Treatment of COVID-19 and the Sequelae with Traditional Medicine
By Adam Tate
March 2023
March 2023
This is a follow-up to our original TCM treatment of COVID-19 article written by Adam in March 2020.
Introduction
COVID-19 continues in 2023 as the world learns to live with the virus. Numerous countries have had multiple waves of infection and multiple lockdowns. As of March 2023 there have been over 680 million cases and over 6,800,000 deaths worldwide, and there has still been over 1000 deaths per day recorded in some days of March 2023.. (1)
In the past 2 years vaccines from a number of manufactures have been used globally on an unprecedented scale. Nevertheless, the virus continues and we are racing to evolve new vaccines and treatments for the evolving strains of the virus.
It is still plausible indeed likely that COVID may remain with us, that annual vaccines for COVID may be required and that mass outbreaks from new strains may continue. In addition, some developing countries are still under pressure with their healthcare system and financial resources being severely depleted.
For this reason it is worthwhile to look at how Traditional Medicine has responded and what treatments have demonstrated efficacy, both in COVID, and in the post-viral syndrome ("Long COVID") that effects some people.
Understanding the Disease
As with many acute seasonal viral infections, COVID typically infects the upper respiratory tract, resulting in Cough, Fever, Breathlessness etc. And just as with the seasonal Flu, some people are exposed but don't develop symptoms, many people develop mild-to-moderate symptoms, and a small percent develop severe symptoms, secondary infections or exacerbation of underlying medical conditions. COVID is clearly different to seasonal Flu in its infection rate, the percent of infected patients requiring ICU, and the death rate.
In a proportion of the population, COVID infection develops rapidly into a severe and life-threatening condition following initiation of symptoms which is typically 5–14 days or more following exposure. This has been shown to be due to an excess immune response, the so-called cytokine storm.
In addition, Cardiovascular disease has been associated with a large proportion of COVID deaths. (2)
Due to its adaptability and evolution, COVID is so far proving to be successfully adapting to numerous climates and seasons with these adaptations spawning new variants. So far a number of strains have been identified but over 1200 genomic variations have been found. This highlights the likelihood of the continuation of the virus, as well as the increasing possibility of a variation with either greater transmission rate, greater mortality, or both.
Understanding Prevention and Treatment
One of the biggest casualties in the information war regarding COVID-19 has been due to a lack of knowledge about prevention and treatment of a Pandemic such as COVID-19. Claims that social distancing or masks 'don't work' are examples of this.
During a Pandemic the more we can reduce transmission the more effectively we can control it. So while it is true that 'Masks don't prevent infection', what they do do is reduce infectivity from perhaps 2.7 to 2.2 infections per infected case (meaning 2.7 or 2.2 people, on average, are infected by each infected person). While that doesn't sound like much, over 10 generations of infection it makes a huge difference in the number of infected (2,655 vs 20,589). The same can be said for social distancing.
If we apply the same rationale to Kitchen remedies, home treatments and herbal medicine we can see a similar picture. The use of herbal Sachets as a type of prophylactic (as has been recommended in parts of China) is a good example. Firstly, the breathing of the aromatic herbs throughout the day could perhaps help prevent infection when there was a very mild exposure. Inhalation of essential oils can stimulate mucosa of the airways, enhance local immunity and improve mood. Importantly too, the fact that a person can do something pro-active will help stop lowered immune response that occurs in times of stress, such as during a pandemic and the associated lockdowns. It's an example of a prophylactic treatment that may have mild benefit, but when combined with other measures, and used widely can contribute to a lowering of infection.
So some recommendations may not be potent against COVID-19 infection directly, but may help reduce the rate of infection, or gently support the body in a mild case and help prevent it becoming more severe. Such treatments are particularly useful for the elderly, and may also be employed during the recovery phase.
Thus, it remains up to the practitioner to choose a formula suitable to the severity of the case or risk of infection. Using a kitchen formula in a critical case will obviously not be sufficient. Therefore, the Chinese differentiation and syndrome-based formulas is the best Traditional Medicine model to follow in the current ongoing COVID-19 crisis for Traditional Medicine Practitioners.
