Integrative Therapy based on Yoga, Ayurveda and Modern Western Medicine for Treatment of High-risk Cases of COVID-19: A Telemedicine-Based Case Series

Abstract

Background: We report a telemedicine-based case-series of thirty high risk COVID-19 positive patients with co-morbidities such as Diabetes Mellitus (DM), Hypertension (HTN), Hypothyroidism, Ulcerative Colitis and Chronic Kidney Disease (CKD) or aged 60 and above (or possibly both), treated successfully using an Integrative Therapy plan based on Ayurveda, Yoga and Modern Western Medicine. The symptoms experienced by the patients included fever, body-ache, sore throat/throat pain, cough/running nose, headache, nasal/chest congestion, stomach problems (such as diarrhea, constipation), nausea, loss of taste, loss of smell, foul smell or taste, loss of appetite, weakness, gastric upset, respiratory trouble (such as breathlessness or high respiration rate) and anxiety. Two patients (both aged above 70) were asymptomatic and remained asymptomatic during the entire course of the treatment. Design: The reported cases have been categorized into YAS (patients taking Yoga and Ayurveda based treatment, with possibly western Supplements), YASP (patients taking Yoga and Ayurveda based treatment, with possibly western Supplements and Paracetamol), YAM (patients taking Yoga and Ayurveda based treatment, and Modern western medicine (MWM) as an adjunct), MYA (patients who first tried the Modern western medicines (in most of the cases mandated by the government) and later switched to Yoga and Ayurveda treatment. The last group has been further subdivided into subgroups – patients who developed new symptoms after the commencement of Yoga and Ayurveda-based treatment (MYA-S) and those who did not (MYS-NS). The YAS group had 4 patients, YASP had 6 patients, YAM had 6 and MYA had 14 patients (MYA-S having 7 and MYA-NS having 7). Case-Series Presentation: Ayurveda is a highly personalized system of medicine that considers the Prakruti (the Ayurvedic constitution) as well as Vikruti (the homeostatic imbalances) in treating the patients. Based on the patient's symptoms and co-morbidities, a personalized treatment plan including Ayurvedic medicines, Yoga protocol, dietary recommendations and lifestyle modifications was prescribed by a registered Ayurveda doctor and a Yoga consultant. More than half of the symptomatic patients started experiencing improvement within 5 days (90% within 9 days) from the start of the treatment. More than 60% of the symptomatic patients reported at least 90% recovery within 10 days (90% within 17 days) from the start of the treatment. Six patients, whose SpO2 level was observed to be at or below 95%, benefited from the practice of Makarasana and Shithilasana. None of the patients progressed to severe stage of illness. Many patients experienced improvement with respect to their comorbidities besides COVID-related symptoms. Some of them, after recovering from COVID, even sought consultation for long-term management of their comorbidities through Ayurveda and Yoga. Some patients got so convinced about the possibility of restoration of health through Yoga, that they adopted this practice into their lifestyle.Conclusions: The Integrative Therapy was found to be very effective in mitigating the symptoms of all the high-risk cases of COVID-19 patients with comorbidities who remained compliant to the treatment. Considering that approximately 32.8% of the patients with the comorbidities such as DM, HTN, COPD, cardiovascular disease, cerebrovascular disease, chronic kidney disease, Hepatitis B, malignancy, immunodeficiency progress to severe stage of illness, and assuming under the null hypothesis that a similar percentage of patients are expected to progress to a severe stage for the treatment population, the corresponding p-value (incorporating 23 symptomatic patients with one or more of the above comorbidities) turns out to be 1.07 x10^-4. Integrative Therapy based on classical texts of Ayurveda and Yoga from the East and emergency treatment of modern western medicine may offer a promising and scalable treatment option for COVID-19 patients. More studies including a suitably designed randomized controlled trial is needed to assess its efficacy.