted for Ayurvedic treatment by consulting Ayurvedic physician by video calling. She was administered the following Ayurvedic medicines immediately.
1. Ṣaḍaṅgapānīyaṃ with Guḍūcī
The dosing and duration of the administration of these medicines are summarised in Table 1 .
The dosing and duration of the administration of these medicines are summarised in