Clinical Cases

Homoeopathic Case Report – Integrated Treatment Approach in a Diagnosed Case of COVID-19 with Comorbidities

Niva Shirke
Written by Niva Shirke

Dr. Niva Shirke shares a case of covid-19 using homeopathy as part of an integrative approach. The patient had various comorbidities including type II diabetes.

Author Affiliations:

Guest Faculty Professor, Department of Practice of Medicine, Bhagawan Buddha Homoeopathic Medical College and Hospital, Malathahalli, Bengaluru, Karnataka, India – 560056,  http://www.bbhmc.org

Funding:

I received no funding for the case-project.

Authors’ Contribution:

Complete work of case taking, recording, homoeopathic treatment and general management to literature search and preparation of the article. Author herself has reviewed and approved the final article.

Ethical Declaration:

The case details and investigation reports do not give away the identity of the patient, yet is shared with informed consent.

Abstract:

The COVID-19 pandemic continues to put tremendous stress on healthcare providers. Doctors of the conventional system of medicine and of AYUSH are doing their best in treating these cases. In some, an integrated approach while in many others, an individual-system approach is resorted to.

The presenting case report is of a 69-year-old male COVID-19-positive patient with severe dyspnea, He has Type II diabetes with worsening blood-glucose levels, cardiac problems and is on many allopathic medications including a blood thinner and steroids.

He improved very well with homoeopathy. Steroids were tapered off and in spite of having SpO2 80 -81%, he could be managed at home, under quarantine and without any oxygen support.  This was a New Delhi case, treated online, during April-May 2021 when there was severe shortage of hospital beds and oxygen cylinders.

Homoeopathic remedy selection was based on his acute totality and the remedies  Carbo vegetabilis 30C and Cinchona officinalis 30C were found to be very effective.

Introduction:

This male patient of 69 years and his 65- year-old wife were living together in New Delhi in strict home lockdown during the pandemic as both have multiple health issues. He has been suffering from Type II diabetes for many years and is on insulin.  He also had heart bypass surgery with stent implant done in 2017, is hypertensive and on allopathic medication for the last 29 years.

His daughter who is a doctor, stays a few kilometers away with her husband, their 15-year-old daughter and her in-laws. Except for the teenager, the rest all had fallen ill one by one (later found to be RT-PCR COVID-19-positive). Before it was confirmed that the first family member with slight fever was affected with COVID-19, the teenage grand-daughter was dropped at the patients’ flat on 10 April 2021. This was done to save her from a probable infection that the doctor mother handling patients may bring home.

She was soon to appear for her X th Boards Examination and could not risk catching the infection and missing her examination. There was no time to wait to check for development of any signs or symptoms in her if exposed, as news was going around that soon Delhi was to go into complete lockdown.

After that, movement outside would become difficult, and so taking the risk, she was dropped at the patients’ residence. But, it seems that the teenager was already an asymptomatic carrier and unfortunately both became ill. His wife came down with fever first followed by him and both became RT-PCR positive subsequently when they were tested on 27 April 2021.

Once Mr. CMS developed fever and dyspnea, covid-19 infection was suspected and he was started on the standard list of allopathic medicines and was advised quarantine protocols. In the next few days, there was worsening of his covid-19 signs and symptoms, shooting up of his blood sugar levels and he also started getting anxiety episodes.

By then his daughter, her husband and her in-laws had become serious with covid19 infection. In fact most of his relatives were becoming covid-19 positive and it was difficult to get a bed in any hospital in or around Delhi. There were a few deaths due to the infection among the relatives and in the neighborhood. The condition in Delhi was becoming very grim with non-availability of basic medical facilities.

All this worsened his mental state. Along with this, there was a problem with cooking food as his wife too was down with the infection. This is when his daughter approached me and after detailed case taking done on mobile call, and the reports seen, Carbo vegetabilis 30 C and Cinchona officinalis 30 C were prescribed based on his symptomatology. They played a key role in treating his acute condition. With improvement settling in, his steroid medicines were tapered off.

Investigations were repeated to confirm his improvement. As his immediate relations were all down with covid-19, there were no paid service attendants available and he himself was very weak. I could not advise him to go out and get a chest X-ray or HR CT chest. It would have been helpful to know how severe the pneumonia was and also would have added value to the record of his case.

