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The Relevance of Complementary and Integrative Medicine in the COVID-19 Pandemic

A Qualitative Review of the Literature

Written by Dr Vijay Murthy et al
first published as a Research paper here

In light of the adverse health risks faced both at the population and individual levels, we conducted a review of scientific evidence on Complementary and Integrative Medicine (CIM) that might be useful during the COVID-19 pandemic. This qualitative literature review is published in Frontiers in Medicine in December 2020.  We reviewed the scientific literature to summarise CIM practices that could be beneficial for improving physical and mental health and well-being of the population under the current pandemic circumstances. The review highlights the role of specific dietary measures, micronutrients, physical activity, Mind-Body Medicine techniques, single botanicals, botanical compounds, and spending time in nature in reducing adverse health risks. The review can possibly help in identifying the role of CIM on immune functions and preventative and therapeutic potential of CIM in viral respiratory conditions. This review can of help to clinicians, patients, and the general population during the current pandemic when discussing and/or considering CIM options.

Nutrition can play an important role in the “individual susceptibility” to bacterial or viral infections and, the outcome of infectious diseases. An optimized nutritional status can have a range of positive effects on the immune system. A predominantly plant-based diet, including e.g., fruits, vegetables, legumes, nuts, and olive oil, may have an influence on the susceptibility to infectious diseases; particularly foods containing potentially antimicrobial, antioxidant, anti-inflammatory, and immunomodulatory phytochemicals, such as bitter substances, vitamin C, mustard oils, herbs and spices, and herbal teas. A 5% higher proportional intake of fruit and vegetables is associated with a 12% lower hospitalization due to influenza infections. The effectiveness of vaccination may be higher when the plant part of the diet increases. In a recent systematic review, vitamins A and D showed a potential benefit in viral respiratory infections, especially in deficient populations. Among the trace elements, selenium and zinc have also shown beneficial immunomodulatory effects in viral respiratory infections. 

A selection of promising herbal medicines (Pelargoniumroot extract, Sambucus nigra, green tea, Glycyrrhiza, Echinacea species, Cistus incanus, Cannabinoids) that may be relevant to the current COVID-19 pandemic.  Catechins as a class of polyphenolic flavonoids are the main active ingredients of green tea as well as many other teas, which among other properties can strengthen the immunity against viral, especially influenza infections. The saponin glycyrrhizin from Glycyrrhiza glabra, extracts of Echinacea species may decrease  pro-inflammatory cytokines that play a role in the progression of cytokine storm and  acute respiratory distress syndrome. 

The review emphasises the importance of Mind-Body Medicine and relaxation, strengthening relationships, focussing on developing a positive attitude as means to improve mental resilience. The review recommends 15–30minuts of exercise a day of morning stretches, walking, jogging or any other activity. The article recommends healthy eating habits, to eat regularly, eating at least one warm main meal a day, preferably freshly cooked. It recommends use a variety of kitchen herbs and spices, drinking plenty of water and incorporating warm drinks such as unsweetened herbal teas, ginger tea, teas with licorice, green tea. The article recommends use of herbs and spices (e.g., thyme, oregano, cloves, bay leaves, ginger, turmeric, basil, lemon balm, peppermint, rosemary, cinnamon). Last but not least, the review highlights the importance of good sleep as long and restful sleep strengthens the immune system. 

Read the full article here: https://www.frontiersin.org/articles/10.3389/fmed.2020.587749/full

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