PATHOGENESIS AND HOMOEOPATHIC MANAGEMENT ON COVID – 19 – DR. A. ALPHONSE IMMANUEL

PATHOGENESIS AND HOMOEOPATHIC MANAGEMENT ON COVID – 19 – DR. A. ALPHONSE IMMANUEL

Pathogenesis of COVID-19:

After the virus enters the body, it needs a special receptor  to help it enter the cell. This receptor is called (Angiotensin Converting Enzymes_2) Symbolized by ACE_2. The ACE_2 is present on the surface of the alveolar cells in the lung.

We have 3 types of alveolar cells:

1. Type1: Responsible for gas exchange.
2. Type2: It is responsible for producing “surfactant” which is a mixture of proteins and fats that reduce the surface tension of the alveoli.
3. Type3: Dust cell, which is macrophages.

The ACE_2 is found on type2 of these cells. Corona virus envelope contains proteins called spikes and special (S_Spike) that help the virus bind to ACE_2.

When the above association occurs, the genetic material of the virus enters the cell and the cell is harnessed to produce viral proteins, thus the virus multiplies and the cell dies.

When (type 2 alveolar cells)die, they release substances called specific inflammatory mediators.

These substances stimulate the existing immune cells “macrophages” and when they stimulate the macrophages, they secrete 3 immune substances called “cytokines” which are:

• Interleukin_1 (IL_1)
• Interleukin_6 (IL_6)
• Tumor Necrosis Factor (TNF_α).

These three substances, when they reach the bloodstream, cause the symptoms associated with infection with Corona virus.

 First – at the level of lungs:

1. These substances cause expansion of the blood vessels surrounding the vesicle, as well as increased permeability of the wall of these vessels
   1. Vasodilation
   1. Capillary permeability increased. and thus leads to “alveolar edema”, which leads to hypoxia and shortness of breath.
2. The loss of surfactant leads to an increase in the surface tension of the vesicle and consequently leads to Alveolar collapse. It also leads to Hypoxia and shortness of breath.
3. These three substances also lead to an increase in the flow of “neutrophils” cells to the place of the viral infection as an immune response. Neutrophils cells kill some viruses by secreting two substances such as:
   1. Reactive Oxygen Species “ROS”
   1. Proteases.

But the above articles also destroy some of the alveolar cells responsible for gaseous exchange and cause a condition called consolidation that causes cough symptoms.

Second: At the CNS level:

The three substances “IL_1, IL_6, TNF” go to the “hypothalamus” and thus increase the body temperature and cause the symptoms of “Fever”.

Third: In the case of severe “SIRS” will occur

Systemic inflammatory response syndrome. That lead to septic shock. Also “MODS” Multiple organ dysfunction syndrome. Especially the kidney and kidney failure.

Homoeopathic Approach:

• Mode of onset & Progress
• Precipitating factor ( If available)
• Stage of the disease.
• The predominant suffering in the patient – Intensity.
• Accompanying symptoms– Chill, sweat, body pain, weakness, mental state, thirst.
• Thermal state & Tongue appearance.
• Coryza, Throat irritation, loss of smell or taste, sore throat.
• Cough- Type of cough – Constant, concussive, hard, barking, whooping, retching, hacking etc
• Respiration – Accelerated, gasping, impeded etc..
• Fever- Stage, special features
• Complicated stage: – Collapse, shock, sinking, weakness, convulsions, acidosis, Thrombosis, sepsis, Hypertension.
• MODS

Remedies:

1st Stage:	2nd Stage:	3rd stage:	Intercurrent :-
Aconite Ars alb Amm. Carb Amm. Mur Amm. Bro Belladonna Bryonia Causticum Cinchona Chin ars Ferr. Phos Ferr.Mett Rhus tox Nux vomica Silecea	Anti-ars Anti –Tart Aspidosperma Eucaluptus Eupatorium per Ferr Mett Cuprum Mett Laurocerus Merc.Iod.Rub Sticta Squilla Sang-can Lobelia Hyosiamus Stann-acet Stramonium Zinc Mur	Phosphorus Plumbum mett Hydrastis Baptisia Elaps Crotolus Horr Merc sol Camphora Acid Phos Veratrum viride Senega Hydocyanic acid Lachesis Lycopodium Kali carb Digitalis	Influenzinum Tuberculinum Bov Drosera

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Dr. A. Alphonse Immanuvel., MD(Hom)

Associate Professor,
Department of Organon of Medicine and Homoeopathic Philosophy