All investigations he could manage were those which were done by himself at home like glucometer readings to check blood glucose levels, or were those where the nearest pathology laboratory could send their personnel for sample collection and a report sent on email id. For progress of the patient, I was more dependent on oximeter readings, patients’ overall comfort-discomfort level and improvement in his quality of life.

Keywords:

Homoeopathy, COVID-19, covid-19 pneumonia, integrated treatment approach, homoeopathic medicines, Carbo vegetabilis 30 and Cinchona officinalis 30, Oxygen saturation, comorbidities, dyspnea.

The Case:

Mr. CMS is a 69-year-old male, Hindu, married, vegetarian patient with moderate to high fever coming on and off, for last 8 – 9 days. He has sore throat, body ache, severe dyspnea and generalized weakness, all gradually worsening for 7 days. He had history of exposure to an asymptomatic covid-19 case and was RT-PCR COVID-19-positive on 27 April 2021. He was considered for treatment in the present study. Has had no covid-19 vaccination doses.

Patient is a K/C/O Type II diabetes, is on insulin for many years.  With covid-19 infection and steroids intake (Tab Tab Omnacortil 40), there is worsening of his blood glucose levels.  He is on anti-hypertensive drugs and blood thinner for long to manage his cardiac conditions.

Pre-covid-19 state:

Insulin : Morning 26U and Night 16U

Hypertension since 1992,

By-pass surgery with stent implant done in 2017,

With blood thinner medicine Ascriptin and antihypertensive Telma 40 now.

Complaints of :

 DATE  DETAILS
18/04/2021: Feverish feeling, axillary temperature: 99·4 F in evening, H/O exertion of household work as wife was down with fever and throat infection for last 3 – 4 days. His teenage granddaughter is staying with them since 10 April 2021 who is unfortunately later found to be asymptomatic carrier of COVID-19.
19/04/2021 Fever, temperature measured was 100 F, with weakness, body ache with headache and throat pain as comes with throat infection. No loss of sense of smell or taste, no nasal discharge or cough. No pain in chest or any breathing related complaints were there.
20/04/2021 Took consultation with his allopathic doctor online and was prescribed the following medicines for next 10 days, to take along with his usual medicines. And was advised for CBC, CRP, ESR

Tab Meftal forte tds Tab Calpol 500 tds

Tab Colchine 0. 5 bd

Tab Zathrin 500 tds

Tab Omnacortil 40 od

Cap Pantop dsr od

Tab famtac 40 od

Tab Vit D3 60k od

Cap Becosule zinc 1od

Tab Cetin 500 1od

Reports:

Hb – 12.8

TLC – 9300 /cumm

ESR – 14

CRP – 8. 87 mg/L

22/04/2021 Patient still had mild fever, and complained of increased overall body weakness +++. Continued same allopathic medicines as advised.
23/04/2021 No fever. But general body weakness+++. Same allopathic treatment continuing.
24/04/2021 Along with general body weakness+++,  Appetite ↓↓↓. He was getting worse.
No fever.

Dyspnea said had started. The weakness and dyspnea made it difficult for him to move and even to eat. Does not have oximeter to measure oxygen saturation levels. Same treatment.

25/04/2021

 

No fever. But does feels feverish on and off. Weakness++++.

Appetite ↓↓↓. Sugar checked on home glucometer was high around 300 – 350, so Insulin doses were increased both morning and night to keep it in check. Dyspnea slightest exertion. On bed mostly. Finding very difficult to go to the attached washroom. Daughter dropped food and bedpan at doorstep as she too is covid-19 positive, but there is no one else to help them. Insulin doses were made morning 33 U and evening 23 U to keep glucose within range. Checking with home glucometer and informing his allopathic doctor who then adjusts the insulin dose.  Rest of allopathic medicines been taken as advised.

Homoeopathic Intervention:

With the above history, patient consulted me online on 26/04/2021 for any help with homoeopathy. The details of the acute totality are summed-up below:

 LOCATION  SENSATION MODALITIES CONCOMITANTS
GENERAL :

Since last 8 days

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Since 4 days

Fever: axillary surface temp on and off,  up to

100 F

No chill or coldness.

No sweating

 

 

 

 

 

 

 

 

 

 

 

Extreme WEAKNESS

 

< sometimes in daytime, in spite of taking allopathic medicines.

