Clinical Characteristics and Remedy Profiles of Patients with COVID-19: A Retrospective Cohort StudyFunding No separate financial support was sought for the conduct of the study; all contributors (except K.R. and R.S.) are full-time staff employed by the Government of NCT of Delhi.
Dr. Kamal Rawal acknowledges the grant provided by SERB, Department of Science and Technology, Government of India (Grant ID: BT/PR17252/BID/7/708/2016), for the study of repurposed drugs on COVID-19, as well as the support of the Ministry of AYUSH, Government of India.
Objective The aim of the study was to identify indicated homeopathic remedies based on the clinical characteristics of coronavirus disease 2019 (COVID-19) patients in India.
Methods In this retrospective, cohort study, confirmed COVID-19 patients admitted at a COVID Health Centre in New Delhi between April 29 and June 17, 2020 were given conventional and homeopathic treatment. Patients were grouped into mild, moderate or severe categories of disease. Their symptomatologic profiles were analyzed to identify indicated homeopathic medicines.
Results A total of 196 COVID-19 patients were admitted. One hundred and seventy-eight patients had mild symptoms; eighteen patients had moderate symptoms; no patients with severe symptoms were included as they were referred to tertiary care centers with ventilatory support. The mean age of patients with mild symptoms was significantly lower (38.6 years; standard deviation or SD ± 15.8) compared with patients in the moderate category (66.0 years; SD ± 9.09). The most important symptoms identified were fever (43.4%), cough (47.4%), sore throat (29.6%), headache (18.4%), myalgia (17.9%), fatigue (16.8%), chest discomfort (13.8%), chills (12.6%), shortness of breath (11.2%) and loss of taste (10.2%). Twenty-eight homeopathic medicines were prescribed, the most frequently indicated being Bryonia alba (33.3%), Arsenicum album (18.1%), Pulsatilla nigricans (13.8%), Nux vomica (8%), Rhus toxicodendron (7.2%) and Gelsemium sempervirens (5.8%), in 30C potency.
Conclusion Data from the current study reveal that Arsenicum album, Bryonia alba, Pulsatilla nigricans, Nux vomica, Rhus toxicodendron and Gelsemium sempervirens are the most frequently indicated homeopathic medicines. A randomized controlled clinical trial based on this finding is the next step.
• Being a new disease, the first step toward identifying the potential effectiveness of homeopathy in COVID-19 is delineating the clinical presentation of this pandemic.
• A retrospective cohort study on laboratory-confirmed symptomatic patients was thus conducted in a COVID hospital in New Delhi, India.
• Based on symptomatology profile, six homeopathic medicines have been shortlisted for further evaluation.
This study was conducted under the overall supervision of R.K.M., who contributed to the protocol, the critical evaluation of data and scrutiny of the manuscript. A.K. provided key insights into the homeopathic management of the patients, besides ensuring logistic support. Data collection was done by a team of doctors posted in the COVID ward (B.J., P.W., R.T., M.M., B.P.R., D.S.), assisted by As.K., M.K., H.S., R.K., S.K. and S.J. B.J., M.G., T.B. and G.M. helped in the development of the protocol, study design, and manuscript writing. K.R. and R.S. worked on data curation. All authors are responsible for and agreed to the content of the manuscript.
Eingereicht: 18. Juli 2020
Angenommen: 11. September 2020
10. Februar 2021 (online)
© 2021. Faculty of Homeopathy. This article is published by Thieme.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Guo YR, Cao QD, Hong ZS. et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res 2020; 7: 11
- 2 Guan WJ, Ni Z-Y, Hu Y. et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382: 1708-1720
- 3 Waisse S, Oberbaum M, Frass M. The hydra-headed coronaviruses: implications of COVID-19 for homeopathy. Homeopathy 2020; 109: 169-175
- 4 Tosato F, Giraudo C, Pelloso M, Musso G, Piva E, Plebani M. One disease, different features: COVID-19 laboratory and radiological findings in three Italian patients. Clin Chem Lab Med 2020; 58: 1149-1151
- 5 Clinical Management Protocol. COVID-19. Directorate General of Health services. Ministry of Health and Family Welfare, Government of India Website. Accessed August 19, 2020 at: https://www.mohfw.gov.in/pdf/ClinicalManagementProtocolforCOVID19.pdf
- 6 Li H, Liu SM, Yu XH, Tang SL, Tang CK. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int J Antimicrob Agents 2020; 55: 105951
- 7 COVID-19 Dashboard. Ministry of Health and Family Welfare, Government of India Website. Accessed July 13, 2020 at: https://www.mygov.in/covid-19
- 8 Iyer M, Jayaramayya K, Subramaniam MD. et al. COVID-19: an update on diagnostic and therapeutic approaches. BMB Rep 2020; 53: 191-205
- 9 Wang Y, Zhang D, Du G. et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet 2020; 395: 1569-1578
- 10 Cao B, Wang Y, Wen D. et al. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19. N Engl J Med 2020; 382: 1787-1799
- 11 Sheahan TP, Sims AC, Leist SR. et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020; 11: 222
- 12 Gao J, Tian Z, Yang X. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends 2020; 14: 72-73
- 13 Savarino A, Di Trani L, Donatelli I, Cauda R, Cassone A. New insights into the antiviral effects of chloroquine. Lancet Infect Dis 2006; 6: 67-69
- 14 Yao X, Ye F, Zhang M. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020; 71: 732-739
- 15 Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis 2020; 20: 398-400
- 16 Li H, Zhou Y, Zhang M, Wang H, Zhao Q, Liu J. Updated approaches against SARS-CoV-2. Antimicrob Agents Chemother 2020; 64: e00483-e20
- 17 Ganguly S, Bakhshi S. Traditional and complementary medicine during COVID-19 pandemic. Phytother Res 2020; DOI: 10.1002/ptr.6828.
