Coronavirus (COVID-19)

Overview of Coronavirus (COVID-19)

The COVID-19 pandemic, also known as the coronavirus pandemic, an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was first identified in December 2019 in Wuhan, China. The World Health Organization declared a Public Health Emergency of International Concern regarding COVID-19 on 30 January 2020, and later declared a pandemic on 11 March 2020. As of 24 April 2021, more than 145 million cases have confirmed, with more than 3.08 million deaths attributed to COVID-19, making it one of the deadliest pandemics in history.[3]

The name "coronavirus" derived from the Latin corona & the Greek κορώνη (korṓnē, "garland, wreath"), meaning crown or halo.

This refers to the characteristic appearance of virions (the infective form of the virus) by electron microscopy.

Strains

There seven known strains of human Coronavirus (COVID-19) i.e.:

1.Firstly, Human Coronavirus (COVID-19) 229E (HCoV-229E)

2.Secondly, Human coronavirus OC43 (HCoV-OC43)

3. Thirdly, SARS-CoV

4.Fourthly, Human coronavirus NL63 (in other words, HCoV-NL63, New Haven coronavirus)

5.After that, Human Coronavirus (COVID-19) (COVID-19) HKU1

6. Then, Middle East respiratory syndrome #coronavirus (MERS-CoV), previously known as novel       coronavirus #2012 and HCoV-EMC.

7.Lastly, Novel coronavirus (2019-nCoV), also known as Wuhan pneumonia or Wuhan coronavirus.

(‘Novel’ in this case means newly discovered, or newly originated, & is a placeholder name.)[1]

Other important key points

Coronaviruses are zoonotic, meaning they are transmitted between animals and people.  Detailed investigations found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans. The virus that caused the outbreak is known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a newly discovered virus closely related to bat coronaviruses, pangolin coronaviruses, and SARS-CoV.  Scientific consensus is that COVID-19 is a zoonotic virus that arose from bats in a natural setting.[3]

All India Radio (4 jun 2020)

Transmission of Coronavirus (COVID-19)

It spreads from an infected person’s respiratory secretions virus-containing particles exhaled by an infected person, either respiratory droplets or aerosols, get into, Mouth, eyes, nose, or through coughing, sneezing, by touching an infected person’s hands or face, or by touching things such as doorknobs that infected people have touched.

It spreads from infected persons to others through close contact, such as caring for or living with that person also to others in healthcare settings, such as hospitals. The closer people interact, and the longer they interact, the more likely they are to transmit COVID-19.

Droplet infection

Closer distances can involve larger droplets (which fall to the ground) and aerosols, whereas longer distances only involve aerosols. Larger droplets can also turn into aerosols (known as droplet nuclei) through evaporation. The relative importance of the larger droplets and the aerosols is not clear as of November 2020; however, the virus is not known to spread between rooms over long distances such as through air ducts.[3]

Airborne transmission

In detail, Airborne transmission is able to particularly occur indoors, in high-risk locations such as restaurants, choirs, gyms, nightclubs, offices, also religious venues, often when they are crowded or less ventilated. Additionally, It also occurs in healthcare settings, often when aerosol-generating medical procedures are performed on COVID-19 patients.

The number of people generally infected by one infected person varies:

on average, infect between two and three other people. Moreover, This is more infectious than influenza, but less so than measles. Besides this, It often spreads in clusters, where infections can be traced back to an index case or geographical location.

There is a major role of "super-spreading events",

where many people are infected by one person. A person who is infected can transmit the virus to others up to two days before they themselves show symptoms, and even if symptoms never appear. Lastly, People remain infectious in moderate cases for 7–12 days, and up to two weeks in severe cases. In October 2020, medical scientists reported evidence of reinfection in one patient.[3]

Cause of Coronavirus (COVID-19)

• COVID-19 is caused by a coronavirus, SARS CoV-2.

• Other types of coronavirus cause different illnesses, from mild ones such as colds, to more serious conditions such as SARS and MERS.

• Since the beginning of the pandemic, new variants of the SARS CoV-2 virus have emerged.

• These are slightly different versions of the virus which behave in different ways. These have tended to be more contagious (spreading more easily) than the original virus did. There is also some concern that existing vaccines and treatments might be less effective against the variants. However, in some cases, they also seem to be less likely to cause serious illness.
• Notable variants of SARS CoV-2 include: the alpha variant; beta variant; delta variant; and omicron variant. (19)

Types of Coronaviruses (COVID-19)

There are four Trusted Source subtypes of coronavirus — alpha, beta, gamma, and delta —and scientists use these classifications to categorize the various species.

Among all the coronaviruses, seven have affected humans. Four of these are common and cause mild illnesses in the upper and lower airways, nose, sinuses, throat, and lungs.

