Analysis on the current quality standards of Chinese materia Medica used in COVID-19 prevention and treatment.

PURPOSE: Traditional Chinese medicine (TCM) has fully engaged and played an essential role in the prevention and treatment of Coronavirus Disease 2019 (COVID-19). This study compares relevant standards on high-frequent Chinese Materia Medicia (CMM) used in this pandemic aiming at reaching a global consensus and ensuring the use of Chinese medicines safely. METHODS: 141 representative Chinese formulas and Chinese Patent Medicines from the National Protocol and the most of Provincial Protocols for controlling COVID-19 in China have been collected to statistical analyze the composition and characteristics of CMM. Among them, the domestic and international standards of 47 varieties with the frequency usage over 10 times were selected to compare their quality requirements in the mainstream pharmacopoeias and international standards. RESULTS: The quality requirements of used CMM for fighting COVID-19 on the terms of overall quality control, marker compounds, and safety indicators showed different patterns in these mainstream pharmacopoeias and international standards. The uniformed and scientific quality standards of CMM were urgently needed to promote global acceptation and trade. CONCLUSIONS: These findings will provide evidence for building unified quality and safety standards that can adapt to the characteristics of CMM and promote international trade, and also will be stated that it is of the highest priority for ISO/TC 249 to formulate high-quality standards that consolidate international consensus to ensure quality and safety of the urgently needed CMM.

A Systematic Analysis of COVID-19 Clinical Trials Registered in the Clinical Trials Registry of India.

BACKGROUND: The Clinical Trials Registry - India (CTRI) database is a registry of various trials conducted in India and this study scrutinized the studies registered for COVID-19 from the database to detect patterns in trial design, appraising the target regions of therapies and comprehending the terrain of research endeavors. METHOD: This was a cross-sectional study that analyzed the registered trials for COVID-19 between March 2020 and September 2023. A trial search was conducted on the CTRI database to include all types of studies registered for COVID-19 with keywords like "COVID" and "coronavirus" and studies conducted on conditions other than COVID-19 were excluded. The data regarding study characteristics were noted under various sections in a preformed proforma. RESULTS: A total of 807 trials were taken for final analysis and there were about 344 prospective and 260 retrospective interventional trials, 35 prospective and 165 retrospective observational studies, and two prospective and one retrospective post-marketing surveillance study. The majority of the studies had duration under 12 months (91%). The maximum number of studies were registered from AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) and allied therapies (n = 283), with about 104 types of interventions, followed by the drug category having 119 trials registered and about 57 types of interventions. Kabasura Kudineer and yoga in the AYUSH category, molnupiravir, colchicine, and favipiravir in the drug category, and tocilizumab and convalescent plasma among biologics were some common interventions used. The majority of trials did not mention the trial phase and declared it as not applicable (54%), whereas 15% were registered as phase 2 and 13% as phase 3. About 54% of the studies were randomized and randomized parallel-group design (20%) was the most common study design. Only 6% of the trials were post-graduate thesis and the majority of the trials (n = 535) denied sharing their individual participant data. Only 0.86% and 0.61% of the trials were terminated and suspended, respectively, denoting proper design and conduct of the trials. CONCLUSION: In the CTRI database, the majority of trials were prospective interventional studies, with a predominance of AYUSH therapies and drug interventions. Common interventions included Kabasura Kudineer and yoga in AYUSH, and molnupiravir, colchicine, and favipiravir in drugs. Most studies had durations under 12 months and randomized parallel-group design was the most common study design. The intention to use and promote an indigenous system of medicine looks promising in the absence of any definite therapy. A minute number of registered suspended and terminated trials might be a positive picture of meticulously designed and executed trials even during a pandemic situation in India.

Efficacy of Arsenicum album 30C in the Prevention of COVID-19 in Individuals Residing in Containment Areas: A Prospective, Multicenter, Cluster-Randomized, Parallel-Arm, Community-Based, Open-Label Study.

