|Year : 2021 | Volume
| Issue : 1 | Page : 18-21
Yoga and naturopathy -based lifestyle during quarantine for the prevention of COVID-19: A pilot cohort study
A Mooventhan1, K Kahlilsubramanian1, N Manavalan2
1 Department of Research, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
2 Department of Naturopathy, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
|Date of Submission||30-Oct-2020|
|Date of Decision||05-Feb-2021|
|Date of Acceptance||12-Feb-2021|
|Date of Web Publication||21-Jul-2021|
Department of Research, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu
Introduction: Coronavirus disease 2019 (COVID-19) caused by a novel coronavirus (CoV) known as severe acute respiratory syndrome CoV-2. It is transmitted through infected patients' droplet and contact. Individuals with chronic cardiorespiratory diseases are mostly affected. Yoga and naturopathy are commonly employed in the prevention and management of cardiorespiratory diseases. This is the first-ever study conducted to find the impact of yoga and naturopathy-based lifestyle (YNBLS) on frequency of conversion of positive cases during COVID-19 quarantine period.
Material and Methods: In this pilot cohort study, 43 participants those who had exposure with COVID-19-positive case (self-quarantined individuals) and adopted YNBLS after exposure were observed till the COVID-19 swab test results had come.
Results: Of 43-participants' swab-test for COVID-19, none of the participant test has turned into positive for COVID-19.
Conclusion: Results suggest that adopting YNBLS during the quarantine period might be considered as an effective strategy for the prevention of COVID-19.
Keywords: Coronavirus disease 2019, naturopathy, prevention, SARS-CoV-2, Yoga
|How to cite this article:|
Mooventhan A, Kahlilsubramanian K, Manavalan N. Yoga and naturopathy -based lifestyle during quarantine for the prevention of COVID-19: A pilot cohort study. Yoga Mimamsa 2021;53:18-21
|How to cite this URL:|
Mooventhan A, Kahlilsubramanian K, Manavalan N. Yoga and naturopathy -based lifestyle during quarantine for the prevention of COVID-19: A pilot cohort study. Yoga Mimamsa [serial online] 2021 [cited 2021 Nov 30];53:18-21. Available from: https://www.ym-kdham.in/text.asp?2021/53/1/18/322045
| Introduction|| |
Coronavirus disease 2019 (COVID-19) is the infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Bulut & Kato, 2020). CoVs are enveloped single-stranded RNA viruses that cause respiratory and gastrointestinal infections in humans and animals (Ozma et al., 2020; Adhikari et al., 2020). Severity of infection varied from asymptomatic infection to critical disease (Bulut & Kato, 2020). It is now affecting many countries globally, and thus the World Health Organization declared that the COVID-19 epidemic is a public health emergency of international concern on January 31, 2020 (Bulut & Kato, 2020). Yoga is an ancient discipline intended to bring balance and health to the physical, mental, emotional, and spiritual dimensions of the individual (Sengupta, 2012). Naturopathy is a drugless system of medicine aims to promote the inherent power within the human body and to accelerate self-healing capacity to prevent and treat diseases. It consists of various therapies including diet therapy, hydrotherapy, fasting therapy, mud therapy, and heliotherapy (Joseph, Nair, & Nanda, 2015).
Currently, there is no vaccine preventing COVID-19. Although several preventive measures (face masks, regular handwashing avoidance of contact with infected people etc.) are implemented (Adhikari et al., 2020), the people affected with COVID-19 are on the raise and are most commonly affected patients with chronic diseases including hypertension, cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease (COPD), cancer (Bulut & Kato, 2020), and the immunosuppressed individuals (Adhikari et al., 2020). Evidence suggests that yoga and naturopathy treatments have positive impact in those chronic diseases and are also effective in improving immunity in immunosuppressed individuals (Sengupta, 2012; Joseph et al., 2015; and Rao et al., 2014). Hence, we have conducted the first-ever pilot cohort (those who had exposure with COVID-19 patient) study to find the impact of yoga and naturopathy-based lifestyle (YNBLS) on the frequency of conversion of positive cases during the quarantine period.
| Materials and Methods|| |
An observational cohort study design was adopted in this study. A group of participants those who had exposure with COVID-19-positive case (a group of self-quarantined individuals) and adopted YNBLS after exposure were observed till the COVID-19 swab test results had come.
