COVID-19 Treatment Protocol Research Articles

Rapid and ecofriendly ultra performance liquid chromatographic analytical methodology for the simultaneous determination of four drugs included in COVID-19 treatment protocol

The global spread of COVID-19 disease has increased the demand for new therapeutic approaches. The clinical studies revealed that remdesivir and molnupiravir have been effective against COVID-19. Remdesivir (REM) is the first FDA-approved antiviral drug for COVID-19, while molnupiravir is the first oral antiviral drug for SARS-CoV-2 infections. In addition to antivirals, anticoagulants such as apixaban (APX) and antibiotics such as levofloxacin (LVF) are also included in the treatment protocols. This study suggests and validates a rapid and selective method for the determination of the four drugs involved in the COVID-19 treatment protocol. The simultaneous separation and determination of REM, MLP, LVF, and APX in human plasma were achieved using UPLC with a fluorophenyl column and a mobile phase composed of acetonitrile and water acidified with formic acid (pH = 3) in the ratio of 45: 55, v/v, at a flow rate of 0.1 mL/min. The PDA detector was adjusted at 254 nm. The method could simultaneously determine the four drugs in a single run in less than 6 min. The method exhibited linearity over the concentration ranges of 1.0–15.0 µg/mL, 0.1–5.0 µg/mL, 0.1–2.0 µg /mL, and 0.1–5.0 µg/mL, for LVF, MLP, APX and REM, respectively. The proposed method was validated following the International Council on Harmonization Q2(R1) guidelines and the findings were compared statistically to previously reported methods. The recovery rates of the drugs from spiked human plasma were satisfactory. The greenness of the suggested method was evaluated using three metrics, namely, Analytical Eco-scale, Green Analytical Procedure Index (GAPI) metric, and the Analytical GREEnness measure approach (AGREE).

Predictive value of D-Dimer and thromboplastin time as coagulation indicators for COVID-19 patients.

Coronavirus 2019 symptoms include coagulopathy and thromboembolic risk. Using one parameter to diagnose coagulopathy has little predictive value. This study will examine if D-dimer and APTT testing can predict COVID-19 severity and aid triage and manage patients. 214 COVID-19 patients were enrolled and classified into two categories based on their respiratory manifestations; mild (126 cases) and severe (88 cases). Patient data regarding age, gender, D-Dimer level, and APTT level were collected. When both D-Dimer and APTT levels were abnormal, in this study, the patient was considered to have a coagulation disorder. Indicators of coagulation in the COVID-19 patients were collected and compared between the two groups. Chi-square (χ2) tests were used to determine the significant differences between coagulation disorders in the two groups. Our findings showed that patients with coagulopathies were more likely to belong to the severe group. Within the two groups of patients, the rate of coagulation disorders was as follows: mild = 8.8 % within coagulation disorders, 4.8% within the two Groups; severe = 91.2 % within coagulation disorders, 77.8 % within the two Groups. There was a statistically significant relationship between coagulation disorder and severe COVID-19 patients compared to mild patients (p < 0.05). Coagulation disorders are more likely to occur in severe COVID-19 patients. D-Dimer and APTT tests are significant indicators for predicting COVID-19 severity. Our research found an abnormal pattern of coagulation disorders and COVID-19 severity that should be considered in the COVID-19 treatment protocol.

EFFICACY EVALUATION OF BD ORAL SPRAY ON THE SYMPTOMS AND COURSE OF COVID-19 PATIENTS IN THE CLINICAL HOSPITAL

A prospective randomized, open-label, single-blinded clinical trial was conducted to evaluate the efficacy of BD on the symptoms and course of the disease in patients with moderate and severe Covid-19 in the field hospital. 200 hospitalized patients with Covid-19 diagnosis were enrolled. The patients were randomized into 100 patients in the interventional group (BD group) and 100 in the control group. The BD group patients were treated with BD oral spray in conjunction with standard Covid-19 treatment protocol. The control group patients were treated with standard of care without BD. Patients of the BD group demonstrated a significantly faster improvement in all Covid-19 related symptoms, resulting in a shorter time for complete recovery than the control group. More remarkably, patients in the BD group showed a shorter time for complete viral clearance. The addition of BD to the standard of care protocol also resulted in significant improvement in the restoration of taste and smell and reduction of lung infiltration. The patients in the BD group also exhibited fewer adverse events related to treatment. BD is a simple-to-use, safe, and effective adjunctive treatment for moderate and severe Covid-19 cases. BD might be effective for Covid-19 symptoms.