OBJECTIVE: During the early part of the COVID-19 pandemic, non-pharmacologic interventions were the strategies for the prevention of severe acute respiratory syndrome coronavirus 2. The Ministry of Ayush, Govt. of India, had advised Arsenicum album 30C as a prophylactic to prevent COVID-19. This study was undertaken to evaluate the protective efficacy and safety of the Arsenicum album 30C. METHODS: We conducted a prospective, multicenter, cluster-randomized, parallel-arm, community-based, open-label study involving apparently healthy individuals residing in containment areas of 7 cities in India. Clusters are defined as the population residing in the containment areas, who are under restriction for movement. Forty-two clusters were randomly assigned at 2:1 to the Arsenicum album 30C group (30 clusters) or to the control group (12 clusters, which received no specific therapy). The medicine was given twice daily for 7 days. The primary outcome was the incidence of COVID-19, as per the case definition notified by the National Centre for Disease Control, Government of India, during 3-week follow-up period. RESULTS: The analysis included 32,186 individuals residing in 42 clusters (containment areas). A total of 22,693 individuals from 30 clusters received Arsenicum album 30C, and 9,493 individuals from 12 clusters were observed in the control group. The overall protective effect of the Arsenicum album 30C was 80.22% (95% confidence interval [CI], 71.16-86.44; 40 cases per 22,693 [6.04 per 10,000 person-weeks] in the Arsenicum album 30C group vs. 84 cases per 9,493 [29.78 per 10,000 person-weeks] in the control group). The protective effect of the Arsenicum album 30C against laboratory-confirmed COVID-19 was 68.22% (95% [CI], 49.64-80; 32 cases per 22,693 [4.83 per 10,000 person-weeks] in the Arsenicum album 30C group vs. 42 cases per 9,493 [14.93 per 10,000 person-weeks] in the control group). Adverse effects observed in both groups were mild and resolved without medication and sequelae. CONCLUSION: Homeopathic medicine Arsenicum album 30C was associated with a decrease in the incidence and provided some protection against COVID-19 as compared to nontreatment. Further randomized, double-blind, placebo-controlled trials may be conducted to validate the results of this study.In der Anfangszeit der COVID-19-Pandemie setzte man auf nicht-medikamentöse Massnahmen zur Prävention von Infektionen mit SARS-CoV-2 (Schweres-Akutes-Respiratorisches-Syndrom-Coronavirus 2). Das Ayush-Ministerium der indischen Regierung empfahl Arsenicum album 30C als Prophylaxe zur COVID-19-Prävention. Das Ziel dieser Studie war die Beurteilung der Schutzwirkung und Sicherheit von Arsenicum album 30C.An unserer prospektiven, multizentrischen, Cluster-randomisierten, unverblindeten Parallelgruppen-Bevölkerungs-Studie nahmen gesund erscheinende Bewohner von Sperrzonen in sieben indischen Städten teil. Die Cluster waren definiert als die Bewohnerpopulation je einer Sperrzone, für welche Mobilitätsbeschränkungen galten. 42 Cluster wurden per Randomisierung im Verhältnis 2:1 dem Arsenicum-album-30C-Arm (30 Cluster) oder dem Kontrollarm (12 Cluster, die keine spezifische Behandlung erhielten) zugeteilt. Das Medikament wurde sieben Tage lang zweimal täglich angewendet. Die primäre Zielgröße war die COVID-19-Inzidenz laut der vom National Centre for Disease Control der indischen Regierung bekannt gegebenen Falldefinition in einem Nachbeobachtungszeitraum von drei Wochen.Die Analyse umfasste 32.186 Personen in 42 Clustern (Sperrzonen). Insgesamt 22.693 Personen in 30 Clustern erhielten Arsenicum album 30C, und 9.493 Personen in 12 Clustern wurden als Kontrollarm beobachtet. Die Ergebnisse für Alter, Geschlecht und Komorbidität waren im Behandlungs- und Kontrollarm vergleichbar. Die Gesamt-Schutzwirkung von Arsenicum album 30C betrug 80,22 % (95-%-Konfidenzintervall [KI]: 71,16­86,44; 40 Fälle unter 22.693 [6,04 pro 10.000 Personen-Wochen] im Arsenicum-album-30C-Arm vs. 84 Fälle unter 9.493 [29,78 pro 10.000 Personen-Wochen] im Kontrollarm). Die Schutzwirkung von Arsenicum album 30C gegen laboranalytisch bestätigte COVID-19-Erkrankung betrug 68,22 % (95-%-KI: 49,64­80; 32 Fälle unter 22.693 [4,83 pro 10.000 Personen-Wochen] im Arsenicum-album-30C-Arm vs. 42 Fälle unter 9.493 [14,93 pro 10.000 Personen-Wochen] im Kontrollarm). Die beobachteten unerwünschten Wirkungen waren in beiden Gruppen von geringer Schwere und klangen ohne Medikation folgenlos ab.Das Homöopathikum Arsenicum album 30C war im Vergleich zur Nichtbehandlung mit einer Verringerung der Inzidenz assoziiert und bot gewissen Schutz vor COVID-19. Weitere randomisierte, doppelblinde, placebokontrollierte Studien könnten durchgeführt werden, um die Ergebnisse dieser Studie zu validieren.

