Guidelines for Ayurveda Practitioners for COVID-19 Patients in Home Isolation
The first cases of COVID-19 were diagnosed in Wuhan, China in December 2019. It was declared a global pandemic by WHO in March 2020 and India went into a complete lockdown to tackle the spread of infections. Effective management to address this infection is still evolving and attempts are being made to integrate traditional interventions along with standard care. Home isolation is applicable to confirmed COVID-19 cases which are asymptomatic or have mild symptoms, or to people who had a contact with suspected cases of the disease.
The Ministry of AYUSH has laid down the following guidelines for Ayurveda practitioners for COVID-19 patients in home isolation:
Management Guidelines for COVID-19 Patients in Home-Isolation
The common clinical features observed in mild COVID-19 cases include sore throat, mild fever, body-ache, nasal congestion, and dry cough. Although a variety of symptoms are being reported, many cases are asymptomatic and some uncommon clinical manifestations include loss of smell and taste.
Some of the asymptomatic cases can be in the pre-symptomatic stage. Considering this possibility, the patient should observe evolving symptoms or signs. This watchfulness should not lead to undue anxiety.
Specific measures for COVID-19 Patients in home isolation
| Stage/Condition | Clinical Presentation | Medicine | Dosage |
| Asymptomatic COVID-19 patients | -- | Guduchi Ghana vati (Samshamani vati) | 500 mg tablet twice daily with warm water for 15 day |
| Ashwagandha Tablet (Aqueous extract) | 500 mg two tablets twice daily with warm water for 30 days | ||
| AYUSH 64 | 500 mg two tablet twice daily with warm water for 30 days | ||
| Mild COVID-10 Cases | Fever, Headache, Malaise, Dry cough, Sore throat, Nasal congestion | AYUSH 64 | 500 mg two tablet thrice daily with warm water for 30 days |
| Ashwagandha Shunthi | Ashwagandha (Aqueous extract) Tablet 250 mg and Shunthi powder 500 mg twice daily with warm water for 15 days | ||
| Guduchi Ghana vati (Samshamani vati) | 500 mg tablet twice daily with warm water for 15 days | ||
| Guduchi + Pippali | Guduchi kwatha* - 100 ml + Pippali Churna-2 gm twice daily before meals for 15 days. OR Guduchi Pippali two Tablets** (375 mg each) twice daily |
*25gm of Guduchi kwath churna (coarse powder) + 400 ml water boiled and reduce to 100 ml.
** Guduchi Pippali Tablet may be advised based on the availability.
Note: Physician may prescribe the above indicated medicines in combination as per his/her own discretion
Symptomatic management of mild COVID-19 patients
| Stage/Condition | Clinical Condition | Medicine | Dosage |
|
Mild COVlD-19 | Mild Fever, Headache, Malaise, Fatigue | Sudarshan Ghan Vati | 500 mg twice daily with warm water for 15 days |
| Nagaradi Kashaya | 20 ml twice a day for 15 days | ||
| Cough | Sitopaladi Churna with Honey | 3 g thrice daily with Honey for 15 days | |
| Sore Throat | Vyoshadi vati | Chew 1-2 pills as required | |
| Yashtimadhu churna | 1-3 g twice daily with honey for 15 days | ||
| Nasal Congestion, Loss of Taste | Vyoshadi vati | Chew 1-2 pills as required |
*The Ayurveda physician can change the dose and duration considering requirement of the patient.
General Guidelines:
1.Patients should follow physical distancing, respiratory and hand hygiene, and wear masks.
2. Gargle with warm water along with an added pinch of turmeric and salt. Water boiled with Triphala (dried fruits of Emblica officinalis, Terminalia chebula, Terminalia bellirica) or Yashtimadhu (Glycyrrhiza glabra) can also be used for gargling.
3. Nasal instillation/application of medicated oil (Anu taila or Shadbindu Taila) or plain oil (Sesame or Coconut) or of cow ghee (Goghrita), once or twice a day, especially before going out and after coming back home.
