Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has created a great burden on governments and the medical fraternity globally. Many clinical studies from the Indian system of Traditional Medicines [Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH)] have been carried out to find appropriate solutions. Through a living systematic review and meta-analysis, this study aims to determine the effectiveness of the Traditional System of Indian Medicine (AYUSH system) in lowering the incidence, duration, and severity of COVID-19. Methods: We will search the following databases: Pubmed; the Cochrane central register of controlled trials (CENTRAL); the Clinical Trials Registry - India (CTRI); Digital Helpline for Ayurveda Research Articles (DHARA): AYUSH research portal; and World Health Organization (WHO) COVID-19 database. Clinical improvement, WHO ordinal scale, viral clearance, incidences of COVID-19 infection, and mortality will be considered as primary outcomes. Secondary outcomes will be use of O2 therapy or mechanical ventilator, admission to high dependency unit or emergency unit, duration of hospitalization, the time to symptom resolution, and adverse events. Two authors will independently search the articles, extract the data and disagreements will be resolved by the involvement of a third reviewer. Data will be synthesized, and the risk of bias will be assessed with RevMan 5.4 tool. Certainty of evidence will be assessed through the GRADE (Gradingof Recommendations, Assessment, Development and Evaluations) tool. The review will be updated bi-monthly with two updates. Conclusion: This living systematic review will be the first to address AYUSH interventions in COVID-19, synthesizing the full spectrum of Indian Traditional System of Medicine against COVID-19. It will facilitate professionals, guideline developers, and authorities with up to date synthesis on interventions periodically to make health-care decisions on AYUSH therapies in the management of COVID-19.
Highlights
The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) has expanded over the globe, affecting most countries in the world, and led to significant morbidity and mortality
Yoga, Naturopathy, Unani, Siddha, and Homeopathy[7] are five alternative and complementary therapies prevalent in India that are widely used in COVID-19 management
At inception of the pandemic, ministry of AYUSH issued advice based on an advisory panel of AYUSH experts and primitive evidence that recommended the use of some herbs and measures to enhance immunity.[8]
Summary
The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) has expanded over the globe, affecting most countries in the world, and led to significant morbidity and mortality. At inception of the pandemic, ministry of AYUSH (regulatory body of Indian system of medicine) issued advice based on an advisory panel of AYUSH experts and primitive evidence that recommended the use of some herbs and measures to enhance immunity.[8] In this advice, traditional herbs and measures, which have already been in use for decades for various ailments like fever, cough, and respiratory distress, and as an non-specific immunity enhancer, possessing anti-viral, antibacterial and anti-microbial properties, were recommended.[9] Among recommended formulations, some have undergone scientific investigations, such as Ayush 64, Chyawanprash, Guduchi Ghanavati, Arsenica Album, Kabasur Kudineer, Nilavembu Kudineer, for their possible preventive or therapeutic impact.[10] Some trials on AYUSH interventions are already completed and published[11,12,13] or in press Findings of such studies need to be appraised and summarized carefully through syntheses of evidence to determine the strength of the evidence. Guideline developers, and authorities with up Invited Reviewers 1 version 1
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