Integrative Medicine Case Reports, Volume 2, Issue 2 (July), 2021

Integrated therapy as a tool to help fight asymptomatic COVID-19: A case report

Subodh Tiwari¹, Shruti Sharma² and Anita Verma^3*

^1,2Kaivalyadhama, Swami Kuvalayananda Marg, Lonavla, Pune, Maharashtra, India
³Scientific Research Department, Kaivalyadhama, Swami Kuvalayananda Marg, Lonavla, Pune, Maharashtra, India

Introduction

COVID-19 is a novel respiratory disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) emerged initially in Wuhan, Hubei Province, China in December 2019. Globally, there have been 141,754,944 confirmed cases of COVID-19, including 3,025,835 deaths, reported to WHO as of 20^th April, 2021. A total of 843,158,196 vaccine doses have been administered as of 19 April 2021 (1).  

(COVID-19 is a rapidly changing and evolving situation and is extremely challenging to the humankind since it is highly infectious). The CoV-2 is transmitted via person-to-person in both family and hospital settings (2). Further, recent study suggests that SARS-CoV-2 spreads by airborne transmission (3). The symptoms of COVID-19 include fever, cough, fatigue, nasal congestion, dizziness, arthralgia, diarrhea, and rashes (4). However, according to Indian Health Ministry analysis, majority of the COVID-19 positive individuals are asymptomatic. Even though asymptomatic, these patients need special care so that they don’t develop any further serious complications in due course of infection. (The aim of present case study was to assess the effect of integrated therapy of yoga practices and Ayurveda on vital parameters of a COVID-19 positive asymptomatic patient).

Case presentation

Mr. X aged 47 years was a healthy, active Indian male with a height of 180 cm and weighing 75 kg. He has always followed an active lifestyle which included regular walking, exercise and yoga practices along with a vegetarian diet. The patient has been practicing yoga for the past 20 years along with active lifestyle.

Present Medical History

Mr. X was suffering from a dental problem since past one year but avoided a visit to the dentist due to prevalent pandemic situation and subsequent lockdown. However, on 18^th February, 2021, he decided to visit his local dentist for his dental problem as the pain was unbearable due to underlying sinusitis. He had two cavities and required a cavity filling procedure which took around 45 minutes at the dental clinic.

Mr. X had a scheduled work-related travel to New Delhi for which he had to carry a COVID-19 negative RT-PCR test report. Therefore, he got himself tested on 22^nd February, 2021 and received a negative RT-PCR report on 23^rd February, 2021. Thus, he proceeded with his travel plans to New Delhi and returned on 25^thFebruary, 2021.

Upon return, Mr. X got himself tested again on 26^thFebruary, 2021 for COVID-19 as per the standard COVID-19 protocol at his workplace. On 27^th February, 2021, he was found out to be COVID-19 positive with ORF CT value of 29.85. This was confirmed once again on 29^th February, 2021, wherein ORF CT value was 30.91 (15).

Clinical Findings

Mr. X was asymptomatic and quarantined himself in a separate room. His body temperature and SpO₂ were checked regularly twice a day using infrared thermometer (EVERYCOM, India) and pulse oximeter (RoHS, India) respectively, for 8 days. Further, sleep score, resting heart rate and walking steps were recorded for 8 days using Fitbit Charge 3 (Table 1).

There were no clinical symptoms of COVID-19 infection throughout the course of the disease. However, Mr. X experienced burning sensation while urination on the 4^th day of infection. This symptom was managed by increasing water intake for next few days. Mr. X was rechecked on 5^th March, 2021, and the results were found to be COVID-19 negative.

Table 1: Timeline of the Case

Therapeutic intervention comprised Ayurvedic medications, yoga practices and regular walking. Mr. X had self-quarantined from the first day of COVID-19 positive report. The details of the therapeutic intervention have been presented in Table 2. During his quarantine, Mr. X practiced Yoga for 30 minutes each morning and utilized the 15 m walking space in his room for covering a distance of approximately 5 km, as recorded by his fitness tracker. Further, he also did steam inhalation twice a day for about 3 minutes. Mr. X had been practicing Jala Neti every morning since last six months and continued to practice it.