4. Steam inhalation with Ajwain (Trachyspermum ammi), Pudina (Mentha spicata) or Eucalyptus oil (1-5 drops) or Karpur (Camphor) once a day.
5. Frequent intake of water processed with Tulasi (basil leaves – Ocimum tenuiflorum L.Merr (synonym Ocimum sanctum L.) is advised.
6. Adequate sleep (7-8 hours) should be taken and day time sleep preferably be avoided.
Dietary Guidelines:
1. Drinking of warm water or water boiled with herbs like Saunth (Zingiber officinale),Dhania (Coriandrum sativum),Tulasi (Ocimum sanctum), or Jeera (Cuminum cyminum) seeds.
2. Food should be freshly prepared, and easily digestible.
3. Drinking of Golden Milk (Half tea spoon Haldi(Curcuma longa) powder in 150 ml hot milk) once at night. The same should be avoided in case of indigestion.
*These suggested guidelines are supported by Ayurvedic literature, scientific publications and emerging evidence based on COVID-19 studies undertaken by the Ministry of AYUSH.
References:
1. Guidelines for Ayurveda practitioners for COVID-19; available at https://www.ayush.qov.in/docs/ayurved-quidlines. pdf
2. Advisory from Ministry of AYUSH for meeting the challenge arising out of spread of corona virus (COVID-19) in India; available at https://wwwayush.govin/docs/25.pdf
3. Ayurveda's immunity boosting measures for self-care during COVID-19 crisis; available at- https://www.ayush.gov.in/docs/123.pdf
4. National Clinical Management Protocol based on Ayurveda and Yoga for management of Covid-19available at- https://main.ayush.gov.in/event/nationalclinical-management-protocol-based-ayurveda-and-yoga-management-covid-19
5. A Retrospective Study on Efficacy and Safety of Guduchi GhanVati for Covid-19 Asymptomatic Patients available at-https://www. medrxiv.org/ content/10.1101/ 2020.07.23.20160424v1
6. Efficacy of AYUSH 64 as add-on therapy in early stage COVID 19 - An open-label randomized controlled pilot study. available at- https://osf.io/t8wza/
7. Ram TS, Munikumar M, Raju VN, Devaraj P, Boiroju NK, Hemalatha R, Prasad PVV, Gundeti M, Sisodia BS, Pawar S, Prasad GP, Chincholikar M, Goel S, Mangal A, Gaidhani S, Srikanth N, Dhiman KS. In silico evaluation of the compounds of the ayurvedic drug, AYUSH-64, for the action against the SARS-CoV-2 main protease. J Ayurveda Integr Med. 2021 Feb 25. doi: 10.1016/j.jaim.2021.02.004.
8. Zorofchian Moghadamtousi S, Abdul Kadir H, Hassandarvish P, Tajik H, Abubakar S, Zandi K. A review on antibacterial, antiviral, and antifungal activity of curcumin. Bio Med research international. 2014;2014
9. Ghoke SS, Sood R, Kumar N, et al. Evaluation of antiviral activity of Ocimum sanctum and Acacia arabica leaves extracts against H9N2 virus using embryonated chicken egg model. BMC Complement Altern Med.2018;18(1):174. Published 2018 Jun 5. doi:10.1186/s12906-018-2238-1
10. Efficacy of AYUSH 64 as add-on therapy in early stage COVID 19 - An open-label randomized controlled pilot study. Available from: https://osf.io/t8wza/
11. Efficacy and safety of Guduchi Ghan Vati in asymptomatic and mild to moderate cases of COVID-19: A randomized controlled pilot study. Available from: https://osf.io/c8f9h
12. AYUSH-64 as add-on to standard care in asymptomatic and mild cases of COVID-19: A randomized controlled trial. Available from: https://osf.io/pgraf/
13. An Open label prospective interventional study to assess the prophylactic effect of Guduchi GhanVati in COVID-19: A community-based study in a containment zone of Himachal Pradesh, India. Available from: https://osf.io/8vwsy