< Soon after fever starts, he takes Tab Calpol.

 

 

 

 

 

 

 

 

 

 

< Chewing, eating, talking even few minutes on mobile,  < Going to toilet few steps away from his bed

< passing stools

Headache,   whole, frontal and around eyes, starts with the fever and goes on increasing with it.

Appetite ↓↓↓

Thirst ↓↓↓

Bitter taste in mouth.

Abdominal discomfort due to acidity, food intake has reduced a lot, feels tired and bloated in whole abdominal region

Dyspnea

 

<Bathing, so avoiding

now

RESPIRATORY SYSTEM :

Since about last 2 days

Dyspnea getting worse. Oxygen saturation  afternoon was 92%

 

Smell unaffected. No more sore-throat or pain.

No    cough         or expectoration.

< Slightest exertion any kind.

> Complete rest.

 

Sleep      disturbed.

Sleep↓↓ more so due to breathlessness.

Getting bad thoughts. Mind is active and with all the thoughts, gets upset and tired.

Blood sugar was higher than his usual readings due to covid-19 and steroids intake, so his allopathic doctor has increased his insulin dose.

(His daughter dropped food and digital thermometer, oximeter and medicines at his doorstep.)

08:00 pm O2 saturation 80 -81%, Pulse 84 / min,    Temp 98.4 F

09:42 pm O2 saturation 93%,       Pulse 90 / min,    Temp 98. 5 F

Prone position and complete rest advised to deal with such low oximeter reading. No hospital bed, or home oxygen cylinder could be managed.

Diagnosis : Confirmed case of Covid-19 infection  pneumonia, investigations reports submitted.

Homoeopathic Prescription

Based on the above acute totality, the following homoeopathic medicines were prescribed :

  1. Cinchona officinalis 30, half to one hourly doses
  2. Carbo vegetabilis 30, a dose every 10 – 15 min. was advised to help deal with the severe dyspnea.

NOTE: Choice of the remedy is based totally on the acute totality. Lower potencies were used very frequently due to severity of the symptomatology. In addition, the patient is on steroid Tab Omnacortil 40 od, so to get significant response for longer duration repetition of remedy is again unavoidable.

Allopathic Medicines:  Allowed as it is.  Integrated Treatment approach Advised

General Management :

  • To make Cap Becosules Zinc BID
  • Eucee or Vitamin C OD or two lemons juice and two fresh fruits
  • Had advised sea cod capsules OD alternate days.
  • Steam inhalation twice, deep breathing exercises as and when can. Without straining himself.
  • Lot of lukewarm drinks,
  • Betadine gargle
  • Prone position if severe breathlessness.
  • 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 hour for next 24 hrs. With improvement, to make it 3 – 4 hourly
  • Blood tests given for CBC, ESR, CRP by arranging home collection of sample. Since patient had no help and was much exhausted and breathless, could not advise him to go out to get HR CT or even plain X-ray of Chest.
  • Patient’s allopathic medicines for controlling BP, blood sugar were allowed as it is, no interference in them.
  • Daily monitoring of sugar levels with home glucometer and consult his allopathic doctor to adjust the insulin units to be taken, to keep blood glucose levels within normal range.

Follow up:  

 

SR. NO.

 

DATE

 

SYMPTOMS & SIGNS NOTED

 

<, > or

SQ

 

MEDICINES

 

REMARKS

1 27/4/2021 Weakness still present.

Sugar ++

Appetite ↓↓↓

11:10 am      O2 saturation 85%.

08: 15 pm     O2 saturation 93%    Pulse 84

Could not take much data today as patient was mostly sleeping. He had missed his sleep last few days so did wife did not want to disturb him. Only oximeter reading was taken.

Temperature was felt by wife with her hand only. Patient too did not complain of fever or headache.

Report dated 26/4/2021 :

CRP : 39.50 mg/ L

> Same medicine, allopathic continued. Insulin given based on sugar levels checked.

Same homoeopathic medicines continued as patient generals like sleep and dyspnea and fever seems better.

CRP is high
2 28/4/2021 Same breathlessness Weakness ↑↑↑ as before No fever in daytime.

Appetite slightly better but is still ↓↓ Low grade fever feeling in evening but normal temperature on measuring.

