Keywords
COVID-19 - homeopathy - prognostic factor research - likelihood ratio
Introduction
Coronavirus disease 2019 (COVID-19) cases were identified in early December 2019 in
China, and the first case in India was reported on January 30, 2020, in Kerala.[1] Since then, India has been grappling with the ever-increasing number of cases and
various approaches for the containment of infection. India has a unique health care
system, with a pluralistic approach wherein Ayurveda, Yoga and Naturopathy, Unani,
Siddha, and Homeopathy (AYUSH) systems have been integrated in the primary health
care provided through wellness clinics across the country. The public health services
are free of cost, both at primary and secondary levels of health care. Of these, homeopathic
services are available at approximately 30% of centers and cater to about one-fifth
of the annual patient turnover. These services are immensely popular, even among the
AYUSH systems, and are being optimally utilized.[2] In Delhi too, the Government offers integrated health care services at their health
centers, where Ayurveda, Unani and Homeopathy services co-exist with conventional
services under one roof. Patients can choose any one or more services at their discretion.
Presently, 107 Delhi Government wellness centers have integrated homeopathy facilities.
In a survey of these clinics, 85.2% of patients felt that the homeopathy services
are essential and a majority of conventional doctors felt that homeopathy clinics
within the same premises are beneficial.[3] Respiratory ailments are among the top 10 diseases reported in the annual morbidity
profiling of patients visiting these centers.[2] Studies have shown that homeopathic medicines have a beneficial effect in influenza-like
illnesses (ILIs)[4]
[5] but their effectiveness in COVID-19 is yet to be established.
It is suggested that homeopaths should take full advantage of this rare opportunity
and aim to demonstrate homeopathy's efficacy in COVID-19 based on the modern methods
of fundamental and clinical research.[6] The homeopathy community can analyze the available data about potential medicines
used for ILI. Medicines such as Bryonia alba, Calendula officinalis and Passiflora incarnata might prove to be inhibitors of angiotensin-converting enzyme 2, and are worth investigating
for the treatment of COVID-19.[7] Randomized controlled trials (RCTs) are considered to be the gold standard in clinical
research and assume the highest importance in evidence-based medicine. A well-designed
randomized placebo-controlled study requires prior experience and outcome documentation.
Observational studies provide such prior experience, as they describe “real-world”
care settings and allow for a more generalized and robust estimation of effects in
clinical practice; they are thus an important approach to assist in designing RCTs.[8] The need is for a series of systematic studies that includes collection and analysis
of good-quality cases treated with homeopathy. Prognostic factor research is an important
technique for the analysis of cohorts of such cases. “Prognostic factor” means a characteristic
of a patient that can be used to estimate the chance of recovery from a disease. In
homeopathy, doctors prescribe medicines based on the specific symptoms of the patients
and expect that a medicine will work based on their experience that specific symptoms
of the patient indicate specific medicines; the prevalence of such symptoms is higher
in a population responding well to a specific medicine than in the remainder of the
population.[9]
[10] Such symptoms are considered as prognostic factors and can play an important role
in accurately prescribing medicines during RCTs.
The Government of India has pooled all available resources, including the AYUSH sector,
for the management of the COVID-19 pandemic using scientific, evidence-based, solutions
and with a caution against false claims.[11] An interdisciplinary AYUSH research and development task force has been constituted
with the objective of identifying potential preventive and therapeutic approaches
within these systems.[12]
Homeopathic doctors have been posted in COVID Care Centers and COVID Testing Centers
as part of a team with conventional doctors and have been authorized to provide an
integrated care package including homeopathy for COVID-19 patients.
Objectives
The primary objective was to identify clinically useful homeopathic remedies and their
characteristic indications using the prognostic factor research model for COVID-19.
The secondary objective was to catalog the symptomatology of the disease.
Methods
Study Design and Settings
This was an open-label, multi-centric, observational study performed from April 2020
to July 2020. Patients treated were confirmed COVID-19 positive cases, defined as
those with positive results on real-time reverse-transcriptase–polymerase-chain-reaction
(RT-PCR) assay of nasal and pharyngeal swab specimens.[13] Patients who gave informed verbal consent to take homeopathic medicines were prescribed
based on their individualized symptoms.