The remaining three can cause more severe illness. They are:

• severe acute respiratory syndrome coronavirus (SARS-CoV), which led to the SARS epidemic in 2002–2003
• Middle East respiratory syndrome coronavirus (MERS-CoV), which caused an outbreak of MERS that began in 2012
• SARS-CoV-2, the virus responsible for the COVID-19 pandemic. (21)

Risk Factor of Coronavirus (COVID-19)

It can get COVID-19, and most infections are mild. The older you are, the higher your risk of severe illness.

You also a have higher chance of serious illness if you have one of these health conditions i.e.:

• Chronic kidney disease
• Chronic obstructive pulmonary disease (in other words, COPD)
• A weakened immune system because of an organ transplant
• Obesity
• Serious heart conditions such as heart failure or coronary artery disease
• Sickle cell disease
• Type 2 diabetes [2]

Conditions that could lead to severe Coronavirus (COVID-19) illness include i.e.:

• Moderate to severe asthma
• Diseases that affect your blood vessels and blood flow to your brain
• Cystic fibrosis
• High blood pressure
• A weakened immune system because of a blood or bone marrow transplant, HIV, or medications like corticosteroids
• Dementia
• Liver disease
• Pregnancy
• Damaged or scarred lung tissue (i.e. pulmonary fibrosis)
• Smoking
• Thalassemia
• Type 1 diabetes

Some children and teens who are in the hospital with Coronavirus (COVID-19) have an inflammatory condition that doctors are calling multisystem inflammatory syndrome in children. Doctors think it may be linked to the virus. It causes symptoms similar to those of toxic shock and of Kawasaki disease, a condition that causes inflammation in kids’ blood vessels. [2]

Pathophysiology of Coronavirus (COVID-19)

• Coronaviruses are enveloped positive strand RNA viruses which mean that the viral RNA acts as mRNA once it enters human host and starts synthesizing viral proteins.
• The envelope plays an important role in viral pathogenesis.
• The viral assembly and release is promoted by the envelope proteins.[20]

Sign and Symptoms of Coronavirus (COVID-19)

Symptoms of COVID-19 are variable, ranging from mild symptoms to severe illness. Common symptoms include

• Headache^.
• Loss of smell and taste,
• Nasal congestion
• Runny nose,
• Cough,
• Muscle pain,
• Sore throat,
• Fever, diarrhoea,
• Breathing difficulties.

People with the same infection may have different symptoms, and their symptoms may change over time.

Common symptoms

Three common clusters of symptoms have been identified i.e.:

[1] Firstly, respiratory symptom

• Cluster with cough, sputum, shortness of breath, and fever; a

[2] Secondly, musculoskeletal symptom

• Cluster with muscle and joint pain, headache, also fatigue;

[3] Thirdly, cluster of digestive symptoms

• with abdominal pain, vomiting, also diarrhea.

In people without prior ear, nose, and throat disorders, loss of taste combined with loss of smell is associated with Coronavirus (COVID-19). [3]

81% develop mild to moderate symptoms (up to mild pneumonia), while

14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging) and

5% of patients suffer critical symptoms (respiratory failure, shock, or multiorgan dysfunction).

Other symptoms

At least a third of the people who are infected with the virus do not develop noticeable symptoms at any point in time. These asymptomatic carriers tend not to get tested and can spread the disease. Other infected people will develop symptoms later, called "pre-symptomatic", or have very mild symptoms and can also spread the virus.

As is common with infections, there is a delay

 between the moment a person first becomes infected and the appearance of the first symptoms. The median delay for Coronavirus (COVID-19) is four to five days. Most symptomatic people experience symptoms within two to seven days after exposure, and almost all will experience at least one symptom within 12 days.

Most people recover from the acute phase of the disease. However, some people continue to experience a range of effects for months after recovery named long COVID and damage to organs has been observed. Multi-year studies are underway to further investigate the long-term effects of the disease. [3]

Symptoms of Coronavirus (COVID-19) Infection coronavirus

Clinical examination of Coronavirus (COVID-19)

• Physical exam of a suspected or confirmed case of COVID-19 patient should be conducted in a private room, preferably a negative pressure one.
• The examiner should have PPE that includes gloves, gowns or aprons, masks, or respirators covering the mouth and nose, goggles, and face shields. Due to the risk of aerosol spread of the SARS-CoV-2 virus, CDC recommends that protective eyewear (such as goggles or a face shield) should cover the front and sides of the face with no gaps between glasses and the face.
• If possible and the patient is in no respiratory distress, patient should wear a surgical mask.

Appearance of the Patient

• General appearance of the patient infected with SARS-CoV-2 virus (cause of COVID-19) depends on the severity of the illness and the presence of infection associated complications involving different organ systems.
• Patients with mild disease may appear healthy.
• Patients will appear sick, lethargic, and short of breath in severe disease.
• Patient may appear dehydrated (decreased skin turgor and dry mucosa) due to increased respiratory rate, nausea and vomiting,
• Anxiety is an important accompanying factor with majority of patients visiting hospitals, provided the heterogeneous nature of the disease. A healthy patient may worry regarding contracting the infection while visiting the hospital or doctor’s office.
• Cyanosis depicts severe hypoxemia and the need for supplemental oxygen.

