Clinical Cases

Covid -19 in a Woman of 62

Niva Shirke
Written by Niva Shirke

Dr. Niva Shirke shares a case of Covid-19 in a woman of 62. SpO2 was 80-81 at one point, and due to lack of a hospital bed the patient’s family requested homeopathic treatment.

Patient: Smt AP, female, 62 years, married, Hindu, Mixed diet, basically from Kerala. But settled in Bengaluru since her marriage around 44-45 years back.

CASE HISTORY:

Patient has a k/c/o type II diabetes, hypertension and hypothyroidism, controlled on allopathic medications for the same for last 5-6 years. Her son approached me on 9/5/21, to treat her covid-19 pneumonia.

The husband and her son were both covid-19 positive as per their RT PCR tests. She had come negative in both rapid antigen test as well as in RT PCR but her HR CT chest showed her to have viral pneumonia, with CO-RADS V, and CT severity 15/40.

Her oxygen saturation was dipping and they could not get a bed in any hospital. They were desperately trying for bed with oxygen support, or any bed and trying for oxygen cylinder with no success. In desperation they contacted me for help after getting to know of me from some staff in a local government hospital.

Chief Complaints : on 9/5/2021

LOCATION, ODP SENSATION MODALITIES CONCOMITANTS INVESTIGATIONS
Respiratory System

Since       6

days, more

A/F : H/O exposure to covid-19 positive

son      and

husband

 

 

 

Dyspnoea +++

SpO2 80 to 83, in prone would occ be 89

Coughing +++ , continuous, one after other, mostly dry, with occ. scanty white sticky, difficult to

expel, expectoration. Occasionally

dirty white color.

Whole    day,

esp night <

 

 

>Complete

rest

 

 

 

 

H/O high fever 25/4/21 she was given Allopathic medicines. And it became fine.

 

 

 

Mouth completely dry with thirst increased.

Appetite reduced.

Son and husband both had tested RT PCR positive for covid19 while she had tested negative in both

RAT   done     on

26/4/21 and RT PCR done on

3/5/21.

 

Her HR CT chest showed CO RADS

5,       covid pneumonia with severity score mild

 

 

 

 

Chest,

retrosternal and lower ribs on

sides

 

 

 

 

Pain

 

 

 

 

<    coughing

while

Changed taste to bitterness. Smell sense okay.

Headache,

forehead, if tries to get up, faintness. Pain in eyes region when headache gets severe.

Lower back pains

+++

Weakness +++

Drowsiness as due to dyspnoea has    had    no proper sleep last 2-3 days.

Stools,          urine, sweat NAD

Temp : 98

Pulse : 111/ min

15/40 done on

8/5/21.

 

Had taken 7 days course of :

–      Ivermectin

12 mg OD,

–      Doxycycline

100 mg BD,

–      Montek   lc

OD, 

–      Dolo    650 mg 

from 26 April with no relief, except fever was reduced, but her state was only, worse and her SpO2 was dipping. Was advised further allopathic tt and oxygen support ASAP but bed not available.

General

Since  5-6 years

Diabetic Hypothyroid hypertensive On allopathic medication.

Glycomet 500 od,

Thyronorm 50 mg

Tab Repace

25 od

 

No invest done for last 3 yrs.

PATIENT

ADVISED     TO

CONTINUE WITH HER ALLOPATHIC MEDICINES.

Fresh invest of thyroid profile and random blood glucose given , both came wnl.

She had been to govt hospital K C General Hospital on 8/5/2021 and was advised oxygen inhalation, inj dexona 6 mg IV stat, and Inj Deriphylline  1 amp IV stat. that time her  SpO2 recorded was  93%, and BP was 114/79. (Reports attached)

Was also advised Vit C and some investigations like CBC, CRP, D- Dimer and serum ferritin. But due to unavailability of bed and after trying at other hospitals too, they took her home so the above injections were not brought or given to the patient.

The whole case was taken online, on WhatsApp chat and calls.

DIAGNOSIS: Covid pneumonia

HOMOEOPATHIC PRESCRIPTION:

Based on the acute totality of the case, Bryonia 30, one dose was prescribed every 30 min.