Primary Modalities to Prevent Spread of Infection
- Isolation: this is the most effective means to prevent spread during a pandemic. In China, many areas went through a total lockdown where they were unable to leave their homes for several weeks. However, this helped China contain the infection and return to a relatively 'normal' life for many months while the rest of the world was in harsh lockdowns for months.
- Distancing: less severe than Isolation, avoiding close contact with the general population
- Washing Hands: whenever we are out, return home, and frequently throughout the day, washing hands with soapy water for 20 seconds significantly decreases chances of spread. Using alcohol hand washes also sterilizes the hands.
- Wearing Masks: while not 100% effective, masks do 'work' by reducing transmission.
Conventional Treatment of COVID-19
There are 2 types of COVID intervention where Traditional Medicine is indicated apart from preventing infection and aiding recovery. The first is mild cases which require isolation and monitoring with minimal symptoms and little or no western medicine intervention. The second is severe cases which may be simultaneously treated with modern and traditional medicine, as has been demonstrated in China, India and numerous other countries.
In the latter cases it is good to review standard western medicine protocol:
1. Oxygen Therapy
2. Antibiotics, typically:
i. Amoxicillin
ii. Fluoroquinolones
iii. Azithromycin
3. Antivirals including:
i. Lopinavir
ii. Ribavirin
iii. Remdesivir
iv. Chloroquine
v. Interferon
4. Corticosteroids
5. New anti-COVID medications
Other therapies are added depending on individual symptoms.
The 4 Stages of COVID-19 in Traditional Medicine
Early
Cold-Damp invading Lung and Spleen
Manifest with Cold, Dampness, Qi deficiency with Qi stasis
Middle
Cold-Damp obstructing Lung and Spleen
Manifests with Cold-Damp with Qi stagnation and/or Yang deficiency
Late
Cold-Damp closing Lung and injuring Spleen
Manifests with Heat and Damp and Qi deficiency
Recovery
Lung and Spleen Qi deficiency
Manifests with Heat and Damp and Qi deficiency
Clinical Stage differentiation of COVID-19
In Practice, it can be divided into Non-Severe and Severe, and this has been used in India. However, in China, a more detailed division has been defined, the first 3 stages being Non-Severe, the next 2 Severe, and the last stage being the Recovery phase.
1. Early Stage–before Confirmed Diagnosis but with possible symptoms
A. Fatigue with gastrointestinal symptoms
–Huo Xiang Zhen Qi Shui
B. Fever and Fatigue
–Jinhua Qinggan granules
–Lianhua Qingwen
–Shufeng Jiedu formula
2. Mild Stage
Cold-Heat Invading Lungs
–Qing Fei Pai Du Tang
–Ma Xing Shi Gan Tang
–Da Yuan Dan
–Toujie Quwen granules
3. Moderate Stage:
Cold–Damp Obstructing Lungs
–Ma Xing Shi Gan Tang (Fever, Fatigue, Cough)
–Da Yuan Dan (Cough, Asthma, Dry Throat)
–Toujie Quwen granules (fever, cough, fatigue, chest tightness, panting, lung CT)
–Xuan Bai Cheng Qi Tang
4. Severe Stage
Epidemic Toxin Closing Lungs
–Qing Fei Pai Du Tang (Cough, Fever, Breathlessness)
–Hua Shi Bai Du Tang
–Shufeng Jiedu formula
–An Gong Niu Huang Wan
–several injectable TCM preparations are also used
5. Critical Stage
A. Internal Obstruction causing Collapse
–Shufeng Jiedu formula
–An Gong Niu Huang Wan
–Su He Xiang Wan
–several injectable TCM preparations are also used
6. Recovery Stage:
Lung and Spleen Qi Deficiency
–Liu Jun Zi Tang with Astragalus Huang Qi, Pogostemon Huo Xiang, Amomum Sha Ren
Herbs or Herb constituents with Anti-COVID activity
Indian Research
CHEBULA–chebulagic acid and punicalagin have demonstrated efficacy against COVID-19 (3)
WITHANIA–interupts COVID virus replication (4)