Vital Signs

Pulse:

• Heart rate: A normal heart rate is between 60 and 100 bpm with a few exceptions such as athletes. A healthy asymptomatic patient may have a normal heart rate but that does not rule out infection. Sinus tachycardia, the most common type of arrhythmia among COVID-19 patients can be due to fever, hypoxia, shock due to sepsis, and anxiety. Some pathologic causes of arrhythmias include ventricular ^{tachyarrhythmia} , atrial fibrillation (pulse rate 100 to 175 bpm) and atrial flutter (pulse rate 150 bpm).
• Rhythm: Sinus tachycardia has a regular rhythm. An irregular pulse due to a few pathologic arrhythmias can be due to atrial fibrillation and ventricular tachyarrhythmia and COVID-19-associated Guillain-Barre syndrome.
• Volume: A low volume pulse indicates dehydration and the potential need to rehydration therapy.

Temperature:

• Fever (>100.4°F )is a common temperature finding (observed in 89% patients) with rest of the patients being a febrile. Temperature of the patient can be in any range (102°F-99.5°F) reported. Although body temperature is a good screening tool, afebrile patients have been confirmed to have COVID-19 infection. A recent non-peer reviewed case report describes acute hypothermia in a COVID-19 patient.(30.2°F).

Respiratory rate:

• Normal respiratory rate among adults is 12 to 16 breaths per minute. Tachypnea (> 30 breaths/min) among COVID-19 positive patient sis the response to lung inflammation or can be a sign of progressive respiratory failure and can be found in COVID-19-associated pneumonia, ARDS and COVID-19-associated Guillain-Barre syndrome. A respiratory rate of > 28-30 / min, or dyspnea, warrant the administration of oxygen by of 40% venturi mask. Oxygen saturation, respiratory rate, CXR and importantly dyspnea help determine the need for invasive mechanical ventilation.

Oxygen saturation:

• SpO2 < 93-94% warrants the administration of oxygen by of 40% venturi mask and marks severe disease. In younger individuals, the arterial oxygen saturation is more important than it appears. The deterioration of inflammatory lung injury is manifested by a decrease in oxygen saturation (< 93%) first, followed by dyspnea among younger individuals with no other comorbidities.

Blood pressure:

• Low blood pressure can be due to dehydration, septic shock, heart failure or pathologic arrhythmias associated with COVID-19. Hypertension is itself a risk for severe COVID-19 infection.

Skin

• Skin examination of patients with COVID-19 includes the following lesions:
  • Erythema multiforme-like Further studies are required to evaluate exact etiology these lesions to be COVID-19, drug intake or any other conditions.
  • Erythematous maculo-papular Acral eruption of erythema to‐violaceous papules and macules, with possible bullous evolution, or digital swelling can be observed.
  • Urticarial
  • Chickenpox-like
  • Purpuric peri-flexural
  • Transient livedo reticularis
  • Acro-ischemic: The lesion constitutes finger or toe cyanosis, skin bullae and dry gangrene.
  • Chilblain-like They constitute bilateral red-purple papules on the dorsum of the fingers and diffuse erythema on the subungual area of thumb. During the COVID-19 disease course, pseudo‐chilblain patterns may appear.

HEENT

Head exam:

• Patients with fluid retention due to COVID-19-associated acute kidney injury may have edema (especially peri-orbital) and swelling of face and extremities. Cervical lymphadenopathy can be present although very few cases have been reported.

Eye exam:

• • Conjunctivitis: has been reported but there is no well-established data regarding this manifestation.
  • Epiphora: Patients can have teary eyes due to conjunctivitis itself or foreign body sensation.
  • Papilledema can be due to increased ICP or cranial nerve palsy.
  • Although there are no reports of blurred vision, but visual acuity should be accessed.

Ear exam:

• A case report of COVID-19 associated otitis media demonstartes hyperemia and bulging tympanic membrane among the patient. Audiometry and tympanometry can help investigate hearing sequelae.

Nasal exam:

•  Runny nose and nasal congestion are relatively common physical exam findings.

Throat exam:

• Throat congestion, Tonsil edema have been reported.

Neck

• On inspection, a patient with severe hypoxia will be using accessory muscles for respiration visible on the neck exam. A direct sign of increased work of breathing is palpation of the sternomastoid and detecting the phasic contraction.
• Jugular venous pressure:
  • High JVP or Jugular Venous Distension (JVD) can be a sign of COVID-19-associated heart failure or COVID-19-associated myocarditis.
  • Low JVP: Demonstrates low CVP indication low intravascular volume. Among patients with COVID-19 associated ARDS, CVP guides the fluid management.

Lungs:

Tachypnea

Maybe normal respiratory rate

Increased vocal fremitus

Diminished chest expansion at the affected side

Dull percussion note

Decreased breath sounds if pleural effusion accompanies

Bronchial breath sounds

Rhonchi

Rales and Crackles

Heart

• Pulse pressure: A narrow pulse pressure may indicate hypovolemic shock requiring fluid therapy or fulminant myocarditis.