> Same frequency of Carbo vegetabilis 30 and Cinchona officinalis 30.

Allopathic treatment :

Cap Becosule Zinc was advised OD but I had advised him to take it BD.

 

 

 

05:00 pm  O2 saturation 91%,   Pulse 94 / min

O2 saturation whole day was around 94/ 91/ 93/ 94 at night which was a good sign.

Patient feels comfortable today overall.

Measured BP with BP portable machine and said it was within normal range.

Report dated 27/4/2021 :

RT PCR positive

E Gene Ct VALUE 27

RdRP +  N Gene Ct value 27

Tab Colchine  0. 5 BD

Tab Omnacortil 40 OD

Cap Pantop dsr OD

Cap Becosule Zinc OD

Debistar 150 U OD X

10 days

And insulin inj

Continuing with his  Telma 40 OD.

With improvement, the following           medicines were stopped. Tab Meftal forte

Tab Calpol 500

Tab Zathrin 500

Tab famtac 40

Tab Cetin 500

Diet advised. Protienex

D advised as supplement as his appetite has been down for last few days.

3 29/4/2021 08:00 am     O2 saturation 91%,

Could not take much data as patient was sleeping mostly, was comfortable and ate better than last few days.

Dyspnea also is better, tolerable.

> Same frequency           of Carbo vegetabilis 30 and           Cinchona officinalis    30 to           be continued.

 

Same allopathic medicines.

His daughters mother-in-law passed away at night due to covid-19 pneumonia, was on oxygen support in hospital. Daughter now very busy managing her covid-19 positive husband and father-in-law who are both having severe symptoms as well while she too is positive.
4 30/4/2021 O2 saturation 93%,   Pulse 84 / min,  Temp 93.4 F

Overall better.

> Same as above. Integrated           treatment approach Daughter           busy with the mother-in-laws’ funeral and    other

observances,

could not send me much           details today except that he’s better

5 31/4/2021 O2 saturation 90 –  93%  whole day.

Pulse 84 / min in afternoon.

Overall better.

Worried a lot for daughter and her husband as there is death in family. Lot of stress on daughter. And he is unable

> Same frequency of Carbo vegetabilis 30 and Cinchona

officinalis 30

 

Same allopathic medicines.

Overall       better.

Improving gradually.

 

to help in any way. Worried about own son too.
6 1/ 5 /2021 Overall feeling better.

Able to do breathing exercises in a better way compared to before.

Walked in the room to check if he could without feeling tired or breathless. Did feel tired after some walking.

Able to eat well.

No fever at all. No bitter taste.

Abdominal discomfort not there.

Stools and urine are fine, no issues.

08:00 am       O2 saturation 91%

01:00 pm       O2 saturation 92%,   Pulse

77 / min,   Temp 97.9 F

10:00 pm       O2 saturation 93%,   Pulse

92 / min,  Afebrile

> Same frequency          of Carbo vegetabilis 30 and          Cinchona officinalis 30

 

Same allopathic medicines.

Tab Omnacortil 40 OD

Cap Pantop dsr OD

Cap Becosule Zinc OD

Debistar 150 U OD X

10 days

And insulin inj

Telma 40 od

7 2/ 5 /2021 Overall patient much better.

No fever

Took bath without any help.

Did light exercise.

(Sent me message saying lot of thanks to you.)

Weakness much better Appetite has improved.

Blood Sugar in morning was  :  118

08:00 am   O2 saturation 93%,   Pulse 82 / min,   Temp 97.9 F

09:30 am   O2 saturation 93%, Afebrile

> Carbo vegetabilis 30 half hourly to hourly during waking time and Cinchona officinalis 30

once every 3 hourly

 

Same allopathic medicines.

Daughter came to visit with food and enquired from outside the door. Later called me to say he is much better and able to move around the house and help with some kitchen work.
8 3/ 5 /2021 Better. Took bath and had shaved beard without help.

 

> Carbo vegetabilis 30  half hourly to hourly during waking time and Cinchona officinalis 30

once every 3 hourly

 

Same allopathic medicines.

9 4/ 5 /2021 Much better.

Tapering of steroids requested from his allopathic doctor.

Weakness better.

Started doing normal routine activities. Walking in room. Taking steam, deep breathing exercises. Taking warm drinks, ginger masala tea, eating well.