A systematic review of trials currently investigating therapeutic modalities for post-acute COVID-19 syndrome and registered on WHO International Clinical Trials Platform.

BACKGROUND: Post-acute COVID-19 syndrome (PACS) is a well-recognized, complex, systemic disease which is associated with substantial morbidity. There is a paucity of established interventions for the treatment of patients with this syndrome. OBJECTIVES: To systematically review registered trials currently investigating therapeutic modalities for PACS. DATA SOURCES: A search was conducted up to the 16 September, 2022, using the COVID-19 section of the WHO Internal Clinical Trials Registry Platform. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Interventional clinical trials of any sample size examining any therapeutic modality targeting persistent symptoms among individuals after diagnosis with COVID-19. METHODS: Data on trial characteristics and intervention characteristics were collected and summarized. RESULTS: After screening 17 125 trials, 388 trials, from 42 countries, were eligible. In total, we had 406 interventions, of which 368 were mono-therapeutic strategies, whereas 38 were intervention combinations. Among 824 primary outcomes identified, there were >300 different outcomes. Rehabilitation was the most employed class of intervention in 169 trials. We encountered 76 trials examining the pharmacological agents of various classes, with the most common agent being colchicine. Complementary and alternative medicine encompassed 64 trials exploring traditional Chinese medicine, Ayurveda, homeopathic medications, naturopathic medications, vitamins, dietary supplements, and botanicals. Psychotherapeutic and educational interventions were also employed in 12 and 4 trials, respectively. Other interventions, including transcranial direct current stimulation, transcutaneous auricular vagus nerve stimulation, general electrical stimulation, cranial electrotherapy stimulation, various stem cell interventions, and oxygen therapy interventions, were also employed. CONCLUSION: We identified 388 registered trials, with a high degree of heterogeneity, exploring 144 unique mono-therapeutic interventions for PACS. Most studies target general alleviation of symptoms. There is a need for further high-quality and methodologically robust PACS treatment trials to be conducted with standardization of outcomes while following WHO's recommendation for uniform evaluation and treatment.

Knowledge, Concerns, and Psychological Distress Among Caregivers of Patients Seeking Emergency Medical Care for Non-COVID-19-Related Illness During the COVID-19 Pandemic: A Cross-Sectional Study.

Introduction During the active phase of the COVID-19 pandemic, the global healthcare system failed to meet the increased demand for healthcare resources, infrastructures, and facilities. The brunt of the healthcare crisis was faced not only by COVID-19 victims; a large majority of non-COVID patients were deprived of routine and emergency care. Factors that possibly affected resource utilization, healthcare-seeking behavior, service delivery patterns, and national health systems' priority during the pandemic were the knowledge and attitudinal concerns related to the COVID-19 disease and its control measures. Here, we evaluated the knowledge, concern, and psychological distress among the caregivers of the patients attending the emergency department at a tertiary healthcare center in India.​ Methodology We conducted a survey-based study using a pre-validated questionnaire on the caregivers of the patients visiting the emergency department (ED) from June to September 2020 (during the first wave of the COVID-19 pandemic). The demographic details and responses of the participants were documented in the semi-structured proforma. A pre-validated COVID-19 Peritraumatic Distress Index (CPDI) questionnaire was used to assess psychological stress. Results Out of 1014 participants interviewed, the majority were male attendants (72%), aged 18-45 (82%), and seeking medical attention for patients with chronic illnesses (76%). Acute onset emergencies like stroke, myocardial infarction, trauma, etc. were the ED presentation in only one-fifth of patients. COVID-19-related knowledge was adequate for questions related to age groups at risk for the viral infection (97% agreed that all age groups were at risk), mode of transmission (75-90% were aware of the common modes of transmission), and >65% knew the common symptoms of COVID-19 infection. However, only 38.5% knew about frequent handwashing as a protective measure. More than half of the participants considered the COVID-19 vaccine as the sole ray of hope and disregarded the effectiveness of alternative medicines such as Ayurvedic/homeopathic/allopathic medicines as preventive options. One-third were first-time visitors to the hospital, while two-thirds of all participants were afraid to visit any hospital during the COVID-19 pandemic. The majority (84%) faced difficulty in accessing the index tertiary care center due to transport, socioeconomic support, or lockdown-related restrictions. In comparison, 60% reported some form of discrimination at almost all levels of healthcare settings due to COVID-19-related priority changes. Nearly half (48%) of all enrolled caregivers reported experiencing mild-to-moderate distress (CPDI score=28-51), and 15.7% felt severe distress (CPDI score >51) while seeking treatment for the non-COVID-19 illness of their patient. Age and socioeconomic status were significantly associated with COVID-19-related psychological distress levels (p<0.001 in logistic regression), while gender, education, and residence showed no significant associations. Conclusion Most of the patient caregivers visiting the emergency department during the COVID-19 pandemic had an adequate understanding of risk factors and preventive measures. The major barriers to accessing healthcare facilities were transport, financial issues, and lockdown-related restrictions. Almost two-thirds of the caregivers revealed mild-to-moderate to severe psychological distress due to the pandemic and lockdown-related concerns.