A group of 43 male participants aged between 20 and 40 years were recruited from a residential college, South India. Male participants aged 18 years and above, subjects who had recent contact with COVID-19-positive case and are in self-quarantine, subject who is willing to adopt YNBLS during quarantine were included in this study. Subjects diagnosed as COVID-19 positive case, subjects with known chronic respiratory diseases and are on regular medication for any systemic and mental illness, and subjects those who are not willing to provide consent were excluded from this study. The study was approved by the institutional ethics committee, and informed consent was obtained from all the participants.
All the subjects adopted YNBLS during their quarantine period. The details of the YNBLS are provided in [Table 1].
|Table 1: The details of the yoga and naturopathy based lifestyle provided to the study participants (n=43)|
Click here to view
After 14-day completion of their quarantine period, all the participants underwent swab test for COVID-19 in the nearby Government Hospital, Chennai, India.
| Results|| |
The observation made out of this study showed that out of 43 participants' swap test for COVID-19, none of the participant test has turned into positive for COVID-19 and thus, all were informed to be the negative cases for COVID-19. Moreover, none of the participants reported any major symptoms of the COVID-19 or any adverse effects during the quarantine period.
| Discussion|| |
The severity of COVID-19 outbreak all over the world made us to seek solutions to control the spread. Identifying the people with close contacts and suspicious exposure and advising them to undergo 14-day quarantine is one of the several public health measures being taken to control the spread of COVID-19 (Ozma et al., 2020). People those who had exposure with COVID-19 patients are more likely to become a positive case for the same infection. In this study, we had followed a group of people who were in contact with a COVID-19 patient to find the impact of YNBLS on the frequency of conversion of positive cases during the quarantine period. After completion of the quarantine period, none of the participants has turned into a positive COVID-19 case. It indicates that adopting YNBLS during quarantine might be useful for the prevention of COVID-19, and thus it could be considered as one of the important preventive measures and included along with other commonly employed preventive measures such as maintaining social distance, using face mask, and handwash to slow down the COVID-19 infection in a better way.
Stress-induced immune dysregulation reduces the immune response, delay wound healing, reactivates latent viruses, and enhances the risk for more severe infection (Arora & Bhattacharjee, 2008). Yoga has been shown to downregulate the hypothalamic–pituitary adrenal axis by reducing perceived stress and anxiety, which in turn reduces physiological arousal, ease the respiration, and improve the sense of well-being and immune functions. In addition, yoga has been shown to improve pulmonary functions (vital capacity, maximum voluntary ventilation, forced expiratory volume at 1-s, peak expiratory flow rate, breath-holding time, maximal inspiratory and expiratory pressures, dead-space ventilation), strength the inspiratory and expiratory muscles (Sengupta, 2012), increase peripheral capillary SpO2%, and reduce the dyspnea and fatigue in patients with COPD (Ranjita, Hankey, Nagendra, & Mohanty, 2016).
Bhramari pranayama has shown to reduce mucosal edema, dislodge the mucous from sinuses and ventilate it, improve nasal mucosal temperature and humidification, and prevent microbes and allergens from settling down (Abishek, Bakshi, & Bhavanani, 2019). Similarly, Jalaneti has shown to remove mucus, foreign bodies such as allergens and dust and enhance the nasal and sinuses drainage, reduce the hypersensitivity, and prevent the progression and occurrence of upper respiratory tract infections (URTI). Thus, it is recommended in conditions such as cold, cough, sinusitis, rhinitis, rhinosinusitis, and allergic rhinitis (Meera, Vandana Rani, Sreedhar, & Robin, 2020) that are commonly present in COVID-19 (Ozma et al., 2020; Adhikari et al., 2020).