Indian Research showed addition of herbs such as Sacred Basil, Turmeric and Withania to standard treatment improved recovery. (5)
Chinese Research
12 Most Used Chinese herbs in COVID-19 formulas with proven Anti-COVID-19 compounds:
- Licorice (Gan Cao)
- Scutellaria Huang Qin
- Apricot kernel (Xing Ren)
- Ephedra Ma Huang
- Gypsum (Shi Gao)
- Forsythia Lian Qiao
- Lonicera Jin Yin Hua
- Poria Fu Ling
- Pogostemon Huo Xiang
- Pinellia Ban Xia
- Atractylodes Bai Zhu
- Magnolia Hou Po
Useful herbs to increase Immunity
- Astragalus Huang Qi
- Licorice
- Withania
- Tinospora
Important Chinese medicines for use in COVID Fever include:
- Buplerum Chai Hu
- Scutellaria Huang Qin
- Cinnamon twig (Gui Zhi)
- Forsythia Lian Qiao
- Lonicera Jin Yin Hua
- Gardenia Zhi Zi
- Gypsum (Shi Gao)
- Houttuynia Yu Xing Cao
- Andrographis Chuan Xin Lian
Most important herbs for Cough, Wheezing and Breathlessness
- Licorice (Gan Cao)
- Apricot / Almond kernel (Xing Ren)
- Ephedra Ma Huang
- Gypsum (Shi Gao)
- Pinellia Ban Xia
- Houttuynia Yu Xing Cao
Preventing Infection of COVID-19
Indian Approach (4, 6, 7, 8)
The Government of India has recommended spices like Cumin, Turmeric, Coriander and Garlic to be used in cooking.
Interestingly the Indian Government suggested Yoga practices to tackle psychoneuroimmuno perturbation occurring during COVID-19; that is, lowered immunity due to excess stress, fear and worry due to the pandemic. Yoga has been shown to relieve fear, depression, anxiety and negative thinking while enhancing sleep quality and has therefore been promoted.
Ayush kwath
The Government developed and promoted this herbal tea which can be made from common kitchen herbs and spices, and which increases immunity as well as promoting digestion and relieving Damp.:
- Holy Basil 4 parts
- Black Pepper 1 part
- Ginger 2 parts
- Cinnamon 2 parts
- Raisins 4 parts (a later addition which isn't in all versions)
Chyawanprasha
Chyawanprasha is a famous health tonic in India, composed of a number of herbs along with mineral ingredients in a honey-paste form. It is recommended as a daily health tonic but has been recommeded to take 10 grams each morning to boost immunity. It was also recommended for healthcare workers. There has been a 283% increase in sales of Chyawanprasha since COVID-19 begun.
In addition, Ayurvedic cleansing procedures are recommeded both as prophylactic and as treatment:
1. Oil Pulling (holding oil in the mouth for 2–3 minutes daily) using Sesame or Coconut oil, followed by rinsing.
2. Applying oil inside the nostrils with Sesame or Coconut oil, or Ghee, morning and evening.
3. Steam inhalation from Mint in boiling water
TCM Formulas
1. Sang Ju Yin + Yu Ping Feng San
This combination was used by 1063 hospital and high-risk laboratory workers. None of them were infected compared to 0.4% infection in the control group. (9)
Formulas effective in the treatment of COVID-19
1. Chinese (TCM)
China was first hit with the pandemic and has been integrating TCM with western medicine in the treatment of COVID ever since. With over 80,000 confirmed cases, China has had more clinical experience with the use of Traditional Medicine than most other countries.
1. Huo Xiang Zheng Qi
This classical formula aromatically revives the Stomach and clears Damp. It is most used for acute Damp-Toxin gastrointestinal disease, Gastroenteritis, Food Poisoning etc. However, it has been found effective for COVID-19, particularly in the early stages. It was first recommended when it was found that over 50% of COVID-19 patients presented with Diarrhea which is asociated with early Damp-Toxin attack. It enhances gastrointestinal function, resolves Damp and enhances immunity. Therefore, it is indicated in early stages but especially in observation period where symptoms have presented by diagnosis has not been confirmed.