Homeopathic Treatment for COVID-19-Related Symptoms: A Case Series.

BACKGROUND: Severe acute respiratory syndrome due to coronavirus 2 (SARS CoV-2) is a novel infectious disease, which has quickly developed into a pandemic. The spectrum of COVID-19 symptoms is broad, ranging from a mild, self-limiting respiratory tract illness to severe progressive pneumonia, multi-organ failure and possible death. Despite much effort and multiple clinical trials, there are, to date, no specific therapeutic agents to treat or cure the coronavirus infection. CASE REPORTS: The present paper presents 5 cases of patients with moderate to severe COVID-19 infections, 2 of them hospitalized in the intensive care unit, who were successfully treated with homeopathy. RESULTS: All 5 patients responded to homeopathic treatment in an unexpectedly short time span, improving both physically and mentally. CONCLUSION: The present case series emphasizes the rapidity of response among moderate to severely ill patients to homeopathic treatment, when conventional medical options have been unable to relieve or shorten the disease. The observations described should encourage use of homeopathy in treating patients with COVID-19 during the acute phase of the disease.

In search for a panacea for coronavirus disease-19: Analysis of ongoing clinical trials for the management of coronavirus disease-19 pandemic in India.

OBJECTIVE: To analyze the clinical trials that are registered on the Clinical Trial Registry of India (CTRI) portal for a year, for the treatment, prevention, and supportive therapy of coronavirus disease-19 (COVID-19). MATERIALS AND METHODS: All the trials registered on CTRI (since January 2020 till January 2021) for therapeutic, preventive, and supportive interventions for COVID-19 were searched with the keywords "Coronavirus," "COVID-19," "SARS-COV-2," and "2019-nCoV". These registered studies were analyzed as follows: Trials under different systems of Medicine-Allopathy/Homeopathy/Ayurveda/Unani/Yoga/Naturopathy. The Allopathy trials were further analyzed in detail: Intervention, design, comparator, number of subjects, duration, and approvals taken. RESULTS: A total of 1597 records were found. After excluding the overlaps, behavioral and other studies conducted to understand the diagnosis, epidemiology, a total of 419 registered studies were included for further analysis. Out of these 419 studies, 166 (39.6%) were in Ayurveda, 154 (36.7%) in Allopathy, 33 (7.8%) in Homeopathy, 30 (7%) in Unani/Siddha, 18 (4.3%) in Yoga and Naturopathy and 18 (4.3%) in Nutraceuticals. A total of 264 interventions had been registered in 419 clinical trials. Sixty-seven interventions were being studied under allopathy in 154 studies. Same product was being evaluated in differently designed protocols with different endpoints. Maximum number of trials and subjects were for Hydroxychloroquine 25 (17,998), Ivermectin 11 (2820), Convalescent Plasma 11 (3982), Remdesivir 8 (3725), Tocilizumab 6 (884), and Azithromycin 6 (582). CONCLUSIONS: In response to the COVID-19 pandemic, Indian researchers came forward from all the systems of medicine to evaluate interventions for prophylaxis or treatment of the disease. The involvement of AYUSH systems of medicine was specifically more in this regard. A wide variation and heterogeneity in doses and outcomes were observed in trial designs which might make it difficult to generalize the study results when they are made available. Urgent analyses of studies involving interventions on the treatment advisory of the Government may help the healthcare providers take more informed decisions for managing COVID-19 patients in India.

Safety and Evaluation of the Immune Response of Coronavirus Nosode (BiosimCovex) in Healthy Volunteers: A Preliminary Study Extending the Homeopathic Pathogenetic Trial.

