Evaluation of efficacy and safety of adjuvant Ayurvedic therapy in patients with severe post-covid mucor-mycosis at a Government tertiary care hospital – A Case-Control study

Abstract

BackgroundIn the wake of the unprecedented Mucormycosis epidemic following the delta variant run second wave of SARS COV-2, the Government of Telangana decided to utilize Ayurveda for its adjuvant immune-boosting role. Based on clinical assessment of patients, Mucor mycosis was identified as Vataja vidradhi and treatment was planned. ObjectiveTo assess the safety and efficacy of Ayurvedic regime as an adjuvant therapy in post covid mucor mycosis patients at Gandhi Hospital, the largest Government tertiary care center in Telangana. MethodsIn this prospective case control study, 77 patients with positive or probable post covid mucor mycosis were included. The varunadi kwatha regimen could be given in very few patients precluding its meaningful analysis. 65 patients received Pancha Tikta Ghrita Guggulu [PTGG] regimen. These patients were assigned into 2 groups; Intervention [A] group n = 36, who used PTGG for a mean duration of 34.1 days and Control [B] group [drop outs] n = 29 who used PTGG for a mean duration of 2.1 days. Objective parameters like biochemical changes and parameters like disease progression, recurrence, mortality rate, subjective and objective wellbeing, readmission, repeat surgeries, and persistence of symptoms were assessed before and after treatment. Statistical analysis was done using Mann Whitney, chi square and ANOVA test. ResultsThe Intervention group mortality rate was ZERO where as it was 13.8% in control group. The statistical analysis showed significant improvement in all clinical parameters tested. ConclusionPTGG based regimen as adjuvant seemed to help across the entire spectrum of Mucormycosis. It was safe and tolerated very well with concomitant antifungal usage and in pre and post-operative patients, thus validating the host factor modification approach of Ayurveda and an integrative usage.