Medicines procured from a GMP-certified firm were used. The homeopathic remedies prescribed
in all these patients were in addition to their standard conventional treatment as
advocated by the Ministry of Health and Family Welfare, Government of India. The conventional
drugs were mainly symptomatic, such as paracetamol, antibiotics, cetirizine, cough
syrups, or multi-vitamins. No patient was given corticosteroids or antivirals in this
group. Homeopathic remedies were prescribed based on individualization at the discretion
of treating doctors. Twenty-eight qualified and experienced homeopathic doctors, working
at 23 homeopathic clinics operational at conventional health centers and hospitals,
recorded cases in a specially designed format and analyzed each patient's data for
prescribing a specific remedy.
Formal approval for the study was obtained from the relevant research ethics committee
and was conveyed by letter no: F/No5(11)/93/NHMC/Academic/PG 2007 onward/1913, dated
June 2, 2020, allowing the publication of these data after removing the personal details
of the patients.
Participants
All RT-PCR-confirmed COVID-19 patients, treated at COVID Care Centers and in home
isolation, were studied. All patients with mild to moderate disease were considered.
Mild cases were patients with uncomplicated upper respiratory tract infection without
evidence of breathlessness or hypoxia (normal oxygen saturation). Moderate cases were
those with pneumonia but no signs of severe disease, SpO2 < 94% (range 90–94%) on room air, and respiratory rate more than or equal to 24 per
minute.[14] Patients with co-morbidities were also included in the study.
Variables
The variables were:
Data Source
Doctors were trained in data collection at the start of the study. A bespoke Excel
spreadsheet was shared with all doctors who then, on a daily basis, added data of
their respective cases from their centers. The spreadsheet contained 71 fields covering
a spectrum of COVID-19 symptoms. It also contained fields related to the mental and
emotional states of patients to record associated fear and/or anxiety.[15]
[16] The prescriptions were based on the individualization of symptoms. The spreadsheet
also contained fields for detailed follow-ups and outcomes after 1 week of treatment.
The identifying information of patients was kept confidential at each center by recording
their registration numbers instead of names.
Follow-up was done daily until complete resolution of symptoms or up to a week. Patients
who were in home isolation were followed up telephonically every day. In each follow-up,
the patient was asked about any change in their symptom intensity and overall well-being,
as is done in any homeopathic case follow-up in a regular setting. The Outcome in
Relation to Impact on Daily Living (ORIDL) scale, which ranges from –4 to +4, was
used for patient assessment at each follow-up.[17]
Regular online meetings with all doctors were organized to ensure the quality of data
collection. The data were regularly monitored, and any issues related to outliers,
misreported or missing data, etc. were quickly resolved. This was done to ensure consistency
in data, maintain the good quality of cases, and to reduce bias.
An important challenge in prognostic factor research is establishing causality between
medicine and improved health, as the cure may be due to the effect of the prescribed
homeopathic medicine or other factors such as spontaneous and natural recovery or
placebo effect. The following selection criteria were adopted for identifying good-quality
cases:
-
Only those cases with a reported outcome of ORIDL +3 or +4, and within 7 days of starting
homeopathic treatment, in both chief complaint and general well-being, as this is
considered as a desirable effect of the homeopathic prescription.
-
Improvement began within a few hours of starting homeopathic treatment. Twenty-four
hours from the start of treatment was considered as cut-off time.
-
Continuing improvement after repeated doses of the selected remedy.
After data collection on the spreadsheet was complete, each of the above cases was
further reviewed using certain domains of the Modified Naranjo Criteria for assessing
causal attribution of clinical outcomes.[18] Out of 10 domains, only the following four domains were considered:
-
Domain 1: Was there an improvement in the main symptom or condition for which the homeopathic
medicine was prescribed?
-
Domain 2: Did the clinical improvement occur within a plausible time-frame relative to the
drug intake?
-
Domain 5: Did overall well-being improve?
-
Domain 10: Did repeat dosing create similar clinical improvement?
Cases with inadequate information or where causality could not be established were
excluded from the analysis. Mild to moderate cases are known to improve spontaneously
in 10 to 14 days; therefore, the cut-off time for assessment was set as 7 days, to
eliminate, as far as possible, cases with spontaneous recovery.
Cases with the following attributes were excluded from the analysis ([Fig. 1])
-
Inconclusive or unconfirmed RT-PCR report.
-
Drop-out cases/lost to follow-up/incomplete cases/inadequate information.
-
Asymptomatic patients: i.e., tested positive but without any symptoms, as it was not
possible to make any assessment.
-
Two or more medicines used simultaneously. In such cases “which medicine worked” was
difficult to assess and specific causality could not be established.