The participants received vegetarian diet along with herbal drinks and fruits and vegetables, nuts, and legumes that are rich in vitamins, minerals, and phytochimicals including Vitamin A, Vitamin-C, zinc, selenium, and flavinoids. Vitamin A (anti-infective vitamin) plays a vital role in body's defenses against infection. Vitamin A deficiency is associated with viral infection and is recommended for the prevention of lung infection and COVID-19. Vitamin C is reported to support the immune functions and protects against infection caused by CoV. Zinc is important for maintenance and development of immune cells of both the innate and adaptive immune system. It helps to reduce the COVID-19 symptom such as diarrhea and lower respiratory tract infection. Moreover, zinc and pyrithione combination inhibits SARS-CoV replication. Selenium also suggested to improve immune function and reported to be useful for the prevention of COVID-19. Flavonoids (Herbacetin, Rhoifolin, & Pectolinarin) have reported to have anti-CoV activity (Zhang & Liu, 2020). Ginger is known to stimulate mucosal cells to secrete IFN-β to counteract with viral infection (Chang, Wang, Yeh, Shieh, & Chiang, 2013). Glycyrrhizin (a major component of licorice root [Glycyrrhiza glabra L.]) has been reported to induce interferon activity and augment NK cell activity and acts as a potent inhibitor of replication of the viruses and is highly sensitive to SARS-CoV (Cinatl et al., 2003).
Sunbath is known to trigger Vitamin D synthesis. Vitamin D regulates calcium absorption and homeostasis and helps in improving the immune status (Joseph et al., 2015). In calves, low Vitamin D levels cause the bovine CoV infections and thus increasing Vitamin D levels through sunbath could help for the prevention and management of COVID-19 (Zhang & Liu, 2020). Water gargling is deemed to wash out pathogens from the pharynx and oral cavity, disrupt viral propagation, and prevent URTI (Satomura et al., 2005). Steam inhalation produces hyperthermia and enhances general and local host defense mechanisms and potentiates the antiviral activity of interferon as well as its immunoregulatory effect on suppressor cells. It elevates intranasal temperature and inhibits effect on the release of mast cell mediators; it reduces the duration and severity of nasal symptoms during common cold. Thus, it could be useful to prevent the respiratory symptoms that are associated with COVID-19 (Ophir & Elad, 1987).
These literatures suggest that yoga and naturopathy treatments are effective in reducing which the symptoms of COVID-19 (Ozma et al., 2020; Adhikari et al., 2020) such as cold, cough, rhinosinusitis and dyspnea, headache, and fatigue (Sengupta, 2012; Rao et al., 2014; Ranjita et al., 2016; Abishek et al., 2019; Meera et al., 2020; Zhang, & Liu, 2020; Satomura et al., 2005; Ophir & Elad, 1987), and in the prevention and management of various viral infections including SARS-CoV (Joseph et al., 2015; Ranjita et al., 2016; Abishek et al., 2019; Meera et al., 2020; Zhang & Liu, 2020; Chang et al., 2013; Cinatl et al., 2003; Satomura et al., 2005; Ophir & Elad, 1987). It indicates that YNBLS might be considered as an effective method for the prevention and management of most of the common symptoms of COVID-19. Although several preventive measures have been taken to control the speared of COVID-19 (Adhikari et al., 2020), the people those who had contact with the COVID-19 patients are highly prone to become a positive case. Results of this study showed no such conversion (i.e., positive cases) among those who had exposure with COVID-19 patients and underwent YNBLS. Thus, the results of this study might attribute to the above mentioned effect of YNBLS adopted during the quarantine period.
This is the first-ever cohort study reporting the effect of adopting the YNBLS during COVID-19 quarantine on the frequency of conversion of positive cases from those who had exposure with COVID-19 patients. However, the limitations of this study are (1) small sample size and sample size calculation were not made, (2) study does not had a control group, (3) only male participants were followed up, (4) participants were not associated with any other comorbidities, (5) we did not take any subjective or objective assessments other than the swab test. Thus, a randomized controlled trial with a larger sample size and more subjective and objective variables are necessary to validate the results.
| Conclusion|| |
The results of this study suggests that adopting YNBLS along with general COVID-19 preventive measures during the quarantine period might be considered as an effective strategy for the prevention of COVID-19, and thus it can be provided to the people who had exposure with COVID-19-positive cases and are in quarantine.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Abishek, K., Bakshi, S. S., & Bhavanani, A. B. (2019). The Efficacy of Yogic Breathing Exercise Bhramari Pranayama in Relieving Symptoms of Chronic Rhinosinusitis. International Journal of Yoga
(2), 120-123. doi: 10.4103/ijoy.IJOY_32_18.