- Agastache Huo Xiang
- Perilla Zi Su Ye
- Angelica dahurica Bai Zhi
- Pinellia Ban Xia
- Citrus reticulata Chen Pi
- Atractylodes Bai Zhu
- Magnolia Hou Po
- Areca Da Fu Pi
- Poria Fu Ling
- Platycodon Jie Geng
- Gypsum (Shi Gao)
A number of compounds in this formula directly inhibit COVID-19 virus replication while showing anti-inflammatory effect and inhibition of cytokines. When used with standard Western medicine it significantly reduced clinical symptoms as well as preventing mild cases becoming severe. (10)
2. Ma Xing Shi Gan Tang
This is a famous TCM formula originally from Shang Han Lun.
- Ephedra Ma Huang
- Apricot kernel (Xing Ren)
- Gypsum (Shi Gao)
- Licorice (Gan Cao)
3. Qing Fei Pai Du Tang (QFPDT)
We have previously shown that Qing Fei Pai Du Tang (QFPDT) which was developed over 12 months ago continues to play an important role in Chinese treatment of COVID pneumonia patients.
This is a combination of 4 clasic TCM formulas: Ma Xing Shi Gan Tang, She Gan Ma Huang Tang, Chai Hu Tang and Wu Ling San. Together, they resolve Lung Heat, resolve Toxin from the exterior, settle Cough and Wheezing, warm the Yang and activate Qi while supporting Spleen and Stomach function.
In early 2020, 214 cases were treated with QFPDT. Total effective rate was stated at 90% with 60% of patients showing relieved symptoms and improved imaging. After initial success the formula was employed throughout China. Further studies in Sichuan showed effectivness of 84% after 3 days treatment, 90% after 6 days and 92% after 9 days of treatment. A curative rate of 100% was shown in a small group when QFPDT was combined with Interferon. It has proven to hinder replication of COVID-19 virus, has anti-inflammatory effect via several different pathways and inhibits cytokine release. (10)
In a retrospective study (May 2021), a review of several thousand cases found COVID-19 mortality to be 1.2% in the group who took QFPDT compared to 4.8% in the group that did not. After adjustment for individual patient characteristics and concomitant treatments, QFPDT use was considered to have a 50% reduction in mortality. (11)
4. Lian Hua Qing Wen
- Forsythia Lian Qiao 255 grams
- Ephedra Ma Huang (honey-fried) 85 grams
- Lonicera Jin Yin Hua 255 grams
- Isatis Ban Lan Gen 255 grams
- Dryopteris Crassirhizomatis Mian Ma Guan Zhong 255 grams
- Menthol 7.5 grams
- Gypsum (Shi Gao) 255 grams
- Pogostemon Huo Xiang 85 grams
- Rhodiola Hong Jing Tian 85 grams
- Houttuynia Yu Xing Cao 255 grams
- Rhubarb (Da Huang) 51 grams
- Bitter Apricot kernel (Ku Xing Ren) (stir-fried) 85 grams
- Licorice (Gan Cao) 85 grams
This formula has become well respected and was demonstrated to be effective during SARS and Influenza epidemics in China. It is now regarded as a primary medicine for use in public health emergencies associated with acute respiratory illness. It also alleviates acute exacerbation in COPD patients (10, 12)
5. Hua Shi Bai Du Tang
This is composed of Ma Xing Shi Gan Tang with Huo Xiang Zhen Qi San with modification.