Palpation:

• The apical impulse may be displaced laterally if there is left ventricular dilation in COVID-19-associated myocarditis or COVID-19-associated heart failure. A parasternal heave may be observed depicting COVID-19-associated heart failure.
• Cardiac auscultation may demonstrate tachycardia or arrhythmias (irregular beat).
  • S₃ or a summation gallop especially in significant biventricular dysfunction, COVID-19-associated heart failure or COVID-19-associated cardiogenic shock
  • Mitral or tricuspid murmurs (holosystolic murmurs) may also be noted in the presence of significant ventricular dilation leading to regurgitant flow across AV valves. Among COVID-19-associated heart failure and COVID-19-associated myocarditis.
  • Pericardial friction rub and low intensity heart sounds may be evident if pericardium is involved causing pericarditis and effusion respectively.

Abdomen

• Some patients with COVID-19 may report abdominal pain but abdominal exam findings to be positive is very rare. Based on three case reports describing patients’ atypical COVID-19 presenting complaints the following findings can be observed among patients:
• Inspection: Slight abdominal distension on day 4 of admission in a single case presenting as acute pancreatitis.
• Palpation: One COVID-19 positive patient had abdominal tenderness and rebound tenderness at the right iliac fossa with no diagnostic proof of acute appendicitis. Direct epigastric and peri-umbilical tenderness is reported in only one case. The presence of hepatomegaly among patients with COVID-19-associated hepatic injury maybe a forethought of organomegaly.
• Percussion: No abnormal findings have been reported.
• Auscultation: Hypo/hyperactive bowel sounds have not been reported.

Back

• Gait can be impaired and the patient will have flaccid paralysis among COVID-19-associated Guillain-Barre syndrome and COVID-19-associated polyneuritis cranialis.

Genitourinary

• There are no reports of genitourinary manifestations of COVID-19 but due to the association of SARS with orchitis due to autoimmune mechanisms, urologists recommend that genitourinary examination of patients infected with SARS-CoV-2 virus (case of COVID-19) is usually not be missed.

Neuromuscular

Mental status exam:

•  Glasgow coma scale can gauge the conscious state of the patient. Confusion can be due to severe dehydration, electrolyte imbalances such as among COVID-19-associated acute kidney injury, COVID-19-associated encephalitis, COVID-19-associated meningitis or COVID-19-associated stroke. Moreover, a patient can be unconscious.

Cranial Nerve exam:

• Any cranial nerve can be involved with physical exam findings such as:
  • Cranial Nerve 1 or Olfactory nerve should be examined to evaluate for anosmia. Studies suggests that anosmia can be an important clue, helping the diagnosis of COVID-19 specially in the early stages. According to a study published anosmia and ageusia could be strong predictors of COVID-19 infection.
  • Cranial nerve III: Ophthalmospasms.
  • CN-VII: facial weakness (frequent finding) in GBS. Other cranial nerves involved in the disease include CN- III, V, VI, IX, X and XII resulting in ptosis, facial droop, dysphagia and dysarthria and diplopia.

Extremities

• Patients with fluid retention due to COVID-19-associated acute kidney injury, COVID-19-associated heart failure, COVID-19-associated myocarditis or COVID-19-associated hepatic injury have pedal edema on examination.
• COVID-19 toes: As explained earlier, pseudo-chilblain patterns may appear on toes widely known as COVID toes. A patient presented with purple toes should be tested for COVID-19 virus infection.[22]

Prognosis of Coronavirus (COVID-19)

The severity of COVID-19 varies.

The disease may take a mild course with few or no symptoms, resembling other common upper respiratory diseases such as the common cold.

In 3–4% of cases (7.4% for those over age 65) symptoms are severe enough to cause hospitalization.

Mild cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks to recover. [3]

Among those who have died, the time from symptom onset to death has ranged from two to eight weeks.

The Italian Istituto Superior di Sanità reported that the median time between the onset of symptoms and death was twelve days, with seven being hospitalized.

However, people transferred to an ICU had a median time of ten days between hospitalization and death.

Prolonged prothrombin time and elevated C-reactive protein levels on admission to the hospital associate with severe course of COVID-19 and with a transfer to ICU.[3]

Differential diagnosis of Coronavirus (COVID-19)

• Influenza
• Pulmonary embolism
• Congestive heart failure
• Pericarditis
• Pneumonia
• Vasculitis
• Chronic obstructive pulmonary disease (COPD) [22]

Complication of Coronavirus (COVID-19)

Infection of humans with the severe acute respiratory syndrome coronavirus (SARS-CoV) results in substantial morbidity & mortality, with death resulting primarily from respiratory failure.

While the lungs are the major site of infection, the brain also infect in some patients.

Brain infection may result in long-term neurological sequelae, but little known about the pathogenesis of SARS-CoV in this organ.

