Covid 19 was first reported as an unknown respiratory infection. It is believed to be originated from the Wuhan region of China. The etiological agent was detected to be Novel Coronavirus (CoV). The illness was later named Coronavirus disease 2019 (COVID-19), triggered by the Severe Acute Respiratory Syndrome Coronavirus (SARSCoV 2). World Health Organization, declared it a pandemic on 11 March 2020. The disease proved to be fatal killing millions of people around the globe.
Due to the physiological and anatomical changes, pregnancy is considered a potential risk factor for Covid-19 susceptibility as well as for illness and death. In a normal human body, cytokines produced by the T-helper lymphocytes regulate both immune and inflammatory responses. While TH1 acts as a pro-inflammatory mediator, TH2 acts as an anti-inflammatory factor. During pregnancy, the down-regulation of proinflammatory factors; TH1 cells alters the physiological milieu to an anti-inflammatory TH2 dominant phase to protect the fetus. This shift in the inflammatory cell cascade contributes to overall infectious morbidity by accelerating maternal susceptibility to viral pathogens like SARS-CoV-2. Adding on, changes that occur in the hormonal status during pregnancy might also influence the immune response against viral pathogens. However, in pregnant women affected with Covid-19, there occurs to be an early adaptive immune response. This acts as a predictive for a very less severe outcome. All credits go to the transition of TH2pressions with anti-inflammatory cytokines and other immune adaptations. These may serve as the predominant immune response to SARSCoV- 2 which can result in the lesser severity of Covid-19 compared to non-pregnant individuals.
This does not mean that pregnant women will not have any symptoms if she gets affected. The only positive side is that, due to the fast action of immunological response, there is a chance that the symptoms may not aggravate. Although present observations do not give any clear evidence of intra-uterine vertical transmission of this disease, the aftermath of this disease on fetal development cannot be ruled out.
Considering all these factors, the Kerala government prepared a protocol to treat Covid-19. The medicines are selected after due consideration of relevant areas like published scientific evidence, outcomes, and trends of completed and ongoing studies taken up by the Ministry of AYUSH across India. There are different projects of the Kerala government for Covid management. One of them is ‘Amritam’ project, which mainly aims to treat those who have come in the list of primary contact with Covid positive patients. The medicine recommended for the pregnant women who have been a primary contact is Drakshadi kashaya choornam. This can also be given if symptoms of Covid are present. It can act as vata pitta samana, raktaprasadana. It can also be really effective in vomiting and dehydration also. This can be used as paana jala instead of normal drinking water. Other available options as per the protocol are Ela kanadi choornam and Nayopayam kashaya choornam. Ela kanadi is advised in conditions like rajayakshma, swasa and kasa. Though it is samana, it is not too langhana. Nayopayam kashaya mainly acts as a vatanulomana, but the highlight is that this is a balya kashaya. It can be fearlessly administered to the pregnant women as the indication throws light to the fact that it is suitable for garbha raksha and is also swasa hidhma hara.
The SARS-CoV-2 is a human pathogen that can interact with the host antiviral defense in a specific way, especially in pregnant women. When we look into the protocol followed by the Central Government, in cases where infection of Covid-19 virus is suspected, immunity enhancers are considered as the primary treatment. Primarily considering the single drugs, the drugs advised are Amalaki, Ashwagandha and Haridra. Amalaki can be taken as fresh fruit or Amla candy. Ashwagandha root powder mixed in warm milk is also desirable. Haridra along with a pinch of salt added in warm water is also advised for gargling which can prevent the main symptoms of Covid 19 like sore throat and tastelessness. Medicines in the form of formulations described in this protocol are Indukantham ghrita and Aravindasava.
For those pregnant women in the post- Covid phase, rasayana therapy is also advised in this protocol. They are Phala sarpis, Kalyanaka ghrita, Ashwagandha rasayana and Soubhagya Shunti leha. According to the concept of Ayurveda, there will be Dhatu- Kshaya and Agnimandya avastha postinfection. All these should be administered only after recovery from the fever and once agni is stabilized during pregnancy. Daily use of milk with ghee also acts as a rasayana and supports pregnancy.
The protocol by the central government also mentions clearly about the diets and regimens to be followed to boost immunity. A pregnant lady should drink at least 2 Liters of water daily. Gandusha or Kabala with 1 teaspoon of sesame or coconut oil followed by warm water rinse is a good option. Warm water with Haridra and Saindhava, Triphala and Yashtimadhu can also be used for gargling. Pratimarsha nasya with tila taila or coconut oil is also advised for nasal health. As dietetic rules, eat in appropriate amount according to the digestive power. Always take warm and healthy food that are easily digestible. Include cereals like Shalishashtika, Laja, Godhuma,Yava and pulses like mudga, masur in the diet in a balanced quantity. More fruits and vegetables should also be included in the diet. While eating dinner, try to leave at least a gap of 2-3 hours between your meal and sleep. Ministry of AYUSH, also recommends daily practice of Yogasana, Pranayama and meditation for at least 30 minutes daily. While taking body bath, warm water can be preferred. Sleep during daytime is contra-indicated. Devoting more time to recreational activities like reading, painting, gardening and listening to music can enhance the mental health of both mother and baby.
Covid 19 is not yet eradicated from this world. Though the world is trying to come back to its normal pace, the current reports shows that number of Covid cases per day in India is shooting up. Hence, continue using masks and hand sanitizers to prevent the spread of this disease. Wash your hands with soap and water frequently.
As Acharya Caraka says,
“Sarvameva parithyajya sareeram
anupaalayet.
Tadaabhave hi bhaavanaam sarva abhava
sareerinam.”
Leaving aside all other things, it is the duty of a human being to take care of the sareera. If the sareera is destroyed, nothing else can be achieved in this world.