- Ephedra Ma huang
- Bitter Apricot kernel (Ku Xing Ren)
- Gypsum Shi Gao
- Licorice (Gan Cao)
- Pogostemon Huo Xiang)
- Magnolia Huo Po,
- Atractylodes Cang Zhu
- Amomum tsaoko Cao Guo
- Pinellia Ban Xia
- Poria Fu Ling
- Rhubarb (Da Huang)
- Astragalus Huang Qi
- Eruca sativa Zhi Ma Cai
- Paeoniae Rubra Chi Shao
6. Ba Bao Dan
While Ba Bao Dan is not a regular TCM formula, and while it would be not possible to (legally) use it in most developed countries, it is worth mentioning as it has demonstrated a powerful effect against cytokine storm in vivo and in vitro and cytokine storm is associated with severe COVID symptoms. (13)
- Bezoar (Niu Huang)
- Snake Bile (She Dan)
- Antelope horn (Ling Yang Jiao)
- Pearl (Zhenzhu)
- Musk (She Xiang),
- Notoginseng (San Qi)
Other TCM formulas recommended
Da Yuan Tang
Hua Shi Bai Du Tang
Shu Feng Jie Du Tang
TCM Patent Medicines recommended:
- Lianhua Qingwen capsules
- Huoxiang Zhengqi capsules
- Jinhua Qinggan granules
- Toujie Quwen granules
- Xuebijing injection
Ayurveda
1. Sudarshan Ghanvati
- Withania
- Turmeric
- Clove
- Black Pepper
- Ginger
- Cyperus rotundus
- Triphala
Tibetan Medicine
Norbu 7 Decoction (Norbu bdun thang)
Unani
Triyaq Arba (known as Theriac of Four Ingredients, or Diatessaron)
- Gentian
- Bay berry (Laurus nobilis)
- Myrrh
- Long Birthwort
Other Therapies
Moxibustion
Moxa has been used as an adjunct both in prevention, treatment and during recovery..
1. Zu San Li St36, Qi Hai, Zhong Wan–regulates immunity, improves symptoms (suspected cases or preventative)
2. Zu San Li St36, Shen Que–regulates immunity, shortnens course of disease (mild cases)
3. He Gu LI4, Tai Chong–regulates immunity, shortnens course of disease (mild cases)
4. Da Zhui, Fei Yu–strengthens Lung and Spleen, increases Qi (recovery stage)
5. Zusan Li ST36, Kong Zui–strengthens Lung and Spleen, increases Qi (recovery stage)
Aromatic Sachets
Interestingly, carrying aromatic sachets was widely promoted in 7 provinces in China to help prevent infection. This apparently almost superstitious practice is exactly what was regularly done in the West during epidemics including the plague. The government of Heilongjiang recommended the following prescription:
- Pogostemon Huo Xiang
- Eupatorium Pei Lan
- Camphor (Zhang Nao)
- Realgar (Xiong Huang)
- Angelica dahurica Bai Zhi
- Artemisia argyi A Ye
Four Thieves Vinegar
Following the use of Aromatic Sachets in China, we should make mention of the Four Thieves Vinegar of the West. The origin story says that in the year 1720 in the town of Toulouse, France, Four Thieves were luting the house of Plague victims yet never contracted the disease. When caught they were sentenced to death, but offered a pardon if they shared their secret. They revealed that they made a herbal vinegar which they sprinkled on a sponge and carried with them. The recipe spread rapidly with many European Pharmacopeieas having version of it. Until relatively late, it remained in the French Codex as Antiseptic Vinegar.
- Calamus
- Cinnamon
- Mint
- Lavender
- Rue
- Sage
- Wormwood
- Rosemary
- Clove
- Nutmeg, of each 1/4 oz.
- Garlic heads, 2 heads
This can be used to wash the hands or splash on the face, or it can be sprinkled on a sponge or clothing such as a scarf when going outside. It would also be a sensible home remedy to use in disinfecting surfaces or as a hand wash. A spoonful can also be taken diluted in water as a prophylactic every morning.
It must be stated that there is no research regarding this formula. However, a number of the herbs have shown anti-bacterial, anti-viral and/or immune-enhancing effects. It has only been added due to the use of aromatic sachets to prevent infection in China.
Fumigations
Fumigation can be used to help purify a room or home, or to help keep the air fresh and clean of potential pathogens. Inhaling the fumes of decocting herbs can also be used directly to relieve symptoms, and loosen phlegm to relieve Cough and Wheezing.
