A 56-year-old male, Mr. X, consulted us on 4th May 2021 with fever since that morning. The complaint started on 3rd of May with irritation in throat. He started doing warm water gargles and the irritation in his throat got better but then in the morning the fever appeared.
On taking further history, it was found that his son just recovered from COVID 19 and Mr. X was the one who was taking care of his son. Considering him as a high risk contact and a suspect case of COVID 19, as per the guidelines, he was advised to get isolated at home immediately and start following the guidelines of Govt of India for home isolation, instructions for which were clearly given to him.
He was advised to get the COVID-19 test done. The following symptoms were reported:
- High fever (1020F) with chill since morning.
- Fatigue since the fever.
- No desire to eat.
- Mouth dry
- Urging remaining after stool since last 2 days.
The patient stated the thought of being COVID 19 positive has generated the following feelings:
- Anxiety that something bad may happen.
- Anxiety that other members of family may also get infected.
- Worry about what would happen if he gets severely affected.
- Feeling irritability since not well.
Medical history: For fever patient already started allopathic antipyretic.
Co-morbidity: Nothing significant
Physical generals: Thermal reaction: In general hot patient, but presently chilly with fever.
Appetite: poor
Thirst: Normal
Stool: ineffectual urging
Urine: NAD
RTPCR report: Positive for COVID 19 (dated 05 May 2021)
Totality of symptoms:
Patient was properly counselled and motivated. The case was repertorised by Vithoulkas compass system. The following rubrics were taken (Table 1 – Repertorisation table)
- Mind –Irascibility
- Mind – Anxiety –Health about
- Mind – Anxiety –others for
- Mind –Fear –Misfortune of
- Mouth – dryness
- Stomach –Appetite –Diminished
- Rectum -constipation – ineffectual urging and straining
- Fever – chill with
- Generalities – weakness – fever during
(Repertorisation Table 1)
Selection of remedy: Sulphur
Potency: 200C
Prescriptions:
Date | Follow up status | Prescription | Investigations if any | Advice given | |
1st prescription | 04-04-21 | Sulphur 200C /BD/2 days
Ferrum phosphoricum 6x/2 hourly/2 days |
|||
2nd prescription | 05-04-21 | Temperature: 1010F
SPO2: 98% Irritability little reduced.
|
CST* | RTPCR: Positive for COVID 19
|
Advised to stay away from bad news. Keep himself occupied with positive thoughts and positive news. |
3rd prescription | 06-05-21 | Temperature maximum 1000F.
SPO2: 97%
Fatigue is there but a little reduced.
Stool: better
Cough started since a day. Cough < night
Chest feeling pressure
Pain chest on coughing. |
Lycopodium clavatum 30C/QID/1 day
(See repertorisation table 2) |
CBC-
TLC: 8200/cumm N67L20M8E3 B0.5 ESR: 24mm/hr
CRP: 87.92mg/L (raised)
|
Keep monitoring SPO2 at least 3 times a day.
Record SPO2 after 6 minute walk test.
|
4th prescription | 07-05-21 | Temperature not more than 990F
Fatigue improved
Cough persisting. |
Lycopodium clavatum 30C/QID/1 day | SPO2: 97%
SPO2 after 6 minute walk test: 96%
|
|
5th prescription | 08-05-21 | Temperature 98.50F
Cough better |
Lycopodium clavatum 30C/QID/1 day | SPO2: 97%
SPO2 after 6 minute walk test: 96% |
|
6th prescription | 09-05-21 | Temperature 98.60F
Cough better
|
Lycopodium clavatum 30C/QID/1 day | CBC-
TLC: 8200/cumm N68L23M7E0 B0.2 ESR: 24mm/hr
CRP: 15.16 mg/L (decreasing trend) |
|
7th prescription | 10-05-21 | Feeling of well being
Temp: 98.60F |
Lycopodium clavatum 30C/QID/1 day | ||
8th prescription | 11-05-21 | Feeling of well being
Temp: 98.60F |
Lycopodium clavatum 30C/QID/1 day | ||
9th prescription | 12-05-21 | Feeling of well being
Temp: 98.60F |
Lycopodium clavatum 30C/QID/1 day | CRP: 6.33 mg/L (decreasing trend)
|
SPO2: 97%
|
10th prescription | 13-05-21 | Temperature: 98.6 0F
No specific complaint |
Lycopodium clavatum 30C/QID/1 day | SPO2: 98%
|
|
11th prescription | 14-05-21 | No complaint | Sac Lac 30/tds/3 days | Advised to consult if any new complaint arises. |
As patient started feeling better and also clinically stable with normal SPO2 and no temperature since last 7 days and CRP took decreasing trend with no appearance of new symptoms, and considering the stable clinical condition of the patient, no further investigation was advised and he was asked to follow normal daily routine along with following of COVID appropriate behavior.