- 18 Liu M, Gao Y, Yuan Y. et al. Efficacy and safety of integrated traditional Chinese and Western medicine for Corona virus disease 2019 (COVID-19): a systematic review and meta-analysis. Pharmacol Res 2020; 158: 104896
- 19 Jacobs J. Homeopathic prevention and management of epidemic diseases. Homeopathy 2018; 107: 157-160
- 20 Nunes LAS. Homeopathy and dengue: Macaé, Rio de Janeiro, Brazil, 2007–2012. Rev Homeopatia 2016; 79: 1-16
- 21 Prass-Santos C, Brina NT, Magalhães IL. et al. Report on the use of homeopathic medication in the prophylaxis of dengue in Belo Horizonte, Minas Gerais, Brazil, in 2010. Rev Homeopatia 2012; 75: 1-12
- 22 Bracho G, Varela E, Fernández R. et al. Large-scale application of highly diluted bacteria for leptospirosis epidemic control. Homeopathy 2010; 99: 156-166
- 23 Hahnemann S. Organon of Medicine. 6th ed.. New Delhi: B. Jain Publishers; 2004: 267
- 24 Mathie RT, Baitson ES, Frye J, Nayak C, Manchanda RK, Fisher P. Homeopathic treatment of patients with influenza-like illness during the 2009 A/H1N1 influenza pandemic in India. Homeopathy 2013; 102: 187-192
- 25 Chakraborty PS, Lamba CD, Nayak D. et al. Effect of individualized homoeopathic treatment in influenza like illness: a multicenter, single blind, randomized, placebo-controlled study. Indian J Res Homeopathy 2013; 7: 22-30
- 26 Oberai P, Varanasi R, Padmanabhan M. et al. Effectiveness of homeopathic medicines as add-on to institutional management protocol for acute encephalitis syndrome in children: an open-label randomized placebo-controlled trial. Homeopathy 2018; 107: 161-171
- 27 Nayak D, Chadha V, Jain S. et al. Effect of adjuvant homeopathy with usual care in management of thrombocytopenia due to dengue: a comparative cohort study. Homeopathy 2019; 108: 150-157
- 28 Vithoulkas G. COVID-19: Thoughts of Prof. G. Vithoulkas. Accessed July 13, 2020 at: https://www.vithoulkas.com/academy/newsletter-archive/2020-03-24/covid-19thoughts-prof-g-vithoulkas
- 29 Manchanda RK, Gupta M. Homoeopathy in the COVID-19 pandemic: opportunities, challenges and the road ahead. Accessed July 13, 2020 at: https://hpathy.com/homeopathy-papers/homeopathy-in-the-covid-19-pandemic-opportunities-challenges-and-the-road-ahead/
- 30 Guidelines for Homoeopathic Practitioners for COVID 19, Ministry of AYUSH, Government of India Website. Accessed July 13, 2020 at: https://www.ayush.gov.in/docs/homeopathy-guidelines.pdf
- 31 Global COVID-19: clinical platform: novel coronavirus (COVID-19): rapid version. World Health Organization Website. Accessed July 13, 2020 at: https://www.who.int/publications/i/item/global-covid-19-clinical-platform-novel-coronavius-(-covid-19)-rapid-version
- 32 Rutten L, Muraleedharan KC, Shinde VH, Manchanda RK. What is a homoeopathic symptom, in daily practice and research?. Indian J Res Homoeopathy 2017; 11: 12-20
- 33 Guidelines on Clinical Management of COVID-19. Directorate General of Health services. Ministry of Health and Family Welfare, Government of India Website. Accessed July 13, 2020 at: https://www.mohfw.gov.in/pdf/GuidelinesonClinicalManagementofCOVID1912020.pdf
- 34 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506
- 35 Valeri A. Symptomatic COVID-19 positive and likely patients treated by homeopathic physicians—an Italian descriptive study. 2020 . Accessed July 13, 2020 at: https://www.researchgate.net/publication/340631586
- 36 To KLA, Fok YYY. Homeopathic clinical features of 18 patients in COVID-19 outbreaks in Hong Kong. Homeopathy 2020; 109: 146-162
- 37 Chilamkurthy S, Ghosh R, Tanamala S. et al. Deep learning algorithms for detection of critical findings in head CT scans: a retrospective study. Lancet 2018; 392: 2388-2396
- 38 Hatton CM, Paton LW, McMillan D, Cussens J, Gilbody S, Tiffin PA. Predicting persistent depressive symptoms in older adults: a machine learning approach to personalised mental healthcare. J Affect Disord 2019; 246: 857-860
- 39 Rajpurkar P, Irvin J, Ball RL. et al. Deep learning for chest radiograph diagnosis: a retrospective comparison of the CheXNeXt algorithm to practicing radiologists. PLoS Medicine 2018; 15: e1002686
- 40 Ustun B, Westover B, Rudin C, Bianchi M. Clinical prediction models for sleep apnea: the importance of medical history over symptoms. J Clin Sleep Med 2016; 12: 161-168
- 41 Sadidpour SS, Ghidary SS. Remedy selection based on artificial intelligent methods. Int J Comput Appl 2011; 19: 6-9