Objectives: Regulatory clinical Phase I studies are aimed at establishing the human safety of an active pharmaceutical agent to be later marketed as a drug. Since homeopathic medicines are prepared by a potentizing method using alcohol, past a certain dilution, their toxicity/infectivity is assumed to be unlikely. We aimed to develop a bridge study between homeopathic pathogenetic trials and clinical trials. The primary purpose was to evaluate the safety of a nosode, developed from clinical samples of a COVID-19 patient. The secondary objectives were to explore whether a nosode developed for a specific clinical purpose, such as use during an epidemic, may elicit laboratory signals worthy of further exploration. Methods: An open-label study was designed to evaluate the safety and immune response of the Coronavirus nosode BiosimCovex, given orally on three consecutive days to ten healthy volunteers. Clinical examinations, laboratory safety and immune parameters were established. Interferon-gamma, Interleukin-6, and CD 4 were measured. (CTRI registration number: CTRI/2020/05/025496). Results: No serious/fatal adverse events were reported. Laboratory tests to measure safety were unchanged. Three subjects showed elevated Interleukin-6 (IL-6) on day 17 in comparison to the baseline, and ten subjects showed elevated IL-6 on day 34. A significant difference between IL-6 observations, calculated by repeated measures ANOVA, was found to be highly significant. On day 60, the IL-6 values of nine subjects were found to return to normal. Corresponding CD4 cell elevation was observed on day 60, when compared to day 34. Conclusions: HPT may potentially extend into physiological changes with regards to immune response and should encourage future studies.

Medicines for the new coronavirus in the view of Classical Systemic Homeopathy.

INTRODUCTION: According to the World Health Organization, the coronavirus disease 2019 (COVID-19) has 48.896.564 reported cases and 1.236.995 deaths worldwide on November 5, 2020. Despite great efforts, there is no treatment of COVID-19 up to nowadays. Therefore, it is essential to search for therapeutic alternatives to COVID-19, such as Integrative Medicine, especially Homeopathy, which was used with excellent results in the great epidemics. AIM: This study aims to describe the coronavirus Pandemic from the perspective of Classical Systemic Homeopathy and to identify the homeopathic medicine (medicines genius) that has its sphere of action in most of the symptoms involved in this pandemic. METHODS: Articles published in indexed journals and websites of medical institutions, books of homeopathic materia medica, scientific journals, and government publications were reviewed. RESULTS: A total of 39 references were selected and enclosed 20 articles indexed on COVID-19, 08 references of systemic conditions, 11 articles indexed of homeopathy, 06 classic homeopathy books. After the study, the homeopathic medicine Cinchona officinalis (China officinalis) was proposed, according to pathogenesis (experimental pathophysiological study in humans) described in the materia medica books consulted, for the relief of symptoms. Its sphere of action in most of the symptoms involved in this pandemic. Moreover, acute homeopathic medicines were determined to act in the relief of symptoms of the various phases of the manifestations of the disease. CONCLUSION: Data contributes to use in homeopathic interventions during the COVID-19 epidemic as a health promotion and treatment strategy that can be used as an adjunct to all sanitary and therapeutic measures recommended by health authorities.

Survey-reported medication changes among older adults during the SARS-CoV-2 (COVID-19) pandemic.

BACKGROUND: Speculation on benefits and harms of prescription, over-the-counter and complementary medications has been widespread during the SARS-CoV-2 (or COVID-19) pandemic. This community-based survey assessed self-reported changes in medications including those stopped, started, or if access had been impacted. METHODS: A survey was collected via Research Electronic Data Capture (REDCap). The survey was advertised in the community through social media, email lists, websites, and post-cards. Survey responses were collected between 5/21/2020 and 6/24/2020. Variables included demographic characteristics such as age, sex, race, marital status, education, employment, income, and community type. Questions related to medication changes included: "Have you started any medication due to COVID-19?", "Have you stopped any medication due to COVID-19?" and "Have you had issues getting your prescription medications?". Respondents aged 50 years or older were included. RESULTS: There were N = 1397 responses of which 1169 were older adults ≥50 years-old. Of these, 1141 responded to the medication changes survey questions and 28 had missing responses and were excluded from the survey sample for this analysis. Among these, 31 (2.7%) reported a medication change included 5 (0.4%) reported stopping a medication, 18 (1.6%) reported starting a medication, and 8 (0.7%) reported trouble obtaining medications. Medications started included mostly vitamins or other supplements including zinc (n = 9), vitamin C (6), and other supplements (3). Among prescription medications, antidepressants and anti-anxiety medications (4) were reported as well as aspirin (1), losartan (1), and low dose naltrexone (1). One respondent reported unidentified homeopathy. There were no significant differences between those with medication changes and those with none. CONCLUSIONS: In this community-based survey sample of over one thousand older adults, only a small percentage (2.7%; n = 31) reported any changes to medications during the pandemic. As essential workers during this crisis, pharmacists have played a critical role in providing medication information and continued access.