Cardiac complications are also recognized

Investigations of Coronavirus (COVID-19)

1. If the rapid test is positive, RT-PCR test should be done on the same day.
2. RT-PCR

The test will find out how active the corona is

• RT-PCR If it occurs between 15 to 20, get the following report in two days.

CBC, CRP,

ESR

LFT

D-Dimmer

SGPT

HRCT required if needed

Treatment of Coronavirus (COVID-19)

There is no specific, effective treatment or cure for coronavirus disease 2019 (COVID-19), the disease caused by the SARS-CoV-2 virus. Thus, the cornerstone of management of COVID-19 is supportive care, which includes treatment to relieve symptoms, fluid therapy, oxygen support and prone positioning as needed, and medications or devices to support other affected vital organs.[3]

In mild cases:

• Rest
• Plenty of fluids.

Isolate at home and wear a face mask.

• Paracetamol/ NSAID

Aspirin to be avoided in children because it can cause Reye’s syndrome.

Use Ibuprofen instead.

In severe cases

May need treatment in hospital.

In those with low oxygen levels, use of the glucocorticoid dexamethasone is strongly recommended, as it can reduce the risk of death.

Non-invasive ventilation and, ultimately, admission to an intensive care unit for mechanical ventilation may be required to support breathing.

Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory failure, but its benefits are still under consideration.

Others were thought to be promising early in the pandemic, such as hydroxychloroquine and lopinavir/ritonavir, but later research found them to be ineffective or even harmful.

Remdesivir i.e.

-Emergency use approval
-Can not stop Death

When to give
– RT- PCR confirm positive patient
– oxygen level below 94%( patient on ventilator, on oxygen)
– Chest infection in CT scan
– In first 9 days to take injection is beneficial, can not stop death but make recovery fast.

Favipiravir i.e.

Emergency use approval
Can decrease viral load

When to give
–Fever, expectoration, difficulty in breathing
-RT PCR positive
-For patients age between 18 to 75 year
-According to National guidelines not beneficial.
-To reduce infection if give within 72 hours it would be beneficial.

Plasma therapy

Emergency use approval is still on an experimental scale
When is it given?
– RT-PCR positive , About Paint 18 & Above
– Fever Cough Shortness of breath respiratory rate more than 30 per minutes or oxygen level below 94%
– Can improve the corona of the primary stage, Therapy needs to be started early, more data is still needed to check the results.

Prevention of Coronavirus (COVID-19)

Tips to Prevent Coronavirus (COVID-19)

The Expert Group has further suggested that general hygienic measures for prevention of Coronavirus (COVID-19) infections

Using Homeopathy for Epidemics

Homeopathy has had a long and successful history of treating and/or preventing epidemics such as smallpox, cholera, diphtheria, malaria, yellow fever, and leptospirosis. Homeopathy had a 98% cure rate of the deadly Spanish flu of 1918, compared to the 30% mortality rate of patients treated with Western allopathic medications.

Prevention Novel coronavirus infections

• The AYUSH ministry has issued a health advisory and recommended that homeopathic medicines could help in prevention of novel coronavirus (nCoV) infections.
• The advisory issued following a meeting on Tuesday(28th Jan 2020) of the scientific advisory board of the Central Council for Research in Homoeopathy (in other words, CCRH) under the Ministry of AYUSH to discuss ways and means for prevention of the nCoV infection through homoeopathy
• It has recommended that homoeopathic medicine Arsenicum album 30 could take empty stomach daily for three days as a prophylactic medicine against the infection. The dose should repeat after one month by following the same schedule in case the nCoV infection prevails in the community

Note:

Note that it is important to select one protocol and to not use all of the following remedies at once for prophylaxis. The remedy or protocol should select in consultation with a professional homeopath.

In January 2020, the AYUSH Ministry in India issued a recommendation for prevention of coronavirus transmission. The Ministry recommended that homeopathic Arsenicum album 30C was to take once per day for 3 days as a preventative measure.

Banerji Protocols

Under ‘The Banerji Protocols’ of Treatment, with Homeopathic medicines: For Prevention of COVID-19 the best medicine is ‘Thuja 30‘. The suggested dose for this medicine will, once daily for 7 days, then once a week for 3 weeks.

Dr. Bhatia

Dr. Bhatia recommends Bryonia alba 6CH or 30CH, as a prophylactic. It can give (only to affected population) once a day, till days become warmer and the epidemic subsides (hopefully).

Amma Resonance Foundation

The Amma Resonance Foundation recommends Gelsemium based on the experience of around 30 homeopaths in treating confirmed cases of coronavirus in China (Source: Hong Kong Association of Homeopathy and Macau Association of Homeopathy). Advice: use Gelsemium C30 once a week as long as the outbreak is not near to where you live, and change to once daily for one week once it gets near and then change to twice per week. Justica adhatoda 3X (or D3) (Malabar nut, India) is also recommended, taken once daily 10 drops in a teaspoonful of water (increases your IgE levels to fight the virus).