Evaluation of the Role of Hemoperfusion on Mortality and Morbidity in Patients with Severe Coronavirus Disease 2019 (COVID- 19)

Background: Cytokine storm in severe Covid-19 disease is one of the leading causes of death in these patients. Hemoperfusion is a method used to purify the blood from toxins and inflammatory factors. The aim of this study was to evaluate the effect of hemoperfusion on mortality and morbidity in patients with severe Covid - 19 disease.&#x0D; Methods: This was a retrospective study which performed by reviewing the files of 30 patients with severe Covid-19 disease referred to Sina Hospital affiliated to Tehran University of Medical Sciences in 2020. Thirty patients with severe covid-19 disease and positive PCR participated in the study. All patients received routine treatment protocol for covid-19. Hemoperfusion was used for 15 patients in addition to receiving routine care. The remaining 15 patients were included in the control group. Patients in the hemoperfusion group underwent four sessions of hemoperfusion using continuous renal replacement therapy with continuous venovenous hemofiltration.&#x0D; Results: the ICU length of stay in the control and hemoperfusion groups was 3.40 ± 11.40 and 9.65 ± 16.33 days, respectively (P= 0.075). 8 patients died and 7 patients were discharged in the control group, but 11 patients died and 4 patients were discharged in the hemoperfusion group (P= 0.256). The respiratory rate of patients in the control and hemoperfusion groups decreased from 7.43 ± 29.40 to 4.03 ± 24.60 and from 6.11 ± 31.60 to 5.04 ± 24.46, respectively (P &lt; 0.001). The percentage of arterial blood oxygen saturation in the control and hemoperfusion groups increased from 90.86 ± 5.61 to 93.06 30 4.30 and from 92.33 26 3.26 to 92.06 31 5.31, respectively (P= 0.456).&#x0D; Conclusion: Hemoperfusion could not prevent the mortality of patients and finally out of 15 patients, 11 patients died and 4 patients were discharged. Also, no significant difference was observed between the two groups in terms of arterial blood oxygen saturation.

Effectiveness and safety of Qingfei Dayuan granules for treating influenza and upper respiratory tract infections manifested by the pulmonary heat-toxin syndrome: A multicenter, randomized, double-blind, placebo-controlled trial.

Background: Patients diagnosed with influenza and upper respiratory tract infections (URTIs) have similar clinical manifestations and biochemical indices and a low detection rate of viral pathogens, mixed infection with diverse respiratory viruses, and targeted antiviral treatment difficulty in the early stage. According to the treatment strategy of "homotherapy for heteropathy" in traditional Chinese medicine (TCM), different diseases with the same clinical symptoms can be treated with the same medicines. Qingfei Dayuan granules (QFDY), a type of Chinese herbal preparation included in the TCM Diagnosis and Treatment Protocol for COVID-19 of Hubei Province issued by the Health Commission of Hubei Province in 2021, are recommended for patients suffering from COVID-19 with symptoms of fever, cough, and fatigue, among others. Additionally, recent studies have shown that QFDY effectively alleviates fever, cough, and other clinical symptoms in patients with influenza and URTIs. Materials and methods: The study was designed as a multicenter, randomized, double-blind, placebo-controlled clinical trial for treatment for influenza and URTIs manifested by pulmonary heat-toxin syndrome (PHTS) with QFDY. A total of 220 eligible patients were enrolled from eight first-class hospitals in five cities of Hubei Province in China and randomly assigned to receive either 15g of QFDY or a placebo three times a day for 5days. The primary outcome was the complete fever relief time. Secondary outcomes included efficacy evaluation of TCM syndromes, scores of TCM syndromes, cure rate of each single symptom, incidence of comorbidities and progression to severe conditions, combined medications, and laboratory tests. Safety evaluations mainly involved adverse events (AEs) and changes in vital signs during the study. Results: Compared with the placebo group, the complete fever relief time was shorter in the QFDY group, 24h (12.0, 48.0) in the full analysis set (FAS) and 24h (12.0, 49.5) in the per-protocol set (PPS) (p ≤ 0.001). After a 3-day treatment, the clinical recovery rate (22.3% in the FAS and 21.6% in the PPS) and cure rate of cough (38.6% in the FAS and 37.9% in the PPS), a stuffy and running nose, and sneezing (60.0% in the FAS and 59.5% in the PPS) in the QFDY group were higher than those in the placebo group (p < 0.05). The number of patients taking antibiotics for more than 24h in the placebo group (nine cases) was significantly higher than that in the QFDY group (one case) (p < 0.05). There were no significant differences between the two groups in terms of scores of TCM syndromes, incidence of comorbidities or progression to severe conditions, combined use of acetaminophen tablets or phlegm-resolving medicines, and laboratory tests (p > 0.05). Meanwhile, no significant difference was found in the incidence of AEs and vital signs between the two groups (p > 0.05). Conclusion: The trial showed that QFDY was an effective and safe treatment modality for influenza and URTIs manifested by PHTS because it shortened the complete fever relief time, accelerated clinical recovery, and alleviated symptoms such as cough, a stuffy and running nose, and sneezing during the course of treatment. Clinical trial registration: https://www.chictr.org.cn/showproj.aspx?proj=131702, identifier ChiCTR2100049695.

