The COVID-19 pandemic is a world challenge as the cases are increasing every day. The disease has overwhelmed the healthcare system across the world. This scenario calls for fresh approaches for public health and disease management. Traditional Indian medicine has a lot to offer in the management of COVID-19 and prophylaxis and protection of vulnerable organs involved in viral entry. The approach of Ayurveda on strengthening host defense through boosting the immunity may be useful as effective, safer, accessible and affordable prophylaxis of COVID-19.

Introduction

COVID-19 (coronavirus disease 2019) is an infectious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), previously known as the 2019 novel corona virus (2019-nCoV), a strain of corona virus. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.

Enhancing the body’s natural defense system (immunity) plays an important role in maintaining optimum health. We all know that prevention is better than cure. It will be good to take preventive measures which boost the immunity in these times through Ayurveda. Ayurveda interventions become even more relevant by the fact that there is an elaborate description of causation and management of epidemics (Janapadodhwamsa). Coronavirus encroaches the immune system. Boosting the immune system will cause repulsion of viruses. It primarily affects the respiratory system.

Ayurveda offers the solution to improve the strength of the respiratory system. Most of the damage in COVID- 19 disease is caused by the derangement of the immune system. Millions of cells affected by viruses tend to burst, ultimately causing extensive damage to the lung tissue,acute liver injury,acute cardiac injury,several organ failure, This leads to shortness of breath, dry cough, and other complications and may lead to mortality in some cases.

Clinical presentation

COVID-19 typically presents with systemic and/or respiratory manifestations. The disease progression is gradual, and requires about 9-10 days to progress from symptoms of Upper Respiratory Tract Infection (URTI) to Acute Respiratory Distress Syndrome (ARDS). Few Common symptoms are fever (85-90%), cough (65-70%), fatigue (35-40%), sputum production (30-35%), shortness of breath (15-20%) and some less common symptoms are myalgia / arthralgia (10-15%), headaches (10-36%) , sore throat (10-15%), chills (10-12%) and pleuritic pain.

Fever associated with covid-19 is known to be Kaphapradhan (Kapha dominant).Vitiated Kapha along with Ama (toxins) blocks various Naadi’s (channels) in the body which then vitiate Vata and Pitta too.This results in the spread of agni (fire) throughout the body, pushing heat towards the skin and raise body temperature. Respiratory illness accompanied by dehydration, shortness of breath and blockage is because of more vitiated vata and the obstruction of kapha blocks the pranvahasrotas (respiratory passage) which leads to swaskricchta and vitiated kapha accumulates in the lungs which leads to other associated symptoms. Ayurvedic treatment aims at reduction of kaphadoshas and removal of Ama from the body to promote healing and alleviate symptoms.

Risk factors for severe illness or poor outcome

General

Old age, People in a long-term care facility ,Male gender, Children

Comorbidities

Cardiovascular disease, such as Diabetes Mellitus, Hypertension, Chronic respiratory diseases eg COPD, Cancer, Immunosuppression etc

Ayurveda's approach against Covid-19

Ayurveda brings back the energies (doshas) to balance. The therapy includes yoga practice, proper diet regimen, and detoxification procedures. Ayurveda does not see viruses and bacteria as a primary cause of disease. In this case every person would be equally susceptible to the illnesses with which they are exposed. A strong immune system is a prerequisite for protection against diseases. Through strengthening the digestive system and clearing the body of toxins optimum immunity may be achieved. Ayurveda offers many remedies which may help in creating an environment within the human body against corona viruses.

Promoting Ojas (Vyadhikshamatva)

In the present era Immunology is one of the fastest growing disciplines in Medicine and Biology. Its significance has grown more because of the growing requirement of immune strength and resistance against different diseases.Vyadhikshamatwameans the factor which limits the pathogenesis and opposes the strength of disease. Ayurveda describes the bio-factor ojas which is the quintessence of all the seven dhātus of the body and is responsible for the immune strength of an individual classically known as Ojabala and Vyādhikshamatva which refers to natural and acquired immunity. Immunity is a biological term that describes a state of having sufficient biological defences to avoid infection, disease or other unwanted biological invasion.

In view of the immune status of an individual being an important factor for conservation of health and prevention of disease. Ayurveda deliberates extensively on positive health measures such as life-style management, healthy dietetics and rejuvenation therapy with the help of a range of micro-medicinal nutrients called Rasāyana. A rasāyana remedy promotes nutritional status of an individual through qualitative changes in bodily cells and tissue leading in turn to improved bodily function, promotion of health and prevention of disease as well as longevity. These rasāyanas are considered the therapeutic means of obtaining the best quality of dhātus through micro-nutrition dynamics.