Dr. Rajan Sankaran

Dr. Rajan Sankaran’s recommendation for prophylaxis: Camphor 1m 4 pills twice daily 2 days..keep under tongue until melt..nothing but water 30mins before after.

Jeremy Sherr

For prevention, Jeremy Sherr recommends taking Aconite twice daily for two days, then take Ant tart 200C alternating with Phos Ac twice daily each.

Dr. Andre Saine

According to Dr. Andre Saine, in Hong Kong they were able to give 4-5% (about 300,000 out of 7 million people!) prevention with Gels 30: the first week once a day, then once a week. 4-5% took at least one dose. No sick people recorded. In Hong Kong the Corona incidence was relatively low. Now new people are coming to Hong Kong, and the incidence is rising. They now give Gels and Bry as a prevention. Macao (600.000 people) 50% got Gels. No sick people recorded.

Homeopathic nosodes (homeoprophylaxis) have been used successfully during disease epidemics for hundreds of years. This is another possible viable option instead of or along with using the above remedies.

Homeopathic Treatment of Coronavirus (COVID-19)

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis. 

Which includes 

• The medical history of the patient, 
• Physical and mental constitution, 
• Family history, 
• Presenting symptoms, 
• Underlying pathology,
• Possible causative factors etc. 

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions. 

What Homoeopathic doctors do? 

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’? 

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. Now a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition. 

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improve with homeopathic medicines. 

Homeopathic Medicines for Coronavirus (COVID-19)

The homeopathic remedies (medicines) given below indicate the therapeutic affinity but this is not a complete and definite guide to the homeopathy treatment of this condition. The symptoms listed against each homeopathic remedy may not be directly related to this disease because in homeopathy general symptoms and constitutional indications also taken into account for selecting a remedy, potency and repetition of dose by Homeopathic doctor. 

So, here we describe homeopathic medicine only for reference and education purpose. Do not take medicines without consulting registered homeopathic doctor (BHMS or M.D. Homeopath).  

Medicines:

Arsenic Album

This remedy corresponds to the trial form of influenza. It covers more phases of grippe than perhaps any other remedy. Hughes believes that it will cut short an attack, especially when there is a copious flow, prostration and paroxysmal coryza. Its periodicity makes it suitable to epidemics, and it suits the early symptoms when the affection is in the upper portion of the respiratory tract. The burning dryness and copious watery excoriating secretion and the involvement of the conjunctiva are unmistakable indications. Langour and prostration are prominent symptoms. Arsenicum iodide. Chills, flushes of heat and severe fluent coryza, discharge irritating and corrosive, sneezing and prostration. It corresponds to true influenza and is highly recommended. 

Aconite 

Homeopathic medicines for common cold having coryza caused by cold, dry winds; first with violent headache Roaring in ears, in the earlier stage Feverish with dryness in the nostrils, sleeplessness; heat and sense of fullness in nares

Belladona

high fever, red face, cold extremities, throbbing pains, patient radiates heat. Skin hot, dry with high temperature Throbbing headache, very thirsty or not thirsty, sore throat on right side Eyes glassy Eyes dilated. Delirious in high fever

dry barking cough

desires lemons or lemonade

Bryonia 

Homeopathic medicine for common cold having severe dry coryza with catarrh of the frontal and maxillary cavities

Fluent coryza, beginning with violent and frequent sneezing, accompanied by stitching headache when stooping Nose blocked with congestion in the head

Hoarseness and altered tone of voice

Profuse nose bleed; catarrh extending to chest

Gelsemium 

Insidious onset of cold with marked body ache and prostration.

Dullness and drowsiness are marked.

Thirstless.

Muscle’s sore all over body so that sneezing forces him to support chest

Fluent coryza with frequent sneezing and dropping of a clear, hot water

Inner nose red, swollen, interfering with breathing, amelioration in cool room and open air.

Eupatorium perf. 

Coryza, with aching in every bone, and lassitude

Fluent coryza with sneezing and hoarseness

Weight overhead and forehead

Nose and eyes both streaming with water at intervals.[4]

Silicea

Homeopathic medicines for common cold having alternately dry and fluent coryza with every fresh cold

Stoppage and acrid discharge from nose

Frequent but ineffectual sneezing; makes inner nose sore and bloody

Dryness of throat, rough cough

Itching in Eustachian tube; frequent sneezing, especially in cold air

Frequent chilliness, even while taking exercise; cold nose

Influenzinum

Acute or chronic coryza.

Acute and chronic rhino-pharyngitis, Nasal congestion.

Coryza of influenza, sinusitis, nasal polyps, chronic atrophic rhinitis

Dry painful cough, bronchial asthma, bronchitis, bronchopneumonia of influenza

This generally prevents the spread of the trouble and clears up the colds, whether they are influenza or not.[4]

Phosphorus [Phos]

It is "the great mogul of lobar pneumonia." It should remember that Phosphorus is not, like Bryonia, the remedy when the lungs completely hepatize, although it is one of the few drugs which have known to produce hepatization.