-
Cases in which only one or two doses of a medicine were given, and it was not possible
to relate improvement to these doses.
Fig. 1 Flowchart of the study.
Statistical Methods
Prognostic factor analysis is based on the calculation of likelihood ratio (LR) to
improve the reliability of prescriptions for future studies. It is expressed in a
statistical formula known as Bayes' theorem: posterior odds = LR × prior odds, where
LR = (prevalence in the target population) ÷ (prevalence in the remainder of the population).
The target population is the population in which the medicine has a curative effect.[9]
The LR of a symptom indicates a change in the chance of curative action of that medicine
when that symptom is present in a patient. If LR is >1, it implies that the chance
that the medicine will be effective increases if that symptom is present.[9] The higher the LR, the more strongly the medicine is indicated for that symptom.
If the 95% confidence interval (95% CI) of LR does not contain 1 (i.e., the lower
value of the range is not less than 1), then it is considered meaningful.
Results
A total of 327 (203 male, 124 female) patients with COVID-19 were treated with adjunct
homeopathic remedies; the majority were in the age range 18 to 60 years ([Table 1]). All cases showed improvement of varying degrees and no adverse reactions were
noticed. A total of 298 cases were confirmed for COVID-19 via an RT-PCR-positive test
result. Two hundred and forty-four patients had a history of contact with confirmed
COVID-19 cases either at home or at the workplace. Two hundred and ninety-six patients
had mild disease ([Table 1]).
Table 1
Demographic data (n = 327)
|
Gender
|
Male
|
203
|
|
Female
|
124
|
|
Age group (in years)
|
<18
|
23
|
|
18–60
|
277
|
|
>60
|
27
|
|
Contact history
|
Yes
|
244
|
|
No
|
83
|
|
Co-morbidity
|
Present
|
75
|
|
Absent
|
252
|
|
Severity
|
Mild
|
296
|
|
Moderate
|
31
|
|
Homeopathic treatment
|
Single medicine given
|
258
|
|
Two or more medicines given
|
69
|
|
Status of RT-PCR after treatment
|
Negative
|
35
|
|
Not done
|
292
|
A total of 258 patients were prescribed a single homeopathic remedy, whilst in 69
cases two or more homeopathic remedies were sequentially prescribed as per need. RT-PCR
testing was done after homeopathic treatment in 35 cases after 2 to 3 weeks, and all
became negative. Testing could not be done in other cases due to revised guidelines
according to which a patient could be discharged after 10 days of symptom onset and
no fever for 3 days (in mild cases) and absence of fever without antipyretics, resolution
of breathlessness and no oxygen requirement (in moderate cases), and without the need
for testing prior to discharge.[19]
A total of 211 cases met the selection criteria for improvement of COVID-19 symptoms
and were analyzed. A total of 116 cases were excluded from the analysis, due to various
reasons such as inadequate follow-up (22 cases), being asymptomatic (seven cases),
or where causality could not be established (42 cases) ([Fig. 1]).
The most common complaints were fatigue, sore throat, dry cough, myalgia, fever, dry
mouth and throat, increased thirst, headache, decreased appetite, anxiety, and altered
taste ([Table 2]).
Table 2
Presenting complaints/symptoms (n = 211)
|
Symptom
|
Number of cases
|
Cases (%)
|
|
Fatigue
|
100
|
47.4
|
|
Sore throat
|
91
|
43.1
|
|
Dry cough
|
83
|
39.3
|
|
Myalgia
|
82
|
38.9
|
|
Fever
|
80
|
37.9
|
|
Dry mouth and throat
|
77
|
36.5
|
|
Increased thirst
|
67
|
31.8
|
|
Headache
|
65
|
30.8
|
|
Decreased appetite
|
57
|
27.0
|
|
Anxiety
|
52
|
24.6
|
|
Altered taste[a]
|
57
|
27.0
|
|
A sensation of heat in the body
|
38
|
18.0
|
|
Productive cough
|
35
|
16.6
|
|
Disturbed sleep
|
34
|
16.1
|
|
Chest discomfort
|
30
|
14.2
|
|
Loss of smell
|
28
|
13.3
|
|
Dyspnea
|
24
|
11.4
|
|
Constipation
|
22
|
10.4
|
|
Decreased thirst
|
19
|
9.0
|
|
Diarrhea
|
18
|
8.5
|
|
Nausea
|
13
|
6.2
|
|
Abdominal pain
|
10
|
4.7
|
|
Flatulence
|
8
|
3.8
|
|
Increased perspiration
|
7
|
3.3
|
|
Vomiting
|
5
|
2.4
|
a This includes data for loss of taste.