- Perilla Zi Su Ye
- Artemisia argyi A Ye
- Calamus (Shi Chang Pu)
- Indian Spikenard (Nardostachys jatamansi)
- Mint (Bo He)
A suggested Western version made of kitchen herbs for similar use could be made:
- Thyme
- Sage
- Marjoram
- Mint
- Rosemary
TCM Food Therapy
1. To strengthen the Lung and Stomach in a weak body:
Cook Soybean, Black Soybean, Perilla Zi Su Ye, Fresh Ginger, Citrus reticulata Chen Pi, Red dates (Da Zao), Licorice
2. To strengthen the Lung and Stomach in a strong body:
Soybean, Peach kernel (Tao Ren), Fresh Ginger, Job's Tears (Yi Yi Ren), Platycodon Jie Geng, Citrus reticulata Chen Pi, Phragmites communis Lu Gen, Taraxacum (Pu Gong Ying), Licorice
Tea Replacement
These are used to replace tea as a daily drink:
1. To strengthen Weak Bodies:
Astragalus Huang Qi, Atractylodes Bai Zhu, fresh Ginger, Chinese Red Date (Da Zao)
2. To Clear Heat in Strong Bodies:
Phragmites communis Lu Gen, Lonicera Jin Yin Hua, Platycodon Jie Geng
Foot Bath
Foot baths have also been recommeded in some areas of China. A typical recipe:
Dang Gui, Astragalus Huang Qi, Pogostemon Huo Xiang, Eupatorium Pei Lan, Fresh Ginger
Decoct in 1 liter of water for 45 minutes, strain and add to a foot bath.
Exercise Therapy
A number of Qi Gong exercises and breathing exercises were also promoted by to strengthen resistance as well as to relieve mild cases, and help with recovery. These are outside the scope of the current review however.
Post-Viral Care with Traditional Medicine
It is evident that a significant proportion of COVID patients continue to have lasting effects impacting health once their initial infection has been controlled.
The Royal Australian College of General Practitioners (RACGP) has listed 6 common Post-COVID-19 symptoms:
- Fatigue
- Dyspnoea
- Joint pain
- Chest pain
- Cough
- Change in sense of smell or taste.
Breathlessness, fatigue, loss of taste or smell and neurological symptoms are some of the common after-effects which have remained for 6 or more months post cure of initial infection. There is potential for a significant post-viral syndrome to manifest following the pandemic.
Some cases of unresolved pathogen remaining in the body is due to what TCM calls 'Ban Biao, Ban Li', 'Half-Internal, Half-External'. This manifests with symptoms of both internal and external pathogen which is often marked by Chills and Fever. The pathogen has penetrated the exterior defense and is trying to invade the interior. In such cases, especially if there are signs of Heat and Phlegm/Damp along with Spleen deficiency, Xiao Chai Hu Tang (with modification) can be indicated. This strengthens the Qi (immunity) to help expel the exterior.
Fatigue
Post-viral Fatigue may be treated similarly to other Post-Viral symptoms which often manifests with Chronic Fatigue or Fibromyalgia. In general, this requires Qi tonics which will increase energy and improve immunity. Astragalus, Atractylodes, Poria and Withania are examples. However, as there is a residual pathogen, often medicines to clear Heat or Toxin are reuired as well. In addition, if low Spleen energy has been increased by Damp, or perhaps has caused an increase in Damp, medicines to resolve Phlegm and Damp may also be required.
A formula such as Xiao Chai Hu Tang can be indicated, especially if there was occasional Fever or Chills. This formula strengthens the Spleen, increases Qi while clearing Heat and Damp. In marked deficiency Bu Zhong Yi Qi Tang (with additions) can be used, and if the patient gets recurring colds, Yu Ping Feng San could be indicated. In all cases, some measure to attack any residual pathogen should be addressed. This could include adding some of the herbs listed above for the teatment of COVID, or the concurrent use of a formula such as Yin Qiao Jie Du Pian.