When bronchial symptoms are present it is the remedy, and cerebral symptoms during pneumonia often yield better to Phosphorus than to Belladonna.

There is cough; with pain under sternum, as if something torn loose; additionally there is pressure across the upper part of the chest and constriction of the larynx; there is pressure across the upper part of the chest and constriction of the larynx; there mucous rales, labored breathing, sputa yellowish mucus, with blood streaks therein, or rustcolored, as under Bryonia. Besides this, After Phosphorus, Hepar Sulphur. naturally follows as the exudate begins to often; it is the remedy of the third stage, the fever is; of a low character. Tuberculinum.

Other symptoms

Arnulphy says that in lobular pneumonia this remedy surpasses Phosphorus or Antimonium tartaricum, and competent observers convince that it has an important place in the treatment of pneumonia; some using it in very case intercurrently; doses varying from 6x to 30x. When typhoid symptoms occur in the course of pneumonia then Phosphorus will come in beautifully. Phosphorus follows Bryonia well, being complementary to it.

Lastly, There is also a sensation as if the chest were full of blood, which causes an oppression; of breathing, a symptom met with commonly enough in pneumonia.

Carbo Vagetabilis

In case of infection, individualized treatment by a licensed homeopath is recommended.

Prof. Aaron To Ka Lun

Prof. Aaron To Ka Lun (PDHom, MARH), president of the Hong Kong Association of Homeopathy has gathered data from 30 homeopaths and tentatively speculated on a few possible genus epidemicus remedies: Gelsemium, Bryonia and Eupatorium perf.

Dr. Paul Herscu

In terms of the larger remedies, Dr. Paul Herscu has found that the main effective homeopathic remedies have been, in order of likelihood: Sulphur, Lycopodium, Bryonia, and then less likely Phosphorus, and Arsenicum album. By far, at this moment, he has found that the most common remedy is Sulphur.  The more acute remedy seems to be Bryonia.

Dr. Bhatia

Dr. Bhatia believes that the remedy that covers the initial symptoms better is Bryonia alba; and that this remedy will work well as prophylactic too. He also believes that the remedy that covers the later symptoms best is Lycopodium and could expect to help a large majority of people who develop Pneumonia.

Amma Resonance Healing Foundation’s

Amma Resonance Healing Foundation’s current remedy recommendations are Bryonia, Lycopodium, Phosphorus, Gelsemium and Eupatorium perfoliatum (ordered in likelihood of being called for).

Dr. Massimo Mangialavori

As of March 22, 2020, Dr. Massimo Mangialavori has treated 84 patients. His first choice is Chininum muriaticum, followed by Grindelia robusta and thirdly Camphora.

Dr. Rajan Sankaran

In consultation with his teacher, Dr. Rajan Sankaran, Iranian homeopath Dr Aditya Kasariyans has treated coronavirus patients successfully using Camphora 1M.

Jeremy Sherr

As of March 28, 2020, Jeremy Sherr has successful treated also supervised over 200 confirmed COVID-19 cases from around the world, and has had no fatalities. For treatment, Jeremy Sherr recommends giving Aconite at the very first signs of illness. Ant tart (stage 2, 3) has been his most useful remedy. The next most useful remedies used in his practice have been Phosphorus (stage 1, 2), Phosphoric Acid (stage 2) also Bryonia (all stages), Arsenicum (stage 1) and Mercurius (stage 1). Besides this, Other remedies that may prove useful include Gelsemium, Croton tig, Spigelia, Kali bi, Pyrogen, Ars-i and Ant-ars.

Dr. Robin Murphy

Dr. Robin Murphy recommends giving Gelsemium, Arsenicum, or Camphora during the first stage of the illness. He recommends Aconite, Belladonna or Ferrum Phos for mild coronavirus infections. Arsenicum, Bryonia and Gelsemium have been Dr. Murphy’s top remedies during this pandemic. Other remedies that may prove useful include Bapt, China, Drosera, Eup per, Oscillo, Merc, Pyrogen, Rhus tox, and Pulsatilla.

Dr. Andre Saine

Dr. Andre Saine feels that the better indicated remedies for the current COVID-19 pandemic are Bryonia, Beryllium metallicum, Gelsemium, Eupatorium perfoliatum, Camphora, Lobelia purpurescens, and Arsenicum. Other useful remedies (though this list is not exhaustive) include Ammonium mur, Mag mur, Carbo veg, Bapt, Cuprum met, Ferrum phos, Rhus Tox, Sabadilla, Sambucus, and Sanguinaria.

Sally Fallon of the Weston A Price Foundation

For dietary advice on how to protect oneself from any virus (including coronavirus), Sally Fallon of the Weston A Price Foundation has written two excellent articles: How To Protect Yourself From Coronavirus (Or Any Virus)
as well as another article that follows up on her earlier one: More on Coronavirus

Dr. Amy Rothenberg’s

For more lifestyle and supplement advice about keeping one’s immune system in optimal condition, please refer to Dr. Amy Rothenberg’s latest article: COVID-19 Thoughts and Recommendations: April 1, 2020

Disclaimer:

This article is a compilation of homeopathic professionals’ experiences with treating their patients with individually selected homeopathic remedies. This article is not intend as medical advice.