All such situations promote nutritional status of an individual with improved quality of cells and tissues in the body, longevity, immunity and superior health both physical and mental. In this entire process ojas is the basic matrix and all rasāyanas are supposed to be oja-vardhakaremedies.

Rasāyana remedies of Ayurveda especially for their immuno-enhancing, neuro-nutrient, anti-aging and anti-stress effect showing encouraging results nowadays. Ayurvedic immunology is not merely limited to antigen antibody phenomenon in infective diseases and immune-degeneration; rather it is involved in maintenance of positive health in general including homoeostasis, resistance against disease, longevity and stress tolerance with an inherent bond with the nutritional status of an individual

Lifestyle tips for boosting Immunity

This is a period to go within so follow the dinacharya (daily routine). Wake up early in the morning, brush your teeth, scrape your tongue, rinse your mouth and drink hot or warm water, then do Pranayama ,it may strengthen the immune system including the Pranavaha srotas (respiratory system). Rasavaha srotas (lymphatic system) will be cleansed, and in that way it can boost the energy. This will maintain the balance of ojas (immunity, strength), tejas (digestion both subtle and gross), and prāna (vital life force). With pranayama we can clean pranavaha srotas and it will give a boost of energy so that it can keep away the virus from the human body.

Have ginger, cinnamon and cardamom tea, regular chai made with tulsi (holy basil, one or two leaves), or even mint, cinnamon and cardamom tea. These herbal teas boost energy. A warm bath each day is very necessary to warm the body, open the pores, and regulate your body's internal thermostat. Don't forget to do your daily ayurvedic massage (abhyanga) before your bath. Daily massage is very important for opening the channels, stimulating digestion, removing toxins from the body, and pacifying the doshas. It is especially soothing to Vata dosha, which is seated in the skin.

All of these factors make massage a vital therapy in strengthening immunity and preventing respiratory problems.Adequate sleep is especially important, as it counteracts the lively, moving Vata. It is also essential for anyone in any season who wants to enhance immunity and resist disease. Exercise is another important aspect of the ayurvedic routine, because it helps enhance agni and burns away toxins. It's important to choose the right exercise for your body type and for the season, though. Daily walks and yoga postures are good for balancing all the doshas. Exercise helps to boost agni and immunity when toxins are flooding in the body.

As long as we keep our Agni (digestive fire) strong, then illness will not happen. So, Ayurveda has a great way of prevention. This is how we may prevent being affected by coronavirus in unexposed asymptomatic groups. Keep the agni strong and, to do that, follow the Dinacharya. It is the first important thing that Ayurveda recommends.

Diet for boosting natural Immunity

The important thing is to eat light, warm foods, cooked with the immune-enhancing spices like Turmeric, Cumin, Coriander, Cardamom etc. Eat all six tastes, but prefer eating substances having balance of sweet, sour, and salty tastes, as these pacify Vata. Vata-pacifying foods include nourishing grains such as rice and couscous; sweet, juicy fruits such as cooked squashes, zucchini, and asparagus; and light, easily-digestible proteins such as panir (a freshly-made cheese), lassi (a yogurt drink that aids digestion) and vegetable proteins such as mung dal.

Herbs for Immunity

As per Ayurveda herbs which provide immunity can be taken as in daily diet:

Ashwagandha, Mulethi, Amla, Neem, Tulsi, Turmeric, Ginger, Garlic, Onion, Dryfruits, ect. There are phytochemicals in ashwagandha, giloy and tulsihave the potential to fight against any virus. Explore including in your diet, Ayurvedic rejuvenative herbs taken as teas or tonics such as: ashwaghanda, turmeric, triphala, amla (Indian Gooseberry), tulsi (holy basil), Amrit Kalash (an Ayurvedic formulation of rejuvenating herbs plus honey and ghee).

General Herbal and Nutrient support for Infections and Immunity

Guduchi the best for immunity, fevers and infections

Chiraita boosts immunity quickly. Contains antiviral properties

Yashtimadhu possess antiviral properties and supports respiratory health

Medicinal Mushrooms possess antiviral and immune boosting properties

Ashwagandha boosts immunity, anti-stress herb, Vitamin C: strengthens immunity

Tulsi is a potent antioxidant and wonderful for respiratory health

Amla has highest natural source of Vitamin C and helps balance pitta dosha

Amrit Kalashis an ayurvedic remedy for building immunity and ojas.

Remedies for mild Coronavirus Symptoms

Lemon Tea kills the sore throat removes the infection from the passageway

Ginger Tea eases your headaches caused by the respiratory infections

Lemon Honey Tea soothes your airway passage and softens your rough coughs

Mint Tea stops the runny nose and helps in easy breathing.