In more chronic cases of Post Viral infection, deficiency can become more severe, and latent Heat can be in the form of Deficient Heat. In such cases a formula such as Dan Zhi Xiao Yao San (with additions) can be useful. This supports Spleen, reguilates Qi while clearing deficienct Heat.
These are only general guidelines and proper diagnosis is required. However, modifications of the above formulas can serve as a basis for treatment.
Loss of Sense of Smell
Post-viral olfactory dysfunction (PVOD)
Dang Gui Shao Yao San and Ren Shen Yang Rong Tang both showed better effects than nasal gluococorticoids with an effective rate of 43% and 36% respectively. (15)
Dang Gui Shao Yao San
- Angelica Dang Gui 9 grams (9 grams)
- Ligusticum Chuan Xiong 9 grams (9 grams)
- Paeonia Bai Shao 48 grams (12–15 grams)
- Atractylodes Bai Zhu 12 grams (9–12 grams)
- Poria Fu Ling 12 grams (12–15 grams)
- Alisma Ze Xie 24 grams (9 grams)
Ren Shen Yang Rong Tang
- Ginseng (Ren Shen) 9 grams
- Atractylodes Bai Zhu 12–15 grams
- Poria Fu Ling 15 grams
- Honey-fried Licorice (Zhi Gan Cao) 9 grams
- Angelica Dang Gui 9–15 grams
- Paeonia Bai Shao 9–12 grams
- Rehmannia Shu Di Huang 9–12 grams
- Ligusticum Chuan Xiong 9 grams
- Astragalus Huang Qi 12–20 grams
- Cinnamon (Rou Gui) 6 grams
- Citrus Chen Pi 6 grams
- Polygala Yuan Zhi 6grams
- Schisandra Wu Wei Zi 6 grams
- Fresh Ginger (Sheng Jiang) 3 slices
- Jujube (Da Zao) 2 pieces
We can also apply acupuncture at LI20 points, and bleed the tip of the nose.
Other Neurological symptoms
About 1 in 7 patients who have had COVID develope neurological symptoms. (16) Further, there is a 'growing assortment of cases and case series describing a wide array of neurological manifestations generating nearly 2000 PubMed-indexed publications as of 29 November 2020'. (14)
Already, there is a Post-COVID-19 Neurological Syndrome (PCNS) being recogized in medical literature. Five categories of neurological symptoms have so far been described:
- Encephalopathies
- Inflammatory central nervous system (CNS) syndromes
- Ischaemic strokes
- Peripheral neurological disorders
- Miscellaneous other CNS disorders
From a Traditional Medicine viewpoint, these symptoms can be explained by unreolved pathogenic Wind-Damp which has penetrated the exterior defense and has attacked the Interior. This syndrome is sometimes seen with other acute viral infections which in some individuals initiates chronic Wind diseases such as Migraines, Vertigo or Tinnitus. The Wind can manifest with eitehr Damp or Heat.
Medicines which settle Wind can be used, but especially medicines such as Saposhnikovia Fang Feng are useful as it resolves external and internal Wind so it can clear the unresolved exterior Wind while settling the interior Wind which it has generated. It also resolves the Wind obstructing the channels which is related to the ongoing muscle and joint pain some patients experience.
We could assume medicines such as Tian Ma Gou Teng Yin to be effective in Wind-Heat syndromes while Ban Xia Bai Zhu Tian Ma Tang to be effective in cases with Wind-Phlegm/Damp. In both cases, Saposhnikovia Fang Feng or similar medicines can be added to clear the exterior. In cases with marked Brain Fog due to excess Damp, Calamus would be indicated. Any symptoms with Heat which will aggravate inflammation should be treated by adding Scutellaria Huang Qin, Coptis Huang Lian, Gardenia Zhi Zi etc.
Western formula to help the Brain and restore Memory regularly combine Calamus, Cyperus rotundus and Frankincense. These medicines regulate Qi, enhance Brain function and resolve Damp, and may be of use in such cases.
