Evidence-Based Yoga and Naturopathy for COVID-19
The COVID-19 pandemic has taxed the health system and conventional medical resources are insufficient to manage the surge. Mild to moderate covid cases can be managed by this compilation of evidence-based yoga and naturopathy for COVID-19.
1.0 Background:
1.1 The Definition:
Coronavirus disease 2019 (COVID-19) is defined as an infectious illness caused by a novel coronavirus now called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; formerly called 2019-nCoV).
1.2 Route of Transmission:
The principal mode by which people are infected with SARS-CoV-2 is through exposure to respiratory droplets carrying infectious virus (generally within a space of 6 feet).
Additional methods include contact transmission (eg, shaking hands) and airborne transmission of droplets that linger in the air over long distances (usually greater than 6 feet).
Virus released in respiratory secretions (eg, during coughing, sneezing, talking) can infect other individuals via contact with mucous membranes.
The virus can also persist on surfaces to varying durations and degrees of infectivity, although this is not believed to be the main route of transmission.
1.3 Signs and symptoms:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
2.0 Management through Naturopathy
2.1 WHO Guidelines for Prevention of Infection:
2.1.1 Hand Hygiene
Wash your hands often with soap and water for 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
Use a hand sanitizer (at least 70% alcohol based) if soap and water not available cover all surfaces of your hands and rub them together until they feel dry.
2.1.2 Respiratory Hygiene
Use a handkerchief or a tissue to cover your face while coughing or sneezing.
Throw the used tissues immediately into a closed dustbin.
Cover your sneeze into your bent upper arm in case you are not carrying a tissue or a kerchief.
Wash hands immediately after you have covered your sneeze or cough.
2.1.3 Social Distancing
Stay at home unless absolutely necessary.
Keep a distance of at least two meters (6 ft) between yourself and another person.
2.2 Hydrotherapy
Procedure |
Duration |
Rationale |
Hot water drinking |
Throughout the day |
Increases nasal mucus velocity. Therefore helpful in displacing any fluids in the upper respiratory tract (Saketkhoo et al., 1978).
|
Warm water gargling with salt and turmeric |
5-10 min, once a day in the early morning
|
Scientific evidence supports the anti-microbial activity of curcumin. Gargling helps expel virions from the mucous membranes.
|
Facial Steam and Steam Inhalation with tulsi and tea tree essential oils |
5-10 min, twice a day |
Heat inactivates the SARS-CoV-2. At about 60oC it becomes weak, and at 70oC, the virus gets killed. The essential oils also have anti-viral properties. Steam inhalation increases muco-ciliary clearance and nasal patency, and provide symptomatic relief (Cohen, 2020).
|
Warm water bath before bed |
5 min, once daily before bed. |
Produces a sedative effect and helps overcome corona virus anxiety.
|
Hot foot and arm bath |
20 min, once daily before bed. |
Helps relieve lung congestion by improving circulation to the lower limbs. Results in faster sleep onset and less body movements during sleep.
|
Neutral chest pack |
20 min, once every alternate day |
Increases chest wall mobility thereby facilitating an increase in volume of breathed air (Bito et al., 2020).
|
Enema |
SOS |
Helps detoxify the bowel. It can be taken in case of GI symptoms. |
2.3 Mud Therapy
Procedure |
Duration |
Rationale |
Mud eye pack |
15 min |
Reduces perseverative thinking, improves positive affect thereby producing a feeling of wellness. Helps reduce corona virus related anxiety. |
Hot mud application to the chest |
45 min |
Heat application is found to be helpful in managing COVID symptoms (Cohen, 2020). Mud is also anti-inflammatory in nature thereby will help reduce risk of cytokine storm development. |
2.4 Heliotherapy
Procedure |
Duration |
Rationale
|
Sun exposure for 15-20 minutes before 10:00 AM and after 5:00 PM |
Once, daily |
Evidence shows the beneficial effect of Vitamin D in improving immunity and reducing COVID related morbidity (Grant et al., 2020). |
2.5 Acupressure
Patients can be taught to apply self-pressure to these acupressure points in order to improve immunity and pulmonary functions (Zhang et al., 2020).