> Carbo vegetabilis 30  half hourly to hourly during waking time and Cinchona officinalis 30 once every 3 hourly

 

Same allopathic medicines.

 

Sleep is good. No readings taken today. Said was overall better and needed a break.
10 5/ 5 /2021 Comfortable. Readings taken today of oxygen saturation on oximeter were 92 – 94 %. Patient feels good. Able to move around, attended many calls, able to do daily activities without any discomfort. > Homoeopathic medicines same.

 

Steroid dose of tab Omnicortil made half that is 10 bd.

11 6/ 5 /2021 Comfortable in general.

Morning weakness better.

Oxygen level not going down to 86 – 89 as below.

Insulin units reduced.

Diet managed   as   per advice.

Antidiabetic diet,

Mentally and physically both better

Started walks for few minutes in morning and evening inside the hall only

09:30 am  O2 saturation 92%, Pulse 88

/ min,   Temp 97. 6 F

> Carbo vegetabilis 30  hourly to 2 hourly dose during waking time and Cinchona officinalis 30  once every 3-5 hourly

Same allopathic medicines. Insulin doses Morning 33U,

Evening 23U

12 7/ 5 /2021 Better overall. Able to rest comfortably. Move around the house and do daily activities.

09:30 am  O2 saturation 92%, Afebrile

10:00 pm  O2 saturation 95%,

Pulse 85 / min, Afebrile

> Same as above. Rest all instructions too, same as before. For first time his SpO2 has become 95.
13 8/ 5 /2021 Patient overall much better and taking

Steam inhalation,

Multivitamin BD

Doing deep breathing exercises

Movement in       the     house          are comfortable. No complaints.

Eating too has improved.

06:00 am  O2 saturation 94%,   Pulse 73

/ min, Afebrile

10:00 am  O2 saturation 94%,   Pulse 84 / min, Afebrile

06:00 pm  O2 saturation 93%,   Pulse 81

/ min, Afebrile

10:00 pm  O2 saturation 93%,   Pulse 91 / min, Afebrile

> Same as above. Rest all instructions too, same as before. Advised to be more active and not worry about his SpO2 levels.  To be off bed as much as possible. Sitting or moving around.

 

14 9 / 5 /2021 Appetite has improved. Feeling hungry. No bitter taste, mouth better. Stools, urine fine. Sleep was good at night yesterday.

Rest all he feels comfortable in general

06:00 am     O2 saturation 95%,   Pulse 73 / min, Afebrile

10:00 am     O2 saturation 92%,   Pulse 95 / min, Afebrile

02:00 pm     O2 saturation 94%,   Pulse

91 / min, Afebrile

06:00 pm     O2 saturation 94%,   Pulse

99 / min, Afebrile

10:00 pm     O2 saturation 94%,   Pulse

95 / min, Afebrile

> 1. Thuja occidentalis 200, one dose is given as intercurrent.

2. Carbo vegetabilis 30,

2 – 4 hourly dose

3. Cinchona officinalis 30  once every 3-5 hours.

 

Same allopathic medicines.

Insulin doses Morning

33U, Evening 23U

15 10/ 5 /2021 Complained of dryness of lips and mouth for last few days due to past history of mouth breathing when dyspnea was severe, may be. Did not pay attention to it but now feels lips having roughness, dryness and cracks. Lower lip has fine cracks.

Thirst is good. Taking warm drinks as advised.  Appetite good.

Again some anxiety as there was death of his close relation.

Low grade fever but reading coming less than 98 F. Feels so.

Walked fast for 15 min within the house, without difficulty, twice. Doing all daily routine activities at home without any trouble.

06:00 am       O2 saturation 94%,   Pulse

72 / min, Afebrile

10:00 am       O2 saturation 93%,   Pulse 91 / min, Afebrile

06:00 pm       O2 saturation 94%,   Pulse

81 / min,  Afebrile

10:00 pm       O2 saturation 94%,   Pulse

73 / min, Afebrile

> Advised to take more fluids and drink more water.

To apply glycerin on

lips

 

1.       Carbo vegetabilis 30,

2 – 4 hourly

dose

2.       Cinchona officinalis 30  once every 3-5 hours.

 

Same allopathic medicines. Insulin doses Morning 33U, Evening

23U

16 11 / 5 /2021 Now walking time 15min, 2 times.