GENERAL MANAGEMENT:

  • Start zincovit BD
  • Eucee or Vit C OD or two lemons juice and two fresh fruits
  • Had advised sea cod capsules OD alternate days but could not get from chemist. They routinely eat fish though so was skipped.
  • Steam inhalation twice, deep breathing exercises as and when could,
  • Lot of lukewarm drinks,
  • Betadine gargle
  • Diet: Protein rich home cooked soft food, low in salt and low in refined, sugars and starch. Explained in detail.
  • Monitor TPR and oxygen saturation levels every hr for next 24 hrs.
  • Blood tests given for CBC, ESR, CRP, Bl glucose if fasting or random whatever is possible, Thyroid profile. Since patient was too disturbed to go to patho lab, home collection was advised and due to lockdown and difficulty in manpower present, was left to the patho lab technician to come whenever they could at the earliest.
  • Patient’s allopathic medicines for controlling BP, blood sugar and thyroid hormones were allowed as it is, no interference in them.
  • Daily monitoring of sugar levels with home glucometer. Readings were all wnl.
  • Managed to get an oxygen concentrator. Used it few hrs at late evenings for two nights and SpO2 rose to 96.

INVESTIGATIONS:

Her HR CT showed CO RADS 5, covid pneumonia with severity score mild 15/40 done on 8/5/21, but patient suffering a lot from the time CT was taken.

CRP done on 9/5/21 was 32 mg/L

CRP done on 12/5/21 was 18.9 mg/L

CRP done on  26/5/21 is 3.2 mg/ L

FOLLOW-UP:

DATE & TIME S/S >/<

/ SQ

PRESCRIPTIO N GENERAL

MANAGEM

ENT

INVESTIGATION
9/5/21

5:30 pm

Received medicines from nearest

homoeopathic pharmacy. Started as advised.

 

Medicine started.

Bryonia   30,

half hourly

As given above in

detail

Her HR CT showed CO RADS

5,      covid pneumonia with severity score mild 15/40 done on 8/5/21, but patient suffering a lot from the time CT was taken.

 

COMPLETE BLOOD COUNT

done on 9/5/21

 

1.           Hb            –  9.4

2.           TWC        –

8000

3.           DC : N –  83, L –

08, E – 04, M –

05, B –  00

4.           PLATELETS COUNT :       – 1.98

5.           RBC COUNT

–  3.6

 

PCV                – 29

MCV               – 81

MCH               – 26

MCHC            – 32

 

CRP : 32 mg/ L

 

9:30 pm Cough better, oxymeter SpO2 reading 94. Temp normal > Continue

Bryonia   30,

half hourly

10/5/21,

3:18am

SpO2 : 89, pulse 112. Temp 100.3. < Prone position.

AC       2-3

degress lower than room temp for comfort

3:40 am SpO2 dipping to 89, breathlessness severe SQ Carbo veg 30 every 5-10 min. Prone

position.

Rest all same.

3:59 am SpO2 : 93 > Carbo veg 30 every 5-10 min Prone position
10/5/21, 10.10 am SpO2: 89, 91, temp 97.5. pulse 112/ min, having severe headache also as told by husband Carbo veg 30 every 15-30 min
10/5/21,

11:   28 am

SpO2 90, Pulse 98, Temp: 99.6

Dry coughing with pain in       chest , bodyache   and feverish feel.

> Bryonia 30 every 30 min. All

manageme

nt follow.

gen

to

13:19 pm SpO2 90, Pulse 98, Temp: 98.4.

Had little food, oats in milk, but some was vomited, headache still there.

 

> Same

continue

14:14p m SpO2 92, Pulse 98, Temp: 100.

Was hungry so had some rice soup. Headache  mainly on forehead and

both temporals

And near eyes too.

> Same

continue

14:30 pm SpO2 95, P 97,

Temp 96.5

>

 

15:15 pm SpO2 : 90, Pulse , Temp: 99.1

Coughing         had

reduced but again  some coughing restarted,     with difficult       sticky expectoration coming out.

< Kali bi 30 , doses every 1

hrly

Steam

plain water. Deep breathing exercises.

Sit in bed. Light activities.

19:10 pm SpO2 : 92, Pulse : 107, Temp: 100. 2 >
20:     15 pm SpO2 : 90, Pulse : 99, Temp: 99.1 Headache still there, had loose motions 23 times, after eating getting urge and passing small amt loose stools, pain abdomen, thirst +, mouth dry.

Weakness and very tired after going to washroom and back.

Wants to lie still.