Adhikari, S. P., Meng, S., Wu, Y. J., Mao, Y. P., Ye, R. X., & Wang, Q. Z., … Zhou, H. (2020). Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: A scoping review. Infectious Diseases of Poverty, 9
(1), 29. doi: 10.1186/s40249-020-00646-x.
Arora, S., & Bhattacharjee, J. (2008). Modulation of immune responses in stress by Yoga. International Journal of Yoga, 1
Bulut, C., & Kato, Y. (2020). Epidemiology of COVID-19. Turkish Journal of Medical Sciences, 50
(SI-1), 563-570. doi: 10.3906/sag-2004-172.
Chang, J. S., Wang, K. C., Yeh, C. F., Shieh, D. E., & Chiang, L. C. (2013). Fresh ginger (Zingiber officinale
) has anti-viral activity against human respiratory syncytial virus in human respiratory tract cell lines. Journal of Ethnopharmacology
(1), 146-151. doi: 10.1016/j.jep.2012.10.043.
Cinatl, J., Morgenstern, B., Bauer, G., Chandra, P., Rabenau, H., & Doerr, H. W. (2003). Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet (London, England)
(9374), 2045-2046. doi: 10.1016/s0140-6736(03)13615-x.
Joseph, B., Nair, P. M., & Nanda, A. (2015). Effects of naturopathy and yoga intervention on CD4 count of the individuals receiving antiretroviral therapy-report from a human immunodeficiency virus sanatorium, Pune. International Journal of Yoga
(2), 122-127. doi: 10.4103/0973-6131.158475.
Meera, S., Vandana Rani, M., Sreedhar, C., & Robin, D. T. (2020). A review on the therapeutic effects of NetiKriya with special reference to JalaNeti. Journal of Ayurveda and Integrative Medicine, 11
(2), 185-189. doi: 10.1016/j.jaim.2018.06.006.
Ophir, D., & Elad, Y. (1987). Effects of steam inhalation on nasal patency and nasal symptoms in patients with the common cold. American Journal of Otolaryngology
(3), 149-153. doi: 10.1016/s0196-0709(87)80037-6.
Ozma, M. A., Maroufi, P., Khodadadi, E., Köse, Ş., Esposito, I., & Ganbarov, K., … Kafil, H. S. (2020). Clinical manifestation, diagnosis, prevention and control of SARS-CoV-2 (COVID-19) during the outbreak period. Le Infezioni in Medicina, 28
Ranjita, R., Hankey, A., Nagendra, H. R., & Mohanty, S. (2016). Yoga-based pulmonary rehabilitation for the management of dyspnea in coal miners with chronic obstructive pulmonary disease: A randomized controlled trial. Journal of Ayurveda and integrative medicine
(3), 158-166. doi: 10.1016/j.jaim.2015.12.001.
Rao, Y. C., Kadam, A., Jagannathan, A., Babina, N., Rao, R., & Nagendra, H. R. (2014). Efficacy of naturopathy and yoga in bronchial asthma. Indian Journal of Physiology and Pharmacology
Satomura, K., Kitamura, T., Kawamura, T., Shimbo, T., Watanabe, M., & Kamei, M., … Great Cold Investigators-I. (2005). Prevention of upper respiratory tract infections by gargling: a randomized trial. American Journal of Preventive Medicine
(4), 302-307. doi: 10.1016/j.amepre.2005.06.013.
Sengupta P. (2012). Health impacts of yoga and pranayama: A state-of-the-art review. International Journal of Preventive Medicine, 3
Zhang, L., & Liu, Y. (2020). Potential interventions for novel coronavirus in China: A systematic review. Journal of Medical Virology
(5), 479-490. doi: 10.1002/jmv.25707.