Feeling better. No complaints.

Very happy.

06:00 am   O2 saturation 97%,   Pulse

63 / min, Afebrile

> Same as above. First time since covid19 infection, his O2 saturation reading came 97%. He checked it twice more to be sure.

 

10:00 am   O2 saturation 93%,   Pulse

85 / min, Afebrile

02:00 pm   O2 saturation 95%,   Pulse

73 / min, Afebrile

06:00 pm   O2 saturation 97%,   Pulse 81 / min, Afebrile.

17 12 / 5 /2021 All fine, O2 saturation readings between 94 – 97%, and afebrile. No other complaints. > Same as above.
18 13 / 5 /2021 All fine. O2 saturation remained 9694-95-97  %, Afebrile. No complaints > Steroid dose reduced to Tab Omnicortil  10 OD for next 3 days. Then to stop.

Homoeo contd

19 14 / 5 /2021 All fine. O2 saturation remained 9695-97%, Afebrile. No complaints. Tried to stress himself to see how his stamina is affected. Did deep breathing exercise and walked fast within the house. After 30 min of walk, oxygen sat came down to 87. But after rest, recovered and came back to 95% > Same as above.
20 15 / 5 /2021 All fine. O2 saturation remained 95-

97%,  Afebrile

After 20 min walk, O2 saturation 93%, Pulse 70/ min. No complaints. Appetite, thirst, sleep, stools, urine all are fine.

Feels better stamina today.

 

> Same as above.
21 16 / 5 /2021 All fine. O2 saturation remained 9597%,  Afebrile

Blood glucose levels are better. Monitored by his allopathic doctor who has now reduced his Insulin inj units.

>  

Allopathic medicines : now taking only  Debistar 150 U OD

Telma 40 od

And insulin inj that varies from Morning 30

U

Evening 20U approx..

22 17 / 5 /2021 Better than before.

Comfortable

Blood sugar managing with insulin dose. Units are coming down to how it was before covid-19 infection.

Mobility inside the house has also increased

O2 saturation 96 – 97%,   Pulse 70 / min, Afebrile

> Carbo vegetabilis 30,  4 -6 hourly dose. Next five days.

 

Gave Natrum muriaticum 200 one dose stat as his constitutional remedy.

 

 

Worked out his constitutional medicine with more case details taken from him and his daughter over phone.  Natrum muriaticum follows Cinchona officinalis well. He has H/O business loss due to being cheated by friends, was humiliated
After 20 min walk, O2 saturation 93- 95%,   and becomes back to 96 – 97%,  with few min of rest.

 

 

Allopathic same as last time. by relatives, and suffered in silence for many years, it affected how both his kids were married off and he has hardly any savings now. All this disappointments from near dear ones, introvert nature, and his sleep disturbance, too many continuous anxious thoughts, the dwelling on past, brooding,  pointed to Natrum muriaticum

 Old medical reports for reference:
19/ 12/ 2020: Last report available before the covid-19 infection.

HbA1C: 9.72 %
Average blood glucose : 232.26 mg/dl

Liver Function Tests : Total protein 6.7 gm/dl
Serum Albumin 4 gm/dl
Globulin 2.7
A/G ratio 1.48
SGOT  32.3 IU/L
SGPT  31.5 IU /L
Alkaline phosphatase 103 U/L
Total bilirubin  0.4 mg/dl
Conjugated bilirubin 0.21  mg/dl
Unconjugated bilirubin  0.19 mg/dl
Gamma GT 26  IU/ L

Lipid profile : wnl

Renal Function Tests : Urea 20.80 mg/dl
Creatinine 0.61 mg/dl
Uric acid  2.7 mg/dl
Total protein 6.7 mg /dl
Serum albumin 4 gm/dl
Globulin 2.7 gm/dl
Urine routine wnl, except glucose in trace amounts.

Clinical Biochemistry : wnl
Total PSA, Serum: 0.24ng/ml
ESR 21 mm / 1st hour

CBC :
Hb 12 gm/dl
TLC 12120/ cmm Eosinophil  10.9 % RBC 4.41 mill / c mm.
Haematocrit  38.5% AEC 1.32  Rest wnl.