Twenty-seven medicines in varying potencies were prescribed, usually starting from
30C ([Table 3]). The medicines were repeated as per the need of an individual case, usually three
to four times daily. In some cases, they were repeated more frequently. Arsenicum album and Bryonia alba were prescribed in 61 cases each. Gelsemium sempervirens was prescribed in 19 cases and Pulsatilla nigricans in 13 cases. Some less-known medicines, e.g., Magnesia muriaticum and Wyethia, also showed good response though the number of such cases was very low ([Table 3]).
Table 3
Medicines prescribed (n = 211)
|
Medicine
|
Number of patients cured
|
|
Arsenicum album
|
61
|
|
Bryonia alba
|
61
|
|
Gelsemium sempervirens
|
19
|
|
Pulsatilla nigricans
|
13
|
|
Belladonna
|
11
|
|
Nux vomica
|
8
|
|
Magnesia muriatica
|
4
|
|
Ferrum phosphoricum
|
3
|
|
Phosphorus
|
3
|
|
Rhus toxicodendron
|
3
|
|
Sulphur
|
3
|
|
Camphora
|
2
|
|
Causticum
|
2
|
|
Chininum arsenicosum
|
2
|
|
Kali carbonicum
|
2
|
|
Mercurius solubilis
|
2
|
|
Wyethia
|
2
|
|
Antimonium tartaricum
|
1
|
|
Argentum nitricum
|
1
|
|
Calcarea carbonica
|
1
|
|
Justicia adhatoda
|
1
|
|
Kali muriaticum
|
1
|
|
Lachesis mutus
|
1
|
|
Lycopodium clavatum
|
1
|
|
Mercurius corrosivus
|
1
|
|
Sepia officinalis
|
1
|
|
Spongia tosta
|
1
|
LR was calculated for the frequently occurring symptoms of the four most frequently
prescribed remedies ([Table 4]). LR >1 indicates that there is an increased chance that a medicine will be effective
if a certain symptom is present. By calculating LR, a comparative could be drawn,
symptom-wise, between these four remedies for COVID-19 cases. A blank in [Table 4] indicates that there was no patient responding well to this medicine when the symptom
was present.
Table 4
Likelihood ratio calculations for symptoms of four medicines
|
Symptoms
|
Count
|
Arsenicum album
|
LR
Ars
|
Bryonia alba
|
LR
Bry
|
Gelsemium sempervirens
|
LR
Gels
|
Pulsatilla nigricans
|
LR
Puls
|
|
211
|
61
|
|
61
|
|
19
|
|
13
|
|
|
Dry cough
|
83
|
18
|
0.68
|
38
|
2.08
|
6
|
0.79
|
2
|
0.38
|
|
Productive cough
|
35
|
9
|
0.85
|
7
|
0.61
|
3
|
0.95
|
4
|
1.97
|
|
Sore throat
|
91
|
26
|
0.98
|
33
|
1.40
|
5
|
0.59
|
3
|
0.52
|
|
Fever
|
80
|
23
|
0.99
|
23
|
0.99
|
13
|
1.96
|
5
|
1.02
|
|
Myalgia
|
82
|
24
|
1.02
|
27
|
1.21
|
13
|
1.90
|
2
|
0.38
|
|
Headache
|
65
|
13
|
0.61
|
24
|
1.44
|
8
|
1.42
|
5
|
1.27
|
|
Fatigue
|
100
|
36
|
1.38
|
27
|
0.91
|
16
|
1.92
|
3
|
0.47
|
|
Constipation
|
22
|
2
|
0.25
|
16
|
6.56
|
|
|
1
|
0.73
|
|
Sensation of heat in the body
|
38
|
13
|
1.28
|
11
|
1.00
|
5
|
1.53
|
2
|
0.85
|
|
Abdominal pain
|
10
|
3
|
1.05
|
3
|
1.05
|
1
|
1.12
|
1
|
1.69
|
|
Dry mouth and throat
|
77
|
23
|
1.05
|
35
|
2.05
|
5
|
0.70
|
5
|
1.06
|
|
Chest discomfort
|
30
|
8
|
0.89
|
13
|
1.88
|
2
|
0.72
|
2
|
1.09
|
|
Increased perspiration
|
7
|
1
|
0.41
|
3
|
1.84
|
2
|
4.04
|
|
|
|
Anxiety
|
52
|
25
|
2.28
|
7
|
0.38
|
9
|
2.12
|
2
|
0.61
|
|
Increased thirst
|
67
|
27
|
1.66
|
29
|
1.88
|
1
|
0.15
|
1
|
0.23
|
|
Chills
|
24
|
4
|
0.49
|
|
|
12
|
10.11
|
3
|
2.18
|
|
Dyspnea
|