Points |
Location |
Rationale |
Hegu, LI 4 |
Between the base of the thumb and index finger, highest point on the bulge of muscle | Powerful analgesic point |
Yintang, Ex 1 |
Between the inner eyebrows | Anti-anxiety point |
Quchi, LI 11 |
Outer end of the elbow crease | Homeostatic point |
Neiguan, P 6 |
2 cun below transverse wrist crease between the tendons, palmaris longus & flexor carpi radialis | Influential point for chest disorders |
Sanyinjiao, Sp 6 |
On the medial aspect of the lower leg, 3 cun above the medial malleolus, on the posterior border of the medial aspect of the tibia. | It is the intersection of three yin channels, which has a calming effect. It improves sleep quality |
Danzhong, CV 17 |
The centre of the sternum between the nipples. | Point that is related to lung viscera |
Zusanli, St 36 |
The lateral side of the leg below the knee (patella), 3 cun below St 35. | Immunity improving point. |
2.6 Aromatherapy
Essential oils |
Administration |
Rationale
|
lavender, ylang ylang, and bergamot |
Inhalation |
Reduced blood pressure, subjective stress, state anxiety and serum cortisol in a study |
Tulsi essential oil |
Inhalation |
Anti-viral property |
Peppermint essential oil |
Inhalation |
Acts as a vasoconstrictor thereby causing bronchodilation. |
Tea tree essential oil |
Inhalation |
Anti-microbial action |
Eucalyptus essential oil |
Inhalation |
Anti-microbial action |
Thyme essential oil |
Inhalation |
Anti-microbial action against URT pathogens (Ács et al., 2018). |
2.7 Massage
Procedure |
Duration |
Rationale |
Self-massage to the chest with warm oil, before bath. Essential oils can be mixed with mustard oil for massage. |
10-15 minutes, once daily |
Warm oil massage increases cutaneous circulation. Ayurveda advocates use of mustard oil in chest disorders. |
3.0 Nutrition
3.1 Functional Foods
Food |
Dosage/day to meet RDA |
Rationale |
Amla, Indian gooseberry |
150 ml as juice every morning on empty stomach |
Rich source of Vitamin C. |
Zinc rich food
|
4-5 pieces soaked in water for 3-4 hours |
Zinc is essential to preserve natural tissue barriers such as the respiratory epithelium, preventing pathogen entry (Wessels et al., 2020). |
Omega 3 fatty acids
|
1-2 tsp as powder mixed with one glass of warm water. |
Anti-inflammatory: Improves the endothelial cell functions.
|
Vegetables: Brinjal, Bitter gourd, Drumstick, Pointed gourd, Amaranth, Giloy |
To be used regularly in cooking |
Ayurvedic texts advocate the consumption of these vegetables. |
Foods that improve the expression of nitric oxide: Beetroot, Garlic, Meat, Dark Chocolate, Leafy Greens, Citrus Fruits, Pomegranate, Nuts and Seeds, Watermelon |
To be used regularly in cooking |
Nitric oxide has anti-viral properties. |
Alkaline foods: ◉ Bananas, Lime ◉ Yellow lemon ◉ Avocado ◉ Garlic ◉ Mango ◉ Mandarin ◉ Pineapple ◉ Oranges - 9.2 pH |
pH 9.9 8.2 15.6 13.2 8.7 8.5 12.7 9.2 |
The pH of coronavirus ranges from 5.5 to 8.5. So, consuming alkaline foods neutralizes the blood pH. |
Calcium rich food: Boiled chickpeas, black til, raw almonds, moringa powder, orange, dried figs, methi greens, boiled soyabeans, amaranth seed powder |
To be used regularly in cooking |
Improves absorption of Vitamin D |
3.2 Phytonutrients
Food |
Dosage/day |
Rationale |
Polyphenols
|
Plenty of fresh fruits and juices must be taken every day.