Table 2: Therapeutic Intervention

Mr. X was following all norms of social distancing and wore a face mask whenever he stepped out of his house before first COVID-19 positive report. However, as part of the contact tracing protocol, 5 people including family members and office staff were tested and found to be ‘Negative’ for COVID-19. All the contacts wore face masks and followed social distancing norms while interacting with the patient. Vital parameters such as body temperature, oxygen saturation and heart rate were monitored throughout the disease and found to be optimal. This was probably due to physical activity such as walking, yoga practices and Ayurvedic medications.

Discussion

The results of present case study showed that yoga practices, Ayurveda and active lifestyle are effective in preventing progression of COVID-19 infection to moderate/severe stages. The vital parameters of the patient were found to be stable throughout the course of infection. The patient used to follow active lifestyle such as 5 km walking and yoga practice for 30 minutes every morning prior to being diagnosed as COVID-19 positive.

Earlier research studies have demonstrated that active lifestyle such as daily walking and yoga practices can lead to improvement in immune system (5, 6, 7). Moreover, Ayurvedic medicines such as Giloy Ghanvati (8), garlic supplements (9), Talisadi have been found to have immunomodulatory and anti-inflammatory properties (10). Additionally, Jala Neti (nasal irrigation) is beneficial in inhibition of replication of RNA and DNA viruses (11). Furthermore, it is evident from recent study that use of Yoga and Ayurveda therapy is effective in the treatment of high risk COVID-19 positive patients (12, 13). In the present case, Mr. X was practicing Jala Neti since last six months which might have prevented replication of SARS-CoV-2 and subsequent progression of disease. Continuous practice of yoga and walking might have helped him in strengthening the immune system and preventing progression of the disease.

In fact, innate immunity plays an important role in evasion of initial viral attack, and may play an indispensable role in pathogenesis in asymptomatic patients (14). In the present case, the patient visited the dentist on 18^th February, 2021 and underwent a dental procedure which took about 45 minutes. While it is difficult to pinpoint the day when he got infected, the visit to the dentist seems to be a more likely cause. The need to remove face mask while undergoing dental treatment might have increased the risk to contract infection to a greater extent. We suspect that the dentist visit is a more likely cause of COVID-19 infection than travel to New Delhi, because airports are following strict protocols for preventing the spread of COVID-19 and have implemented ways to ensure safe travel. In addition, the patient followed all norms of social distancing, wore face mask, washed hands frequently, used hand sanitizer and did not touch his face throughout his journey, as per WHO travel guidelines. However, the possibility of catching the infection during travel cannot be entirely ruled out.

Since the vital parameters were stable and normal, and the patient was asymptomatic, it can be inferred that the patient’s immune system worked well against the virus to thwart the onset of severe symptoms. However, to establish the efficacy of integrated therapy of yoga practice and Ayurveda in COVID-19 infection, randomized controlled trials on a larger sample size are warranted. (The limitation of present case report is that several biochemical and physiological parameters were not assessed as the patient was asymptomatic).

Conclusion

Yoga and Ayurveda therapy along with active lifestyle are effective in controlling symptoms of COVID-19 and prevent progression of disease. Therefore, it can be concluded that innate immunity plays an important role in reducing the severity of symptoms.

Acknowledgement

The authors are grateful to Shri O. P. Tiwariji, Secretary, Kaivalyadhama, S. M. Y. M. Samiti, for giving constant encouragement to complete research activities and Dr. Jagdish Bhutada, CAO, Kaivalyadhama Health Care Centre for providing Ayurvedic treatment to the patient.

Authorship contribution

ST has conceptualized the manuscript. SS and AV prepared first draft of the manuscript and ST finalized the article.

Informed consent

Signed informed consent was obtained from the patient before conducting this case study.

Source of funding

Nil.

Conflict of interest

Nil.

Received Date: 26-04-21; Revised Date: 03-06-21
Accepted Date: 25-06-21

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