COVID-19 in a Man of 58

This is a case of COVID in a 58-year-old surgeon. He has asthma in winter, is hypertensive since many years and had myocardial infarct last year. His wife is a homoeopath, and she treated him for the first few days.

17-10-20:  The patient started experiencing boring throat pain in the evening and also fatigue.

18-10-20:  Next morning he had mild discomfort and a feeling of malaise.  He continued his daily professional activities. The same evening, he had fever gradually rising up to 101F and throat pain. He had very short lasting (a few seconds) chills before fever. Profound weakness during fever.

Rx:  Ars Alb 30 one dose. He took Paracetamol 650 mg to bring down the fever. Azithromycin 250 mg b.i.d.

19-10-20: Fever going up to 101 F.  Throat pain, difficulty swallowing food.  Profound weakness. Drowsiness.  O2 saturation fluctuated between 95 and 97.

RT PCR, HRCT Chest and basic blood work were done on day 2 of fever because of his co-morbidities.

Blood work was WNL including WBC total and diff. count.

HRCT chest was normal; no GGO noted.

RT PCR:  Positive for COVID19. Cycle threshold was 16.

Rx:  Ferrum Phos 6x dissolved in water q.4.h.. Azithromycin continued for 5 days. Paracetamol as needed.

20-10-20: Fever continued.  Throat pain severity a little less. Oxygen saturation maintained at 95.

Rx:  Ferrum Phos 6x dissolved water, q.4.h. and Pyrogen 30 t.d.s., Paracetamol as needed, Favipiravir 400 mg started.

21-10-20: On this day his wife consulted me in the night. Fever at 99. No chills. Extreme weakness. Thirsty as usual. A little bit of coughing started. Asking for tasty food, pav bhaji, batata poha. Has become very irritable and very drowsy. He would give short answers and when pressed for details, he would get angry. Oxygen maintained at 95. I took these rubrics:

Chill absent fever during

Heat concomitant, Exhaustion, Weakness

Heat concomitant, Sleepiness

Irritability during fever/when questioned

Hurry

Dictatorial

Irritability during fever

He was asking for tasty food. He is very impatient and domineering by nature. He has a feeling of hurry to get better very fast.

I advised Nux vomica 200, q.4.h. which he took on 22nd & 23rd October. After that he was much better. No fever, no throat pain. Weakness was much better.

Covid-19 Coronavirus SARS-CoV-2 cell pandemic virus. 3d render, 3d illustration

26-10-20: Cough with rattling in chest. Advised Nux vom 200, single dose. His wife gave him one powder dose of Nux and he finished the entire bottle of Nux in 2 days. His wife mentioned that usually his cough increases and he gets wheezing and has to use an inhaler. However, this time he did not need to use the inhaler. The Nux was working in spite of the Favipiravir.

HRCT done on 27-10-20:  GGO in both lung bases, score 4/25. CRP 2.9, Ferritin 228, D-dimer 363, IL-6 2.34.

Rx:  Tuberculinum Aviare 30, two doses on 27-10-20.

30-10-20: No cough. Secretions in chest decreased. No more complaints.

4-11-20: CT scan shows scattered fibrosis. RT PCR still mildly positive.  Cycle threshold 33. CRP 4.2.

[In contemporary literature, Hypersensitive Pneumonitis caused by Mycobacterium Avium- “hot-lung disease”- has striking similarities with COVID19 including ground-glass opacities on CT scan. 

Anshutz in “New, Old and Forgotten Remedies” summarizes anecdotal cases of influenzal bronchitis effectively treated by Tuberculinum Aviare.

Other indications of Tub Aviare are:

Recurrent tendency for cough & cold.

Rattling without expectoration

Post influenza, cough remains with weakness]

On 1-11-20 (day 16) patient went cycling for 45 mins at 5 am in the morning as he was feeling fit. On 3-11-20 (18 days after he fell sick) he started with his surgical practice. He did not have any post covid weakness. He only gets tired if he has to stand for very long during surgery. Other than that, he is feeling fine. He took Favipiravir for 9 days as opposed to 14 days as he was feeling fine.