Alternative therapies for viral infections caused by SARS-Cov-2 / Terapias alternativas para infecções virais causadas pelo SARS-Cov-2

Abstract Introduction The relevance of the studied topic lies in the complexity of the treatment of infection caused by SARS-CoV-2. Objective To discuss the potential advantages and disadvantages of alternative treatments compared to conventional medical approaches, and to highlight the importance of collaborative communication between patients and healthcare providers in making informed decisions about alternative treatments of the SARS-CoV-2 virus. Methods The research methodology employed literature analysis methods, including bibliographic and bibliosemantic approaches. The study used theoretical, systematic, and statistical methods, including analysis, synthesis, generalization, interpretation, classification, and meta-analysis to explore alternative treatments for SARS-CoV-2 infections, their interrelationships, and statistical trends in incidence. Results The study identifies diverse alternative therapies for treating SARS-CoV-2 infections, highlighting herbal medicine, acupuncture, reflexology, biohacking, homoeopathy, and magnetotherapy. It underscores the potential benefits of herbal remedies like garlic, ginger, chamomile, and honeysuckle, as well as vitamins (C, D, B12) and minerals (zinc, selenium) in managing COVID-19 symptoms. Conclusion While of-fering holistic benefits, these therapies warrant cautious consideration due to limited scientific backing and potential interactions. Cultural understanding, patient-provider dialogue, and informed choices are key in harnessing the potential of alternative medicine along-side conventional approaches for managing COVID-19 challenges.

Resumo Introdução A relevância do tema estudado reside na comple-xidade do tratamento da infeção causada pelo SARS-CoV-2. Objetivo Discutir as potenciais vantagens e desvantagens dos tratamentos alternativos em comparação com as abordagens médicas convencionais e realçar a importância da comunicação colaborativa entre os doentes e os prestadores de cuidados de saúde na tomada de decisões informadas sobre os tratamentos alternativos do vírus SARS-CoV-2. Métodos A metodologia de investigação utilizou métodos de análise da literatura, incluindo abordagens bibliográficas e bibliosemânticas. O estudo utilizou métodos teóricos, sistemáticos e estatísticos, incluindo análise, síntese, generalização, interpretação, classificação e meta-aná-lise para explorar tratamentos alternativos para as infecções por SARS-CoV-2, suas inter-relações e tendências estatísticas da incidência. Resultados O estudo identifica diversas terapias alternativas para o tratamento das infecções por SARS-CoV-2, destacando a fitoterapia, a acupunctura, a reflexologia, o biohacking, a homeopatia e a magnetoterapia. Sublinha os potenciais benefícios dos remédios à base de plantas como o alho, o gengibre, a camomila e a madressilva, bem como das vitaminas (C, D, B12) e dos minerais (zinco, selénio) na gestão dos sintomas da COVID-19. Conclusão Embora ofereçam benefícios holísticos, estas terapias devem ser consideradas com cautela devido ao apoio científico limitado e às potenciais interações. A compreensão cultural, o diálogo paciente-prove-dor e as escolhas informadas são fundamentais para aproveitar o potencial da medicina alternativa juntamente às abordagens convencionais para gerir os desafios da COVID-19.

Homeoprofilaxis en tiempos de coronavirus / Homeopathic prophylaxis in times of coronavirus

RESUMEN Introducción: la propagación de epidemias ha sido frecuente en la historia de la humanidad. Desde diciembre de 2019, en la República Popular China, con el surgimiento del Síndrome Respiratorio Agudo por Coronavirus 2 (SARS-CoV-2) - conocido mundialmente como COVID-19, este ha ocasionado un impacto mundial sin precedentes al que se asocia un elevado número de fallecidos. Desarrollo: Salen a la luz leyendas y datos curiosos sobre el empleo de esa terapéutica la homeopatía en Cuba. En 1992, el Ministerio de Salud Pública autoriza la difusión de la Homeopatía en Cuba, por lo que se crea el grupo "Juan Artiga", ya en 1993, se abren las primeras consultas y se retomó de esta manera la Homeopatía como modalidad dentro de la MNT. En 1999 tuvo lugar en el Centro de Eventos del Hospital "Frank País", el II Congreso Cubano de Homeopatía, y en el 2003 se realizó el III Congreso. Sin embargo, lo más novedoso a nuestro modo de ver, está referido a cómo a pesar de ser esta una ciencia con orígenes antiguos, sobresale en la actualidad como medida para prevenir enfermedades respiratorias virales. Conclusiones: La Homeopatía, tratar de llevar al enfermo a ese estado de bienestar físico, social y psicológico, que es indefinible e inconsciente. La homeoprofilaxis en Cuba ha puesto en alto los principios de la Medicina Comunitaria y una vez más, demuestra la amplia visión de un sistema de salud socialista cubano.