Translation: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 10)

National Health Commission of the People's Republic of China, National Administration of Traditional Chinese Medicine This is a document released by National Health Commission of the People's Republic of China and National Administration of Traditional Chinese Medicine. The original file is available from: http://www.nhc.gov.cn/ylyjs/pqt/202301/32de5b2ff9bf4eaa88e75bdf7223a65a/files/02ec13aadff048ffae227593a6363ee8.pdf The material was translated by the Infectious Microbes & Diseases Editorial Office. Conflicts of interest: The authors reported no conflicts of interest. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Preparedness in Combating the New COVID-19 Variant, Omicron in Saudi Arabia: A Review of Existing Strategies, Findings, and Implications for the Future

The SARS-CoV-2 is mutating persistently with the newer variant, Omicron infecting many countries including Saudi Arabia. There are concerns regarding the efficacy of the existing treatment and vaccinations in this context. Although the Saudi ministry has issued selected exemptions, public awareness about the need for social distancing, masks, and personal hygiene is key to prevention. COVID-19 booster doses are freely available and easily accessible in Saudi Arabia, and the Ministry of Health (MOH) has underlined the importance of the booster dose vaccine to maintain active immune status in the Tawalkana App, the Saudi Arabian government’s frontline application for managing and combating the pandemic. Moreover, their official website has established forty distinct guidelines for tackling COVID-19. The MOH of Saudi Arabia has also implemented an effective COVID-19 treatment protocol with strict governmental surveillance enabling them to be among the first to lift COVID-19 preventive measures and serve as a role model for others. Nevertheless, considering limited research data, further studies are necessary for the in-depth evaluation of new variants, including Omicron, and their potential implications.

A Comparative Study on Translation of the TCM Terms in the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7)

A Comparative Study on Translation of the TCM Terms in the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7)

Hydroxyurea and pyridostigmine repurposed for treating Covid-19 multi-systems dysfunctions

&lt;abstract&gt; &lt;p&gt;Early in the COVID-19 pandemic, medical care providers at an acute illness hospital received increasing numbers of post-acute advanced COVID-19 patients from referring hospitals where they were showing no signs of improvement after receiving treatments from standard Emergency Use Authorization (EUA)-type protocols. The care providers turned to repurposing medications to treat these patients and added hydroxyurea, a medication commonly used for treating sickle cell anemia, to the hospital's COVID-19 treatment protocol and began to see notable clinical improvements. As the pandemic continued and new concerns arose concerning COVID-19 complications, those same care providers again turned to repurposing drugs. Focusing on the neuromuscular effects seen in COVID-19 patients, care providers turned to medications used to treat chronic neuromuscular conditions. Post-acute advanced Covid-19 patients initially received an abbreviated course of hydroxyurea followed by titrated doses of pyridostigmine. Positive responses were noted with cognition, diminished oxygen demands, progressive decrease in ventilator support, improved swallowing, and mobility. The authors suggest repurposed drugs could have great utility for treating COVID-19. It is recommended larger, COVID-19 clinical trials be completed to include hydroxyurea and pyridostigmine for validating the outcomes and clinical observations seen in these presented cases.&lt;/p&gt; &lt;/abstract&gt;

Late diagnosis of rhinocerebral mucormycosis in patients with COVID-19 (case studies)

From the beginning of the COVID-19 pandemic, the incidence of secondary infections (both bacterial and fungal) has increased due to immune suppression associated with the use of corticosteroids or broad-spectrum antibiotics as a part of COVID-19 treatment protocol, which may exacerbate a pre-existing fungal disease or cause a new infection. Ophthalmologists are often involved in taking medical and surgical decisions in these complex cases. In this regard, a strong clinical suspicion should be applied to possible secondary fungal infections in COVID-19. Their early diagnosis and treatment may reduce mortality due to COVID-19 associated rhinocerebral mucormycosis (ROCM). This article describes two clinical cases of late detection of ROCM with two different scenarios, and compare the features of these cases with the literature data.