24
|
5
|
0.65
|
10
|
1.76
|
3
|
1.44
|
1
|
0.66
|
|
Loss of smell
|
28
|
6
|
0.67
|
7
|
0.82
|
|
|
4
|
2.54
|
|
Flatulence
|
8
|
1
|
0.35
|
3
|
1.48
|
|
|
|
|
|
Vomiting
|
5
|
3
|
3.69
|
1
|
0.61
|
|
|
|
|
|
Blocked nose
|
15
|
|
|
7
|
2.15
|
1
|
0.72
|
2
|
2.34
|
|
Nausea
|
13
|
4
|
1.09
|
4
|
1.09
|
1
|
0.84
|
2
|
2.77
|
|
Decreased appetite
|
57
|
15
|
0.88
|
17
|
1.05
|
10
|
2.15
|
5
|
1.46
|
|
Decreased thirst
|
19
|
2
|
0.29
|
3
|
0.46
|
8
|
7.35
|
3
|
2.86
|
|
Altered taste
|
57
|
10
|
0.52
|
26
|
2.06
|
4
|
0.76
|
8
|
2.49
|
|
Diarrhea
|
18
|
5
|
0.95
|
4
|
0.70
|
1
|
0.59
|
1
|
0.90
|
|
Disturbed sleep
|
34
|
14
|
1.72
|
7
|
0.64
|
4
|
1.35
|
1
|
0.46
|
|
Retrosternal burning
|
10
|
3
|
1.05
|
2
|
0.61
|
1
|
1.12
|
|
|
|
Sneezing
|
9
|
5
|
3.07
|
1
|
0.31
|
|
|
|
|
|
Running nose
|
18
|
10
|
3.07
|
3
|
0.49
|
|
|
1
|
0.90
|
Arsenicum album showed meaningful LR for the symptoms running nose (LR = 3.07; 95% CI, 1.27 to 7.42)
and anxiety (LR = 2.28; 95% CI, 1.44 to 3.59).
Bryonia alba showed meaningful LR for the symptoms dry cough (LR =2.08; 95% CI, 1.52 to 2.84),
constipation (LR= 6.56; 95% CI, 2.69 to 15.96), dryness of mouth and throat (LR = 2.05;
95% CI, 1.46 to 2.87) and increased thirst (LR = 1.88; 95% CI, 1.28 to 2.74).
For the symptom fever, Gelsemium sempervirens had LR = 1.96 and Pulsatilla nigricans had LR = 1.02, whilst Arsenicum album and Bryonia alba each had LR <1.
Gelsemium sempervirens showed meaningful LR for the symptoms fever (LR = 1.96; 95% CI, 1.37 to 2.81), chills
(LR = 10.11, 95% CI, 5.29 to 19.29), decreased thirst (LR = 7.35; 95% CI, 3.37 to
16.02), decreased appetite (LR = 2.15; 95% CI, 1.31 to 2.54), fatigue LR = 1.92; 95%
CI, 1.50 to 2.48), and myalgia (LR = 1.90; 95% CI, 1.33 to 2.73).
Pulsatilla nigricans showed meaningful LR for the symptoms altered taste (LR = 2.49; 95% CI, 1.52 to 4.07)
and loss of smell (LR = 2.54; 95% CI: 1.03 to 6.23).
Discussion
In this study, homeopathic remedies seemed helpful in COVID-19 patients in an integrated
treatment regimen, even in cases with co-morbidities such as diabetes mellitus, hypertension,
chronic kidney disease or hypothyroidism. No adverse reaction with any of the homeopathic
medicines was observed. This disease presents a spectrum of symptoms ranging from
fever and respiratory dysfunction to gastrointestinal complaints and loss of taste
or smell. COVID-19, being a new disease, lacked any literature or past experience
with the use of homeopathic remedies. Besides, in an epidemic, rare and peculiar symptoms
are difficult to find. Therefore, prognostic factor research assumes importance wherein
symptoms are regarded as factors that help in establishing the relationship between
specific symptoms (prognostic factors) and medicines.[20] This is done by calculating the LR of symptoms attributed to those homeopathic medicines
that are found useful. Even common symptoms of a disease can assume importance if
the LR of such symptoms is greater than 1 for a given remedy. Interestingly, LR also
guides the confirmation of any remedy indicated for a set of symptoms.