> Bryonia 30, 2 hourly
11/5/21,

01:06 am

SpO2 : 83, Pulse :

87

Temp 98.4, weakness +++,bitter taste mouth, gastric digestion feels problem, discomfort abdo, back pain

better,

< Carbo veg 30 frequently prone position
1: 40am SpO2: 85, then rose to 90. Remained so during daytime. Had better appetite, took some fruits and food. Weakness still there, passing stools soft type after ever small meals.

 

Cinchona 30 every two

hourly

Advised to use oxygen concentrat or for few hrs     till SpO2  raises to around 95-96
07:     03 am SpO2 : 90 Pulse : 87 > Same

continue

Used oxygen

 

Temp 97.9

Headache          better, vomited      once          in night, no further loose motion

O2concentrat

or for few hrs     at night. Feeling better.

12:07p m SpO2 : 94

Pulse : 87

Temp 36.8 C

 

> Same

continue

No Oxygen concentrat or req.
12/5/21 10:          52 am SpO2 : 83

Pulse : 97

Temp 37.7 C

Just woke up. Will check again after some time. Cough is reduced.

 

 

< No medicine. Oxygen concentrat

or used half an hour.

Having no discomfort.

Repeat CRP done on 12/5/21 was 18.9mg/L. And her random sugar was 111.

Thyroid profile is wnl.

 

12:          12 pm SpO2 : 95 – 96

Pulse : 95

Temp 37.7 C

Hungry, asked for fruits and also ate boiled egg

 

> China 30, 2-3 hourly COMPLETE BLOOD COUNT

done on 12/5/21

 

1.           Hb            – 10.2

2.           TWC        – 4600 3. DC : N –  75, L –

20, E – 03, M –

02, B –  00

4.           PLATELETS COUNT :       – 1.67

5.           RBC COUNT

–  3.4

 

PCV                – 32

MCV               – 89

MCH               – 24

MCHC            – 26

ESR 54

Random      sugar

111

 

CRP 18.9

 

 

Report attached. Thyroid profile was dictated on call and was wnl.

 

13:    42 pm SpO2 : 95

Pulse : 85

Hungry, wanted rice daal and fish fry.

Also had go

 

> Same

continue

13/5/21 08:00

am

 

Had a good sleep in night, no vomiting, no loose motion.

SpO2 : 92,Pulse 91, no fever. Was hungry. Had oats, tender coconut water, rice daal. No coughing.

> China 30 3-4

hrly

Didn’t          use oxygen concentrat or
18:12 pm SpO2 : 95,Pulse 92, > China 30 3-4

hrly

Didn’t           use oxygen concentrat or
Night time No complaints. Slept peacefully. Appetite much better > Didn’t use oxygen concentrat or.
14/5/21 20:25p m Active today, started house work little and cooking. SpO2 94, pulse 87, no fever >> China 30 3-4

hrly

Returned oxygen

concentrator

as was not needed last two days/

nights

15/5/21 10:27a m SpO2 95

Pulse 91

Temp 32.7

Sleep           was comfortable, active now within home, no abdominal discomfort, no loose

> China 30 4-5 hourly
motion or vomiting, no headache, no coughing. Only slight weakness there.
16/5/21 11:38a m SpO2: 95 Pulse 80 No fever.

All good

> China 30 4-5 hourly
17/5/21 SpO2 : 96 Pulse 91 No fever.

All good. Slight tired, that’s all.

> China 30 4-5 hourly
20/5/21 Says shes back to herself. SpO2 keeps at 95-96, pulse at 81-82,  and no other health issues > China 30 tds Gave repeat CBC,

ESR   and    CRP

whenever possible

26/ 5/21 > China 30 BD COMPLETE BLOOD COUNT

done on 26/5/21

 

1.        Hb          –  11.4

2.        TWC        –

5800

3.        DC : N –  51, L –

44, E – 03, M –

02, B –  00

4.        PLATELETS

COUNT :       –  3.1

5.        RBC COUNT

–  3.99

PCV                – 34

MCV               – 85

MCH               – 28

MCHC            – 33

ESR : 44

CRP : 3.2 mg/ L

 POINTS TO NOTE: 