Other important neuroprotective medicines such as Ginkgo, Centella and Bacopa may have a useful role to play too.
Fibrosis
One of the more disturbing Post-COVID issues is fibrosis. Pulmonary fibrosis has been noted in a percentage of COVID patients and in some cases this has progressed rapidly. If we consider that Hepatic Fibrosis often takes years to occur in those with chronic Hepatitis, the speed at which marked shadowing is noted in chest X-rays of some COVID patients is certainly a concern, especially when for many people (particularly the aged) the fibrosis would be expected not to spontaneously regress, but is likely increase with age.
In the SARS-CoV-1 2003 outbreak, a majority of patients showed Lung fibrosis following infection suggesting the SARS-type viruses showed greater incidence of fibrosis than other forms of pneumonia. Severe cases of COVID-19 who required ventilation have shown 72% of patients have radiographic abnormalities 4 months post recovery. (17)
Important Fibrinolytic medicines include:
–Garlic, Ginger, Turmeric, Capsicum, Cayenne
–Feverfew
–Trichosanthes, Lagenaria
–Peach kernel, Bitter Almond
–Salvia Dan Shen
–Ganoderma, Fomitopsis (White Agaric), Phellinus, Poria
–Earthworm, Leech
Anti-thrombotic and Anti-platelet Aggregation herbs can also be used.
Traditional formulas of use in Fibrosis include Shao Fu Zhu Yu Tang, Xue Fu Zhu Yu Tang and Huo Luo Xiao Ling Dan of TCM, and Powder of Gum Lacca Lesser, Greater Syrup of Fumitory and Decoction of Dodder of Thyme of the Western Tradition.
Conclusion
COVID-19 has been the biggest global Health crisis in a century and has heavily impacted most countries. Despite vaccines, and, to a certain extent, treatments being sidely used it is envisaged that COVID will be with us in one form or another for a good while yet. It is probable we will be 'living with COVID' which will mean new variations, continuing outbreaks as well as various Health issues long after infection.
For this reason Traditional Medicine continues to be able to play a useful role in Health management of COVID, especially in poor and developing countries.
References
(1) www.worldometers.info/coronavirus/
(2) Cardiovascular Disease and COVID-19: Insight From Cases With Heart Failure
(3) Discovery of chebulagic acid and punicalagin as novel allosteric inhibitors of SARS-CoV-2 3CLpro
(4) SARS CoV-2: Progression and treatment protocols – An overview
(5) Indian Medicinal Plants and Formulations and Their Potential Against COVID-19–Preclinical and Clinical Research
(6) The journey with COVID-19: Initiatives by Ministry of AYUSH
(7) Scientific rationale of Indian AYUSH Ministry advisory for COVID-19 prevention, prophylaxis, and immunomodulation
(8) Immunity against COVID-19: Potential role of Ayush Kwath
(9) Lau et al. Using Herbal Medicine as a Means of Prevention Experience During the SARS Crisis, Am J Chin Med. 2005; 33
(10) Research progress of traditional Chinese medicine against COVID-19
(11) Association between use of Qingfei Paidu Tang and mortality in hospitalized patients with COVID-19: A national
retrospective registry study
(12) Effect of Lianhuaqingwen Capsules on Airway Inflammation in Patients with Acute Exacerbation of Chronic Obstructive
Pulmonary Disease
(13) Babaodan controls excessive immune responses and may represent a cytokine-targeted agent suitable for COVID-19 treatment
(14) COVID-19 and long-term neurological problems: Challenges ahead with Post-COVID-19 Neurological Syndrome
(15) The effect of traditional Chinese medicine treatment for post-viral olfactory dysfunction: A protocol for systematic review and meta-analysis.
(16) COVID-19 and Your Brain
(17) Pulmonary fibrosis 4 months after COVID-19 is associated with severity of illness and blood leucocyte telomere length
Further Reading
1. Traditional Chinese medicine for COVID-19 treatment. Ren JL, Zhang AH, Wang XJ. Pharmacol Res. 2020 May
2. TCM Treatment of COVID (MedicineTraditions)