Cases that are “false-positive cures”, i.e., causality wrongly attributed to a remedy,
cause underestimation of LR of a specific symptom for a specific remedy.[21] Therefore, cases were selected based on selection criteria that also included the
four domains of the Modified Naranjo Criteria that are relevant for acute diseases.
Out of 327 cases reported, only 211 cases fulfilled the criteria and were analyzed.
The reliability and reproducibility of homeopathic prescriptions were assessed by
calculating the LR of symptoms, medicine-wise. LR was estimated for symptoms attributed
to the homeopathic remedies found useful. LR was considered and compared for the four
most commonly prescribed homeopathic medicines. The medicine that showed high LR (>1)
for a symptom was considered for drawing symptomatology of that medicine in COVID-19.
It also helped to differentiate between medicines with commonly occurring COVID-19
symptoms.
Comparisons were made among the four most frequently used medicines, based on LR and
associated 95% CI calculations: Arsenicum album was most indicated in COVID-19 cases presenting with anxiety and running nose; Bryonia alba was indicated in COVID-19 cases primarily presenting with a dry cough, with increased
thirst, constipation, and dryness of the mouth; Gelsemium sempervirens will act better for symptoms of fever, chills, fatigue, decreased thirst, myalgia,
and decreased appetite; Pulsatilla nigricans was more indicated in COVID-19 cases presenting with loss of taste and loss of smell.
In a study carried out in Hong Kong on 18 mild COVID-19 cases, Bryonia alba and Gelsemium sempervirens were indicated in four and 12 cases respectively. One of the homeopathic rubrics
for Bryonia alba was “thirst for large quantities of water”, similar to the observation in this study.
For Gelsemium sempervirens, homeopathic rubrics were “weakness, chills and thirstlessness”, similar to the observation
in this study.[22]
An Italian public homeopathy clinic studied approximately 50 COVID-19 cases. In the
first phase of the study, Arsenicum album was prescribed to patients with flu symptoms and to “boost their immune system”.
In the second phase, Bryonia alba and Gelsemium sempervirens gave good results in the private practice setting.[23] An article on homeopathic clinical practice on COVID-19 cases in New York viewed
this disease as appearing in stages or as having various clinical manifestations,
each with its own main remedy. It shortlisted Gelsemium sempervirens, Senega and Antimonium arsenicosum as potentially curative remedies based on symptomatology and stages.[24]
A wide spectrum of medicines was used in the present study ([Table 3]). Successful prescriptions are based on careful individualization of symptoms, either
for an individual patient or collectively in epidemic outbreaks.[25] Homeopathy has played a positive role in controlling epidemics afflicting humankind
in the past, as in the Spanish flu pandemic of 1918.[26] These medicines have shown promising results for epidemic diseases such as cholera,
influenza, dengue, and Japanese encephalitis.[5]
[27]
[28]
[29]
[30]
[31]
[32]
[33]
[34]
In a separate observational study at a COVID-19 health center at Nehru Homoeopathic
Medical College, New Delhi, 196 patients were prescribed 28 remedies, out of which
Bryonia alba, Arsenicum album, Pulsatilla nigricans, Nux vomica, Rhus toxicodendron and Gelsemium sempervirens were most frequently indicated (article in press). Four of these medicines are common
to the present study.
The majority of COVID-19 cases (80%) present mild symptoms and recover with general
care and without developing any severe symptoms.[35] Relevant selection criteria were therefore followed to rule out bias due to such
instances. However, there is still a possibility that the database of cases with complete
recovery can be attributed to causes other than the prescribed homeopathic medicine.
Therefore, RCTs become even more important to prove the efficacy of medicines. The
results of our study and other observational studies will be used for designing RCTs
that test the effect of a group of selected homeopathic medicines.
Conclusion
Homeopathic medicines have shown encouraging results in COVID cases. The prescribing
indications of Arsenicum album, Bryonia alba, Gelsemium sempervirens and Pulsatilla nigricans have been identified using prognostic factor research. This information will be useful
for more accurate homeopathic prescribing to COVID-19 patients in future RCT research.