Мукормикоз у пациентов с COVID-19

Rhinocerebral mucormycosis is characterized by a severe course and is one of the late complications in patients who have undergone COVID-19. For the successful treatment of this disease, the earliest possible diagnosis and the appointment of specific conservative therapy in combination with surgical intervention are necessary. Objective. To study the risk factors for the development of invasive mycoses, the clinical manifestations of this pathology, and the results of its treatment in patients who underwent SARS-CoV-2. Research methods. Retrospective analysis of the case histories of 25 patients with mucormycosis. Demographic, subjective, and objective data (medical history, complaints, endoscopic examination), radiological techniques (CT scans), histological, microscopic and cultural studies as well as the results of medical and surgical treatment were analyzed. Result of the study. Groups of patients with comorbid pathology, potentially predisposed to the development of this disease, as well as groups of drugs, the use of which predisposes to the risk of developing mucormycosis, were identified. Conclusion. The predisposing background to the development of mucormycosis is hyperglycemic conditions and the use of high doses of corticosteroids and broad-spectrum antibiotics as part of the COVID-19 treatment protocol. According to epidemiological data, the largest number of cases of invasive rhinocerebral mucormycosis coincided with the highly virulent SARS-CoV-2 delta strain. Early initiation of specific antifungal therapy combined with surgery results in more effective treatment.

Drug-related problems in patients admitted for SARS-CoV-2 infection during the COVID-19 pandemic.

Introduction: Drug-related problems (DRP) are events or circumstances in which drug therapy does or could interfere with desired health outcomes. In December 2019, a new coronavirus, SARS-CoV-2, appeared. Little knowledge about this type of infection resulted in the administration of various drugs with limited use in other pathologies. Evidence about DRP in patients with COVID-19 is lacking. Objective: The aim of the present study is to describe identified cases of DRP and those drugs involved in the first wave of patients with COVID-19, and evaluate associated risk factors. Material and methods: Observational, retrospective study performed in a tertiary university hospital between 14th March 2020 and 31 May 2020 (corresponding to the first COVID-19 wave). We recruited patients admitted during the study period. Exclusion criteria included age < 18years; admission to critically ill units; and care received either in the emergency room, at-home hospitalization or a healthcare center. Results: A total of 817 patients were included. The mean age was 62.5years (SD 16.4) (range 18-97), and 453 (55.4%) were male. A total of 516 DRP were detected. Among the patients, 271 (33.2%) presented at least one DRP. The mean DRP per patient with an identified case was 1.9. The prevailing DRPs among those observed were: incorrect dosage (over or underdosage) in 145 patients (28.2%); wrong drug combination in 131 (25.5%); prescriptions not in adherence to the then COVID-19 treatment protocol in 73 (14.1%); prescription errors due to the wrong use of the computerized physician order entry in 47 (9.2%); and incorrect dosage due to renal function in 36 (7%). The logistic regression analysis showed that patients who received only prescriptions of antibacterials for systemic use (J01 ATC group) faced a higher likelihood of experiencing a DRP (OR 2.408 (1.071-5.411), p = 0.033). Conclusion: We identified several factors associated with an increased risk of DRPs, similar to those reported in other pre-pandemic studies, including a prolonged length of stay, higher number of prescribed drugs and antimicrobial administration. The relevance of pharmacists and tools like pharmacy warning systems can help prevent, identify and resolve DRP efficiently.

Efficacy of Primary Prevention in the COVID-19 Pandemic

Background: The COVID-19 treatment protocol has consistently been under modification since its inception, from the omission of drugs once considered lifesavers such as hydroxychloroquine to the addition of newer medications e.g.: remdesivir. In such situations, it is crucial that we reinforce the importance of primary prevention, especially in low-income countries, where issues exist of shortage of resources such as oxygen and ventilators. We demonstrate how primary prevention holds good against the emergence of new variants, and future pandemics. Discussion: Articles predating and postdating the COVID-19 pandemic were analysed. The articles predating the pandemic included those relating to primary preventive methods used during the H1N1 pandemic of 2009, and articles postdating the pandemic included studies which demonstrate higher mortality of COVID-19 in smokers shed light on the importance of primary prevention, and demonstrate how primary prevention and good health education could have saved countless lives. Conclusion: It is essential that Primary prevention be employed, not only in the case of chronic lifestyle conditions such as hypertension and diabetes mellitus but also in the cases of pandemics, where prevention before the chain of infection starts can prove to be lifesaving. As healthcare providers, the responsibility lies with us to emphasize on the importance of primary prevention and comprehensively propagate information.