|
Anti-inflammatory Anti-oxidant
|
Terpenes
|
1 tsp of lemon+orange peel powder mixed with half a glass of warm water. |
Acts as a natural anti-histamine. Anti-allergic in nature. |
3.3 Healing Herbs
Herb
|
Dosage |
Rationale |
Ginger, pepper, turmeric, long pepper, tulsi, adhimadhuram/liquorice root. |
Mix all the ingredients and boil with 500ml of water, until the water reduces to half. Add a spoon of honey and few drops of lemon juice to the kashayam. 250 ml taken as kashayam, once or twice a day. |
The Ministry of Ayush advocates the use of this “Ayush kwatha”. These herbs have been shown to be helpful in managing “kapha” disorders. |
Moringa leaf powder |
1 tsp with warm water |
Immunity enhancer |
Giloy |
150 mL as juice |
Anti-pyretic property |
3.4 Natural Supplements
Supplement
|
Dosage |
Mechanism of action |
Immune Aid |
1 – 0 – 1 |
Improves immunity |
VSL #3 |
1 – 0 – 0 |
Probiotic supplement |
Inulin |
1 tsp in 150ml warm water |
Prebiotic |
Omega-3 |
1 – 0 – 1 |
Balances LDL:HDL cholesterol ratio and is anti-inflammatory |
Ashwagandha |
1 – 0 – 1 |
Helps manage lethargy and malaise |
L-arginine |
1 – 0 – 0 |
Pre-cursor of nitric oxide (NO) |
Sleep Aid |
0 – 0 – 1 |
Melatonin supplementation helps improve anti-viral efficiency of interferons (Dinicolantonio et al., 2021). |
3.5 Gut health
Food |
Rationale |
Probiotics |
Increase the bioavailability of polyphenols Improve gut microflora diversity |
Prebiotics |
Provide a substrate for the flourishing of intestinal microflora |
4.0 Yoga
(1) Yoga lowers the stress hormones and helps to manage the stress and tension
(2) It helps to improve the immune response
(3) It stimulates the lymphatic system and thereby facilitate to carry away the toxins from the body
(4) It improves the lung functions
(5) It calms the mind and helps in better sleep quality.
4.1 Yoga Special Technique
Practice
|
Time |
Prayer and affirmation |
2 min |
Hands in and out breathing |
2 min |
Hand stretch breathing with A,U,M |
4 min |
Kati chakrasana |
2 min |
QRT in matsya kridasana on right side |
3 min |
Bhujangasana breathing |
2 min |
QRT in matsya kridasana on left side |
3 min |
Vibhagiya pranayama |
3 min |
Kapalabhati |
1 min |
Bhastrika |
2 min |
Nadi shuddhi |
2 min |
Ujjayi |
2 min |
Brahmari |
2 min |
Nada anusandhana in prone posture |
8 min |
Affirmation and concluding Prayer |
2 min |
4.2 The Art of Breathing
Practice 5 rounds of brahmari pranayama once every 2 hours.
Evidence shows the beneficial anti-viral effects of nitric oxide (NO) which inhibits the replication of SARS-CoV-2 (corona virus).
The practice of bhrahmari pranayama increases the NO Expression dramatically (M. Taneja, 2016).
It takes 5 minutes for the exchange of gases in nasal sinusus during bhrahmari, whereas it takes 30 minutes for the same amount of gaseous exchange during quiet breathing.
NO is also anti-inflammatory and improves oxygen uptake by the lungs (M. K. Taneja, 2020).
4.3 Kriyas
Procedure |
Dosage |
Rationale
|
Jala Neti |
Once every day in the morning |
Salt exercises an anti-viral effect by inhibiting replication of viral DNA and RNA. This action is mediated by formation of hypochlorous acid. Saline nasal irrigation helps cleanse the nose and paranasal sinusus and drains inflammatory exudates (Panta et al., 2021). |
Vamana Dhauti |
Once in 3 days, early morning on empty stomach |
Enhances the endurance of the respiratory muscles, decreases airway resistance and therefore improves pulmonary functions (Balakrishnan et al., 2018). |
4.4 Special Techniques
Cyclic meditation
MSRT
These techniques are helpful in reducing anxiety associated with the corona virus.