To curb the infection of the coronavirus, detoxification is important. This virus attack is contagious and if one doesn't want to be a victim of Wuhan pneumonia, it is best to remove toxins from your body.

Detoxify to prevent Infection

Dissolve 1-2 tsf of honey in 1 cup of herbal tea (Herbs like madhuyashti, basil, peppermint, vasa), Prepare salads using detoxifying foods such as beetroot, radishes, cabbage, and broccoli. Boil and mix them gently for a cooked meal. In the Indian herbs (Tulsi, Haldi, Giloy, Black pepper, Ginger, Clove, Cardamom, lemon, and Ashwagandha) which are widely used in the preparation of Ayurvedic medicines in the form of Kadha to control various respiratory disorders such as cough, cold and flu.In a study, has identified an array of phytochemicals present in these herbs which have significant docking scores and potential to inhibit different stages of SARS-CoV-2 infection as well as other

Coronavirus target proteins. Molecular docking also indicated that the phytochemicals present in these herbs possess significant anti-inflammatory properties. The study provides scientific justification in terms of binding of active ingredients present in different plants used in Kadha preparation with viral proteins and target proteins for prevention and treatment of the COVID-19. This preparation can boost an individual's immunity and inhibit the viral severity by interfering at different stages of virus multiplication in the infected person.

Ayurvedic management of Coronavirus

Life starts with breath and ends with Breathlessness. Life can be maintained by proper functioning of Pranavaha srotas which are in connection (moolsthana) with Hrudya (Heart) and Dashadhaminis. This can be managed on the lines of pratishaya, kasa, shwas& jwara. If symptoms of gastrointestinal track like loss of appetite, indigestion etc are found along with it then it should also be treated along with it.

Oja (Immunity) of the patient should be increase with the help of Rasayanas are the drugs which help in delaying ageing process, increases longevity, and Intelligence and provide disease resistant power to the individual.Best Rasayana to prevent coronavirus can be Giloy, Tulsi, Agastya rasayan, Pippali rasayana.

Ayurveda medicines described here have safety and potential efficacy, broad-spectrum applicability, ease of availability, long-term experiential knowledge on clinical use, ease of administration, and as far as possible, and affordability.

Some common preparations available in Ayurveda may be tried which may help in prevention such as Tribhuvankirti ras, Sanjeevani vati, Laxmi Vilas ras, Mahalakshmi Vilas ras, Chitrak Haritaki, Eladivati, Talisadi churna, Sitopaladi churna, Kantakari ghrita, Vasa ghrita, Shwaskaschintamani ras , hinguleshvar rasa, samshamani vati, sudarshan Ghana vati, shadanga paniya, dashmula kwatha, amritarishta, godanti bhasma, tankan bhasma, etc. which are well known and have classical references to be used in different stages of jwara or flu like conditions.

The key criteria for choosing rasa aushadhi is the urgency of initiation of therapeutic actions. Rasaaushadi are shown to have better bioavailability and absorption through sublingual and oral route accounting to the nano size of their particles.

Single herbs which can be used effectively in these types of cases can be Kantakari, Pushkarmool, Harikti, Pippali, Tulsi, Sati, Brihati, Amalaki, Elaichi.

Dhoopan karma an Ayurvedic treatment can be used to prevent the viral attack.Dhupana Karma is the use of medicated fumes (by burning of dried plant & animal parts). We can consider it as a yagya or Havan at the place where we are living.It includes fumigation for creating an aseptic environment for the healthy beings so that no infectious disease can develop, especially wards fumigation and mass areas. Acharya Kashyap has explained Arishta dhoop which destroys all diseases. We may use Cow dung (Gobar) for burning the fire and add cow ghee along with nimba patra, neem fruit, neem bark, Guggal, Sarso (mustard), Devdaru, Jatamansi to make smoke. Circulate this smoke to prevent the virus entry.

Conclusion

Today it is Coronavirus, tomorrow another one. It is not possible to stop the outbreaks of any undetermined viral attacks. It is best to build the firewall, strengthen the system and crush all the malicious viruses. Ayurveda may have enough potential and possibilities to be employed both for prevention and treatment of COVID-19. This will provide an important opportunity for learning and generating credible evidence. Implementation of proposed action is likely to provide evidence-based insights strengthening the scope of Ayurveda beyond preventive health care and care for non-communicable diseases. Prevention is better than cure. So boost the immunity to prevent the virus entry inside the body and win the fight against them.

So be with Ayurveda, Stay Healthy, Stay Happy. Have a healthy lifestyle, Don’t Panic.

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