Potential common mechanism of four Chinese patent medicines recommended by diagnosis and treatment protocol for COVID-19 in medical observation period.

The global epidemic has been controlled to some extent, while sporadic outbreaks still occur in some places. It is essential to summarize the successful experience and promote the development of new drugs. This study aimed to explore the common mechanism of action of the four Chinese patent medicine (CPMs) recommended in the Medical Observation Period COVID-19 Diagnostic and Treatment Protocol and to accelerate the new drug development process. Firstly, the active ingredients and targets of the four CPMs were obtained by the Chinese medicine composition database (TCMSP, TCMID) and related literature, and the common action targets of the four TCMs were sorted out. Secondly, the targets of COVID-19 were obtained through the gene-disease database (GeneCards, NCBI). Then the Venn diagram was used to intersect the common drug targets with the disease targets. And GO and KEGG pathway functional enrichment analysis was performed on the intersected targets with the help of the R package. Finally, the results were further validated by molecular docking and molecular dynamics analysis. As a result, a total of 101 common active ingredients and 21 key active ingredients of four CPMs were obtained, including quercetin, luteolin, acacetin, kaempferol, baicalein, naringenin, artemisinin, aloe-emodin, which might be medicinal substances for the treatment of COVID-19. TNF, IL6, IL1B, CXCL8, CCL2, IL2, IL4, ICAM1, IFNG, and IL10 has been predicted as key targets. 397 GO biological functions and 166 KEGG signaling pathways were obtained. The former was mainly enriched in regulating apoptosis, inflammatory response, and T cell activation. The latter, with 92 entries related to COVID-19, was mainly enriched to signaling pathways such as Coronavirus disease-COVID-19, Cytokine-cytokine receptor interaction, IL-17 signaling pathway, and Toll-like receptor signaling pathway. Molecular docking results showed that 19/21 of key active ingredients exhibited strong binding activity to recognized COVID-19-related targets (3CL of SARS-CoV-2, ACE2, and S protein), even better than one of these four antiviral drugs. Among them, shinflavanone had better affinity to 3CL, ACE2, and S protein of SARS-CoV-2 than these four antiviral drugs. In summary, the four CPMs may play a role in the treatment of COVID-19 by binding flavonoids such as quercetin, luteolin, and acacetin to target proteins such as ACE2, 3CLpro, and S protein and acting on TNF, IL6, IL1B, CXCL8, and other targets to participate in broad-spectrum antiviral, immunomodulatory and inflammatory responses.

Potential therapies against SARS-CoV-2 virus evaluated in large-scale clinical trials

COVID-19 is a viral disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogenesis of SARS-CoV-2 infection in humans manifests as mild symptoms to severe respiratory failure. The development of vaccines against coronaviruses faces several inherent challenges in its establishment as safe and effective, but also in production and distribution. Therefore, supportive treatments are more achievable in a short period of time in controlling the pandemic. Treatment is mainly based on controlling symptoms and inhibiting viral replication. Antivirals are more effective the earlier they are administered during the course of the disease, preferably starting from the first days of evolution; the benefit/risk ratio is the higher the patient has a higher risk of severe evolution. That is why antivirals are primarily administered to patients with nonsevere forms of the disease who have risk factors for severe evolution. Immunomodulatory drugs enhance the immune response against pathogens and may offer a therapeutic approach to treatment of viral diseases, having a significant prophylactic activity in the acute respiratory viral infection. There is a strong scientific rationale which suggest that viral diseases respond to immunomodulatory drugs. People protected with antivirals, immunomodulatory drugs or vaccines often have the disease in a milder or asymptomatic form. In Romania, the latest treatment protocol for COVID-19 includes immunomodulatory, antiviral and anti-inflammatory medication.

Evaluating the Impact of Protocol-Driven Treatment for COVID-19 in an Emergency Department Observation Unit.