ABSTRACT Introduction: the spread of epidemics has been frequent in the history of mankind. Since December 2019, in the People's Republic of China, with the emergence of the Coronavirus Acute Respiratory Syndrome 2 (SARS-CoV-2) - known worldwide as COVID-19, this epidemic has caused an unprecedented global impact associated with a high number of deaths. Development: legends and curious data on the use of homeopathic therapeutics in Cuba come to light. In 1992, the Ministry of Public Health authorized the diffusion of Homeopathy in Cuba, Juan Artiga group was created, and in 1993, the first Homeopathic Medical Service was opened and Homeopathy was retaken as a modality within the Natural and Traditional Medicine. In 1999, the II Cuban Congress of Homeopathy was held at Frank Pais Hospital Convention Center, and in 2003 the III Congress was held. However, the most novel in our view, is referred to how despite having this science ancient origins, nowadays it stands out as a measure to prevent viral respiratory diseases. Conclusions: homeopathy, trying to bring the patient to that state of physical, social and psychological well-being, which is indefinable and unconscious. Homeopathic prophylaxis in Cuba has set high the principles of Community Medicine and once again demonstrates the broad vision of a Cuban socialist healthcare system.

Preparation of Coronavirus nosodes sourced from a clinical sample of SARS-Cov-2 positive patient, inactivated strain, and spike glycoprotein

IntroductionNosodes, the homeopathicpreparationssourcedfrom biological materials including clinical samples, cultures of organisms, and diseased tissues have been in use against the source-specific infections as well as other diseases. The nosodes have demonstrated some efficacy in managing epidemics, such as influenza, dengue, and leptospirosis.This article presents the need and process of development ofnosodes from the SARS-CoV-2 to explore its prophylactic and therapeutic potentials against certain related viral diseases.Materials and methodsA clinical sample of SARS-Cov-2 positive patient,based on the cycle threshold (CT) value of the qRT-PCR, heat-inactivated SARS-CoV-2, and spike glycoprotein all were processed for making nosodesas per the method described in Homoeopathy Pharmacopoeia of India.Molecular tests, such as qRT-PCR and sterility tests were performed to establish the live organisms, RNA material, and the absence of contamination.ResultsThree variants of CoronavirusNosodewere developed using a clinical sample,heat-inactivatedSARS-CoV-2, and spike glycoprotein.In potencies 3c and above, no detectableSARS-CoV-2 RNA material was found by PCR.The analytical results for nosodes were reported as compliant for sterility testing as per the IP.ConclusionThree variants of Coronavirus nosodes were preparedwhich need to be evaluated further through pre-clinical and clinical studies.(AU)

Alternativas terapéuticas para el manejo de la COVID-19 / Therapeutic alternatives for the management of COVID-19

Introducción: La COVID-19 es una pandemia causada por el Coronavirus 2 del Síndrome Respiratorio Agudo Severo (SARS-CoV-2); no existe hasta el momento tratamiento específico completamente eficaz para esta enfermedad, pero el mundo está trabajando incesantemente para buscar una cura. Objetivo: Describir las alternativas terapéuticas de la COVID-19, según los mecanismos fisiopatológicos descritos hasta el momento. Material y Método: Se realizó una revisión bibliográfica a partir de un total de 31 referencias bibliográficas. Se revisaron artículos, en idioma inglés y español, en revistas nacionales e internacionales en bases de datos como Pubmed/Medline, y Elsevier. Se analizó la calidad, fiabilidad y validez de los artículos seleccionados para realizar una adecuada revisión. Desarrollo: La aparición de la COVID-19 ha causado revuelo internacional por la necesidad de encontrar tratamientos efectivos. Debido a que es una enfermedad frecuentemente autolimitada, se vuelve difícil probar si una estrategia terapéutica es eficaz o la enfermedad ha seguido su curso. Las fases del ciclo de vida viral del SARS-COV proporcionan los objetivos potenciales para la terapia con medicamentos, como son: los inhibidores de la fusión de membrana de la envoltura viral, inhibidores de la proteasa similar a la 3-quimotripsina, inhibidores de la ARN polimerasa dependiente de ARN viral, inhibidores de la entrada y endocitosis y otros medicamentos con alguna función inmunomuduladora. Conclusiones: La pandemia actual representa un desafío para la comunidad médica internacional. Aunque no hay tratamiento específico recomendado, se utilizan diversos medicamentos con cierta efectividad como la hidroxicloroquina, azitromicina, kaletra y el remdesivir con sus respectivas combinaciones(AU)