Diet & Regimen of Coronavirus (COVID-19)

• Drink plenty of water
• Get proper rest
• Wash your hands Properly
• Keep hands & finger away from your eyes, nose, mouth
• Avoid close contact with people who infected
• A humidifier or steamy shower can also help ease a sore & scratchy throat.

The Do’s & Don’ts

Do’s:

• Practice good hand hygiene: Wash your hands frequently with soap and water for at least 20 seconds, or use an alcohol-based hand sanitizer.
• Wear a mask: Cover your mouth and nose with a mask when in public settings, especially indoors or when social distancing is difficult.
• Maintain social distancing: Keep at least 6 feet (2 meters) of distance between yourself and others who don’t live with you.
• Get vaccinated: COVID-19 vaccines are safe and effective at preventing serious illness, hospitalization, and death.
• Cover coughs and sneezes: Use a tissue or the inside of your elbow to cover your mouth and nose when you cough or sneeze.
• Monitor your health: Watch for symptoms of COVID-19, such as fever, cough, shortness of breath, or loss of taste or smell. If you have symptoms, get tested and isolate yourself from others. [29]

Don’ts:

• Touch your face: Avoid touching your eyes, nose, and mouth with unwashed hands.
• Go out if you’re sick: Stay home if you’re feeling unwell, even if your symptoms are mild.
• Ignore public health guidelines: Follow the recommendations of your local health authorities regarding mask-wearing, social distancing, and other preventive measures. [29]

Reference

1. https://pib.gov.in/PressReleasePage.aspx?PRID=1600895#
2. https://www.theweek.in/news/world/2020/01/29/indian-government-recommends-homeopathy-to-treat-coronavirus.html
3. https://www.indiatoday.in/india/story/homeopathy-coronavirus-infections-1641219-2020-01-29

4. Case Management of the Influenza and Pneumonia Patient with Homeopathy During the COVID-19 Pandemic André Saine, N.D. Canadian Academy of Homeopathy Webinar—March 28, 2020

5. Coronavirus – analysis of symptoms – prevention and treatment by Dr. Bhatia
6. Coronavirus, Homeopathy and Pneumonia – Part Two (Webinar) with Dr Robin Murphy ND & The Centre for Homeopathic Education
7. Editorial – Corona Virus – Alan V. Schmukler
8. Homeopathy for Coronavirus Covid-19 Infection: Dr Aditya Kasariyans and Dr Rajan Sankaran

9. “How to Boost Immunity Against Coronavirus (COVID 2019)” by Amma Resonance Healing Foundation. Newsletter, March 2, 2020.

10. Jeremy Sherr’s Second Update on the Coronavirus (Webinar). March 23, 2020
11. Jeremy Sherr’s Third Update on the Coronavirus (Webinar). March 29, 2020
12. Three Remedies I Have Used for COVID-2019 by Massimo Mangialavori. Hpathy. March 23, 2020.
13. 2019 Novel Coronavirus (CoVID-19): Part VIII by Dr. Paul Herscu. March 13, 2020.
14. https://www.cdc.gov/coronavirus/mers/lab/lab-testing.html
15. https://www.who.int/health-topics/coronavirus
16. https://www.webmd.com/lung/coronavirus#1

17. https://en.wikipedia.org/wiki/COVID-19_pandemic

18. https://hpathy.com/cause-symptoms-treatment/common-cold-flu-treatment-homeopathy/>
19. COVID-19 (Coronavirus): Causes, Symptoms, and Treatment | Patient
20. Pathophysiology of COVID-19 (amity.edu)
21. Types of coronavirus, their symptoms, and treatment (medicalnewstoday.com)
22. COVID-19 physical examination – wikidoc- Differential diagnosis

23. Epidemiology and transmission dynamics of COVID-19 in two Indian states (Science, 2021)

24. Descriptive Epidemiology of COVID-19 Deaths during the First Wave of Pandemic in India: A Single-center Experience (Indian Journal of Critical Care Medicine, 2022)

25. Epidemiology of COVID-19 scenario in India (Oral and Maxillofacial Surgery, 2021)

26. Viral Infections of Humans: Epidemiology and Control, 5th Edition, Alfred S. Evans, Robert A. Lamb, David M. Knipe, 2011, Springer Science & Business Media

27. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 9th Edition
    John E. Bennett, Raphael Dolin, Martin J. Blaser, 2020 Elsevier

28. COVID-19: Diagnosis and Management-Part I, 1st Edition, Neeraj Mittal, Sanjay Kumar Bhadada, O. P. Katare, Varun Garg (Editors) 2021, Bentham Science Publishers

29. Harrison’s Principles of Internal Medicine, 21st Edition, Dennis L. Kasper, Anthony S. Fauci, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, Joseph Loscalzo (Editors)
    2022, McGraw Hill Professional