Background Hospital overcrowding and operating above capacity have occurred frequently throughout the COVID-19 pandemic. Both phenomena can lead to worsened patient outcomes; thus, it is imperative to find solutions that tackle both. Our goal was to create a treatment protocolfor a subset of patients with mild to moderate COVID-19 infection that would combat inpatient overcrowding by diverting these patients to an emergency department (ED) observation unit (EDOU). This protocol was based on dynamic treatment guidelines and required regular updates to allow our team to provide the most up-to-date care throughout the pandemic. Methods This study is a retrospective chart review of all adult patients seen at twolarge suburban EDs for symptoms related to COVID-19 from April 2020 to January 2022. We subsequently identified adult patients who met the criteria for treatment with our COVID-19 protocol and were placed in our observation unit. These patients were identified using a flag for the protocol orderset within our electronic medical record. Primary outcomes include the need for hospital admission, bounce back rate, and death rate. Results A total of 2,417 patients were treated in our ED observation units using our COVID-19 protocol. Our study population was evenly divided by gender, while a majority self-identified as white (76%). Five hundred two patients (20.8%) required admission to the hospital, and of these, 55 (11%) patients required intensive care unit (ICU) level of care. A total of 27 (1.1%) patientsdied. No deaths occurred for patients that remainedwithin our ED observation units. Bounce back rates at the 48-hour, 72-hour, and seven-day marks were 3.6%, 4.6%, and 7.9%, respectively. Finally, we calculated a total of 284 inpatient days saved with the implementation of our protocol. Conclusion This study shows that our newly created protocol is effective in that it reduces the need for inpatient hospital admissions and results in low bounce back rates. Protocol-driven care in ED observation units can be a powerful tool against hospital overcrowding. Creating such protocols offers opportunities for hospital systems to provide efficient care at a significant cost savings without sacrificing quality of care. Our COVID-19 treatment protocol can be replicated by other hospital systems within their own ED observation units should any future similar outbreaks occur.

Effect of 4-Week Heartfulness Meditation on Stress Scores, Sleep Quality, and Oxidative and Inflammatory Biochemical Parameters in COVID-19 Patients after Completion of Standard Treatment - A Randomized Controlled Trial.

COVID-19-affected patients showed increased stress, impaired sleep quality, altered complete blood count, and increased inflammatory and oxidative parameters. Yoga is an add-on nonpharmacological treatment that is established to normalize the abovementioned parameters. Heartfulness meditation is a form of Raja yoga. The present study aimed to study the effects of 4 weeks of heartfulness meditation on the abovementioned parameters in COVID-19 patients following treatment completion. The present study was a randomized controlled trial carried out in the Department of Physiology, AIIMS, Mangalagiri, Andhra Pradesh. Out of 50 COVID-19 treatment-completed patients recruited for the study, 25 were randomly assigned to the study group who received 4-week app-based heartfulness meditation. Other 25 patients were assigned to the control group who received app-based relaxation for 4 weeks. Perceived stress score, Pittsburgh Sleep Quality Index questionnaire, baseline cardiovascular parameters, complete blood count, serum cortisol, inflammatory parameters, oxidative stress parameters, and antioxidant parameters were assessed before and after 4 weeks of intervention in both the groups. The outcome assessor was blinded in the present study. The mean difference between the two groups was tested using the Student's t-test or Mann-Whitney U-test based on data distribution. Effect of intervention was analyzed using paired Student's t-test for dependent samples test or Wilcoxon signed-rank test based on data distribution. The groups were comparable before intervention for all the variables. After 4 weeks of intervention, we observed a significant decrease in stress, circulating cortisol, inflammatory markers, and oxidative stress biomarker in both the groups. Further, we observed improved sleep quality and antioxidant biomarkers in both the groups. These beneficial alterations following intervention were high in the study group compared to the control group. Our results suggest that app-based heartfulness meditation/relaxation can be used as a nonpharmacological adjuvant to hasten the recovery process in patients who have completed the COVID-19 treatment protocol. Beneficial effects in subjects practicing heartfulness meditation were more than that observed in subjects practicing relaxation.

Introducing the New Versions of Chinese Diagnosis and Treatment Protocol for COVID-19

Introducing the New Versions of Chinese Diagnosis and Treatment Protocol for COVID-19

Translation: Diagnosis and Treatment Protocol for COVID-19 (Revised Trial Version 8)

Translation: Diagnosis and Treatment Protocol for COVID-19 (Revised Trial Version 8)

Translation: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 9)

Translation: Diagnosis and Treatment Protocol for COVID-19 (Trial Version 9)