5.0 Lifestyle Changes
• Rest and sleep for at least 7-8 hours.
• Drink 1 and a half liters of water per day.
• All food should be hot (not cold).
6.0 References
Ács, K., Balázs, V. L., Kocsis, B., Bencsik, T., Böszörményi, A., & Horváth, G. (2018). Antibacterial activity evaluation of selected essential oils in liquid and vapor phase on respiratory tract pathogens. BMC Complementary and Alternative Medicine, 18(1), 1–9. https://doi.org/10.1186/s12906-018-2291-9
Balakrishnan, R., Nanjundaiah, R. M., & Manjunath, N. K. (2018). Voluntarily induced vomiting – A yoga technique to enhance pulmonary functions in healthy humans. Journal of Ayurveda and Integrative Medicine, 9(3), 213–216. https://doi.org/10.1016/j.jaim.2017.07.001
Bito, T., Suzuki, Y., Kajiwara, Y., Zeidan, H., Harada, K., Shimoura, K., Tatsumi, M., Nakai, K., Nishida, Y., Yoshimi, S., Kawabe, R., Yokota, J., Yamashiro, C., Tsuboyama, T., & Aoyama, T. (2020). Effects of deep thermotherapy on chest wall mobility of healthy elderly women. Electromagnetic Biology and Medicine, 39(2), 123–128. https://doi.org/10.1080/15368378.2020.1737803
Cohen, M. (2020). Turning up the heat on COVID-19: Heat as a therapeutic intervention. F1000Research, 9. https://doi.org/10.12688/f1000research.23299.2
Dinicolantonio, J. J., McCarty, M., & Barroso-Aranda, J. (2021). Melatonin may decrease risk for and aid treatment of COVID-19 and other RNA viral infections. In Open Heart(Vol. 8, Issue 1). BMJ Publishing Group. https://doi.org/10.1136/openhrt-2020-001568
Grant, W. B., Lahore, H., McDonnell, S. L., Baggerly, C. A., French, C. B., Aliano, J. L., & Bhattoa, H. P. (2020). Evidence that vitamin d supplementation could reduce risk of influenza and covid-19 infections and deaths. In Nutrients(Vol. 12, Issue 4). MDPI AG. https://doi.org/10.3390/nu12040988
Panta, P., Chatti, K., & Andhavarapu, A. (2021). Do saline water gargling and nasal irrigation confer protection against COVID-19? Explore, 17(2), 127–129. https://doi.org/10.1016/j.explore.2020.09.010
Saketkhoo, K., Januszkiewicz, A., & Sackner, M. A. (1978). Effects of drinking hot water, cold water, and chicken soup on nasal mucus velocity and nasal airflow resistance. CHEST Journal, 74(4). https://doi.org/10.1378/chest.74.4.408
Taneja, M. (2016). Nitric oxide Bhramari Pranayam and deafness. Indian Journal of Otology, 22(1), 1. https://doi.org/10.4103/0971-7749.176507
Taneja, M. K. (2020). Modified Bhramari Pranayama in Covid 19 Infection. Indian Journal of Otolaryngology and Head and Neck Surgery, 72(3), 395–397. https://doi.org/10.1007/s12070-020-01883-0
Wessels, I., Rolles, B., & Rink, L. (2020). The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis. Frontiers in Immunology, 11. https://doi.org/10.3389/fimmu.2020.01712
Zhang, S., Zhu, Q., Zhan, C., Cheng, W., Mingfang, X., Fang, M., & Fang, L. (2020). Acupressure therapy and Liu Zi Jue Qigong for pulmonary function and quality of life in patients with severe novel coronavirus pneumonia (COVID-19): A study protocol for a randomized controlled trial. Trials, 21(1), 751. https://doi.org/10.1186/s13063-020-04693-5