Introduction: COVID-19 is a pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), so far there is no fully effective specific treatment for this disease, but worldwide effort is incessant in the search for a cure. Objective: To describe the therapeutic alternatives for COVID-19 according to the pathophysiological mechanisms described up until now. Material and Method: A bibliographic review was made from a total of 31 bibliographic references. Articles, in English and Spanish, from national and international journals were searched over on-line databases such as Pubmed/Medline and Elsevier. The quality, reliability and validity of the selected articles were analyzed to carry out an adequate review. Development: The appearance of COVID-19 has caused an international stir due to the need to find effective treatments. Because it is a frequently self-limited disease, it becomes difficult to prove whether a therapeutic strategy is effective or the disease has run its course. The SARS-CoV viral life cycle phases provide potential targets for drug therapy, such as: viral envelope membrane fusion inhibitors, 3-chymotrypsin-like protease inhibitors, virus RNA-dependent RNA polymerase, endocytosis and entry inhibitors, and other medications with some immunomodulatory function. Conclusions: The current pandemic represents a challenge for the international medical community. Although there is no specific recommended treatment, various drugs are used with some effectiveness such as hydroxychloroquine, azithromycin, kaletra and remdesivir with their respective combinations(AU)

Similitudes y diferencias entre el síndrome respiratorio agudo severo causado por SARS-CoV y la COVID-19 / Similarities and differences among COVID-19 and the severe acute respiratory syndrome caused by SARS-CoV

Introducción: De manera epidémica, en los años 2003, 2012 y 2019, han ocurrido eventos caracterizados por tener una elevada morbilidad y mortalidad poblacional y ser originados por tres nuevos Beta-CoV denominados: SARS-CoV, MERS-CoV y SARS-CoV-2 (este último comparte una identidad de 82 por ciento en su secuencia génica con el SARS-CoV), causantes del síndrome respiratorio agudo severo, el síndrome respiratorio del Medio Oriente y la COVID -19, respectivamente. Objetivo: Examinar las principales similitudes y diferencias entre el síndrome respiratorio agudo severo causado por el SARS-CoV y la COVID-19. Métodos: Se realizó la búsqueda en las bases de datos Medline, Scielo y Google académico. Se seleccionaron artículos en inglés y en español y las palabras clave: utilizadas fueron: infecciones por coronavirus, COVID-19, SARS-CoV, SARS-CoV-2. Resultados: Una similitud importante entre ambas afecciones es que tienen igual vía de transmisión y periodo de incubación; sin embargo, la letalidad en el SRAS duplicó la de la COVID-19. Existen diferencias estructurales entre el SARS-CoV y el SARS-CoV-2 pero ambos se fijan al receptor de la enzima convertidora de angiotensina 2. Las manifestaciones clínicas y exámenes complementarios son similares, pero existen diferencias relacionadas con el inicio de los síntomas respiratorio, su frecuencia y orden de aparición. Consideraciones finales: Existen similitudes entre las enfermedades causadas por el SARS-CoV y el SARS-CoV 2; pero también existen diferencias en sus características epidemiológicas, clínicas y de laboratorio que nos podrían permitir hacer un diagnóstico diferencial y garantizar un tratamiento y seguimiento adecuado en situaciones específicas(AU)

Introduction: In the years 2003, 2012 and 2019 have happened epidemic events characterized with a high population morbidity and mortality and originated by three new Beta-CoV called: SARS-CoV, MERS-CoV and SARS-CoV-2 (this last one shares with SARS-CoV an identity of 82 percent in its gene sequence) which cause the severe acute respiratory syndrome, the Middle East respiratory syndrome and COVID-19, respectively. Objective: To assess the main similarities and differences among COVID-19 and the severe acute respiratory syndrome caused by SARS-CoV. Methods: It was carried out the search in Medline, Scielo and Google Scholar databases. The requirements used were that the articles were in English or Spanish language and the keywords were: infections by coronavirus, COVID-19, SARS-CoV, SARS-CoV-2. Results: An important similarity among both conditions is that they have the same transmission way and incubation period; however, lethality in the SARS doubled the COVID-19 one. There are structural differences among SARS-CoV and SARS-CoV-2 but both are fixed to the recipient of the angiostensina 2 converter´s enzyme. Clinical manifestations and complementary exams are similar but there are differences related to the onset of respiratory symptoms, their frequence and the order of appareance. Final considerations: There are similarities among the diseases caused by SARS-CoV and SARS-CoV-2; but also there are differences in their epidemiological, clinical and laboratory characteristics that can allow to do a differencial diagnosis and to guarantee an adequate treatment and follow-up in specific situations(AU)