On 20-05-21: RTPCR test for COVID 19: Negative (as per protocol, the test was not needed but patient got it done himself for his own satisfaction).
Basis of prescription:
Organon of Medicine, aphorism 73 states that:
As regards acute diseases, they are either of such a kind as attack human beings individually, the exciting cause being injurious influences to which they were particularly exposed. They are generally only a transient explosion of latent psora, which spontaneously returns to its dormant state if the acute diseases were not of too violent a character and were soon quelled.
Allied to these are those diseases in which many persons are attacked with very similar sufferings from the same cause (epidemically); these diseases generally become infectious (contagious) when they prevail among thickly congregated masses of human beings.
Thence arise fevers, in each instance of a peculiar nature, and, because the cases of disease have an identical origin, they set up in all those they affect an identical morbid process, which when left to itself terminates in a moderate period of time in death or recovery1.
So as per Aphorism 73, homeopathically, the early manifestations of COVID 19 can be a transient explosion of latent Psora. As the virus enters the human body, the body starts reacting to the virus and tries to eliminate it. Due to those reactions, the early symptoms like the general/physical symptoms start appearing, where the body tries to fight the virus and the virus tries to replicate. So, in the early stage of COVID 19, based on the symptomatology, an antipsoric homoeopathic remedy may need to be selected1.
So Aphorism 73, clearly stating the present day scenario of COVID 19, terminating in recovery or death. So as per this aphorism, the early manifestations of COVID 19 are only a transient explosion of latent Psora. As the virus enters the body, the body starts reacting to the virus and tries to eliminate it. Due to those reactions, the early symptoms like the general/physical symptoms start appearing, where the body tries to fight with the virus and virus tries to replicate. So in the early stage of COVID 19, based on the symptomatology, an antipsoric remedy is to be selected1.
Prescription 1: Sulphur
After repertorising the symptoms (Table 1), based on reportorial analysis, SULPHUR was selected which is an antisporic medicine.
Prescription 2: Lycopodium Clavatum
In COVID 19, as the disease progresses, the hyper-inflammatory reactions happen and thrombus formation starts in blood vessels and resulting COVID pneumonia develops2.
Homoeopathically, this phase of disease denotes the SYCOTIC state (Miasm) of disease and we need to understand that if we are dealing with this state of COVID 19, an antisycotic medicine may need to be selected based upon symptomatology of the case. In the next phase of COVID 19, when patients enter in the severe category of diseases, that phase may require a homoeopathic remedy which is anti-syphlitic.
Now in this case, on 06-05-21, the patient presented with high CRP3, appearance of cough, which is showing that disease has entered into an inflammatory stage. We needed to reconsider our prescription.
Repertorisation was done by Vithoulkas Compass system (Table 2) based on symptoms (refer to prescription table for symptoms) of patient at that time and an antisycotic remedy (LYCOPODIUM CLAVATUM) was selected.
(Repertorisation Table 2)
Conclusion: As COVID 19 is an acute disease and may rapidly progresses into worse manifestations, so the aim of treatment in this should be:
- To check the progression of disease to moderate/severe category, to prevent the hyperimmune reactions of body against the COVID virus.
- The recovery should be fast. As per aphorism 2, Organon of Medicine, it should be rapid, gentle and permanent restoration of health.
- Early recovery may lead to lesser or no post COVID 19 complications.
Disclaimer: This is a standalone case report and for the purpose of sharing knowledge. All the guidelines stated by the Government of India for management of home isolation cases of COVID 19 were followed in this case and along with that, homoeopathic medicines were given for the symptomatic recovery of the case. The remedies given are individualistic to this case and the same remedies may not be suitable in other case of COVID 19.
- Early recovery will lead to lesser or no post COVID 19 complications.
Reports:
1. RTPCR for COVID 19 (05-05-21)
2. CBC and CRP reports dated 06-05-21
3. CBC and CRP reports (dated 09-05-21)
4. CRP report (dated 12-05-21)
5. RTPCT for COVID 19 (Negative report)
References:
1. Dudgeon R.E, Organon of Medicine (Fifth and sixth edition) by Dr. Samuel Hahnemann, M Bhattacharyya & Co. (P) Ltd. 8th Indian edition, 1987.
2. Koichi Yuki, Miho Fujiogi, Sophia Koutsogiannaki, COVID-19 pathophysiology: A review. Updated on June 2020 [Cited on 2021 May 22]. Available from: https://www.sciencedirect.com/science/article/abs/pii/S152166162030262X?via%3Dihub
3. Nurshad Ali, Elevated level of C‐reactive protein may be an early marker to predict risk for severity of COVID‐19. Updated on 2020 June 09 [Cited on 2021 May 22]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301027/#:~:text=A%20significant%20increase%20of%20CRP,mild%20or%20non%E2%80%90severe%20patients.
Repertorisation Software:
1. Vithoulkas Compass
Thank you for sharing your work.
Thank you very good case. Very informative.
Very good case!