  • After starting homoeopathic treatment, the patient improved and also the oxygen saturation readings improved from lowest 80-81 to 95– 96.
  • Oxygen concentrator that was somehow arranged on rent as needed two nights for a few hours only when SpO2 was less than 85. Here would like to say that any patient with SpO2 dipping from 92 towards 90 and below, is a case to be admitted in ICU, ASAP. But due to unavailability of beds, I had the opportunity to handle this level of severe case. And she was manageable even at 85 without oxygen support, if resting in prone position.
  • The zincovit and vit C that patient took is a nutritional supplement. I advise all vitamins supplements and a good protein diet. It helps.
  • Another very important thing is under homoeopathy, we did not see any fluctuation in her blood sugar, she remained on her usual tablet only..
  • Treatment started on 9/5/21 evening, and on 14/5/21, she was completely comfortable, did cooking, made fish curry and dinner. Her cough had reduced drastically on day one of homoeopathic treatment only.

As the testimony from her husband says, apart from zincovit, a nutritional supplement, she was full on homoeopathy and used oxygen concentrator for two nights only. Her other meds for hypertension, diabetes and hypothyroid, the allopathic ones, that she was on for last many years were allowed as such with no change in doses needed.

  • Plain steam inhalation twice or thrice to keep secretions fluid and easy to expel. Deep breathing exercise was followed by the patient. I also insisted on light activity on bed and sitting on edge of bed, some stretching exercises.
  • Since the whole family was affected and in quarantine, it was not recommended for them to go out for investigations again and again. I advised minimum investigations. The improvement in all readings esp CRP is good indicator of reducing inflammation. Although not specific for Covid 19 cases but it is good, cost efficient investigation that can be repeated frequently to see if condition is controlled with the medicines or not.
  • The acute condition improved, I advised the patient to continue good nutritious food with supplements for at least next month. Then can stop the supplements provided food is proper.
  • Also, have advised her to consult her family homoeopath to continue her treatment post covid to include the investigation and treatment of the mammary mass found on her HR CT chest, and to also see if her hypothyroidism, hypertension and diabetes can be better managed.

INVESTIGATIONS :  

1. RAT TEST :

2. RT PCR Test:

3.HR CT Chest report:

4. CBC, CRP report 9/5/21:

5. 12/5/21 CBC, Bl Glucose, CRP report :

6. CBC, CRP 26/5/21 REPORT:

Testimony by husband sent to me on whatsapp :

—————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————————XXXXXXX————–

DR NIVA SHIRKE,

MOB NO 9591797988

EMAIL ID : [email protected]

DATE: 2 JUNE 2021

About the author

Niva Shirke

Niva Shirke

Dr Niva Shirke graduated from Smt C. M. P. Homoeoparthic Medical College, Mumbai, did Diploma in Nutrition and Health Education, IGNOU, Delhi and did PG Fellowship Course in Homoeopathic Dermatology, Mumbai, MUHS- Nasik. She is a homoeopathic consultant with 26+ years of experience. She is presently guest faculty in Dept of Practice of Medicine, Bhagawan Buddha Homoeopathic Medical College & Hospital, Mallathahalli, Bengaluru and practicing at Yeshwantpur, Bengaluru. Soon after graduation, she had the fortune of working as an assistant to the late Dr S R Wadia, of Mumbai. She has been associated with Dr Batra’s PHC Pvt Ltd. as their Chief Homoeopathic Consultant and also with Homoeopathic Medical College and Hospital, Abohar, Punjab as a lecturer. She did her Clinical practice at Mumbai, Faridkot, Abohar, Kolkata, Siliguri and Bengaluru. Dr. Shirke has published works in various national homoeopathic magazines and in Express Pharma Pulse. Her published book is: “Understanding Rubrics” in 2001.

3 Comments

  • Its inspiring to know that how well Homeo can diagnise and also treat Covid effectively within a short period.
    This should be an eye opener for all those who think Homeo is slow and not effective.
    Great Share and it is particularly meticulous in describing the clinical diagnisis and symptomatic explanation.

  • Yes. Homeopathy does have solutions to almost all such ailments.

    Hats off to Dr. Nina Shirke jee, for her systematic and most talented approach in handling the case, the Homeopathic way.

    Dr. Reckeweg’s Germany make preparation VITA C 15 Forte would also add value to the treatment, I very strongly believe
    Regards,
    Maheahbhai Kamdar (80), a Civil Engineer, and a strong Homeopathy follower , from Ahmedabad, Gujarat

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