Insulin before covid :  Morning 26 Night 16
During Covid-19, infection, insulin doses varied around : Morning 33 U approx. Evening 23 U approx
Now at present, post-Covid19, insulin requirement : Morning insulin 24U Night 10U

CRP readings :

Discussion points:

When this severe case with such low SpO2 and co-morbidities came to me for treatment, I already had some experience in treating covid -19 cases. I knew that I had to stick to the homoeopathic principles and manage the prescription step-by-step to get him out of the severity. Monitoring vitals on hourly basis day and night is necessary to check if the medicine is helping or any change is needed at the earliest.

  • After starting homoeopathic treatment, the patient improved gradually in general and also the oxygen saturation readings improved from lowest 81 to 96 – 97.
  • Oxygen cylinder, concentrator or even an adult ambu bag could not be arranged so patient was managed with homoeopathic medicines and rest in prone position. 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.
  • The Cap Becosules Zinc, Eucee or Vit C, Sea cod capsules and proteinex D that patient took are nutritional supplements. I advise all vitamins supplements and a good protein diet. It helps.
  • Plain steam inhalation once or twice to soothe throat and help with any congestion.
  • Deep breathing exercise sitting on edge of bed, some stretching exercises whenever he can do it. A few steps walking within house with more improvement is advisable. The earlier the patient is off the bed, the better.
  • Since the family was badly affected and in quarantine, and no one else to help the patient, the least investigations with home-collection of sample could be advised. The improvement in all readings especially CRP is good indicator of reducing inflammation. Although not specific for Covid-19 but it is a good, cost efficient investigation that can be repeated frequently to see if condition is controlled with the medicines or not.
  • The acute condition improved and I advised the patient to continue good nutritious food with supplements for at least next month. Then can stop the supplements provided food intake is proper.
  • Also, have advised him constitutional medicine Natrum muriaticum 200 C once in two weeks, based on his totality so as to avoid any post covid-19 health issues which would also help with better management of his hypertension and diabetes as can be seen in the insulin requirement reduction post covid-19. He is completely fine now back to his usual dose of blood thinners, insulin units and Telma 40 for control of his hypertension in consultation with his allopathic physician.
  • Repeat RT PCR was not required.

Conclusion

A patient of COVID-19 with worsening diabetes, hypertension and on allopathic medicines, an SpO2 down to 81 was successfully treated with homoeopathic medicines along with his allopathic medications with an integrated treatment approach.  Individualized homoeopathic intervention, dietary support and breathing exercises with precautionary measures can be an answer to the ongoing crisis by being more cost effective and less stressful on utilization of hospital resources.

Investigations:

1. RT PCR Test dated 27/ 4/ 2021:

2. CBC, CRP value 20/4/2021:

3. CRP report 26/4/2021:

4. CRP report 04/6/2021:

5. Testimony by the patient:

6. Old reports of the patient dated 19/12/2020 just for reference :

ABBREVIATION USED IN THE ARTICLE:

AYUSH : Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy

References :
Homoeopathic Materia Medica by James Tyler Kent
Homoeopathic Materia Medica by William Boericke
Homoeopathic Materia Medica by John Henry Clarke
Repertory of Homoeopathic Materia Medica by James Tyler Kent
Synthesis Repertory
Lot of online literature on COVID-19
Guidelines for Homoeopathic practitioners for COVID-19

DR NIVA SHIRKE,
MOBILE NO.  9591797988
EMAIL ID : [email protected] DATE: 30/ 08/ 2021

About the author

Niva Shirke

Dr Niva Shirke graduated from Smt C. M. P. Homoeopathic Medical College, Mumbai, did PG Fellowship

Course in Homoeopathic Dermatology, Mumbai, MUHS- Nasik and did Diploma in Nutrition and Health Education, IGNOU, Delhi. She is a homoeopathic consultant with 26+ years of experience. She is presently guest faculty Professor in Department of Practice of Medicine, Bhagawan Buddha Homoeopathic Medical College & Hospital, Mallathahalli, Bengaluru. She is registered with the Karnataka Board of Homoeopathic System of Medicine and practices 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. She is life member with Karnataka Qualified Homoeopathic Doctors Association. Dr. Shirke has published works in various national homoeopathic magazines and in Express Pharma Pulse. Her published book is: “Understanding Rubrics” in 2001.

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.

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