Case report
Journal: Journal of Integrative Medicine
Manuscript title: Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care
Abstract:
There is currently no drug or therapy that can cure the coronavirus disease 2019 (COVID-19), which is highly contagious and can be life-threatening in severe cases. Therefore, seeking potential effective therapies is an urgent task. An older female at the Leishenshan Hospital in Wuhan, China, with a severe case of COVID-19 with significant shortness of breath and decrease in peripheral oxygen saturation (SpO2), was treated using manual acupuncture and Chinese herbal medicine granule formula Fuzheng Rescue Lung with Xuebijing Injection in addition to standard care. The patient’s breath rate, SpO2, heart rate, ratio of neutrophil/lymphocyte (NLR), ratio of monocyte/lymphocyte (MLR), C-reactive protein (CRP), and chest computed tomography were monitored. Acupuncture significantly improved the patient’s breathing function, increased SpO2, and decreased her heart rate. Chinese herbal medicine might make the effect of acupuncture more stable; the use of herbal medicine also seemed to accelerate the absorption of lung infection lesions when its dosage was increased. The combination of acupuncture and herbs decreased NLR from 14.14 to 5.83, MLR from 1.15 to 0.33 and CRP from 15.25 to 6.01 mg/L. These results indicate that acupuncture and Chinese herbal medicine, as adjuvants to standard care, might achieve better results in treating severe cases of COVID-19.
Details of acupuncture treatment:
Symptoms, examination and diagnosis
At the time of admission, the patient presented with significant shortness of breath, chest tightness, cough with light phlegm, substantial cyanosis of the lips and nails, fatigue, loss of appetite, poor sleep, dry mouth with bitter taste, but with no fever, she also had normal urination and bowel movements. Vital signs showed heart rate 108 beats/min, breath rate 23 breaths/min, and pulse oximeter test for peripheral oxygen saturation (SpO2) oxygen 90% (hypoxemic). The patient was diagnosed with a severe stage of COVID- 19 with respiratory failure.
Acupuncture treatment
Acupuncture treatment was performed on-site on admission day 1 (February 20; in Leishenshan Hospital). Bilateral acupoints (Fig. 1) of Taixi, Metabolic (Metabolic-point), and Zhichuan (Breathless-relief point) were used at depths varying from 1.5 to 2.5 cm, depending on the point. Hwato 0.25 mm 40 mm disposal needles (Suzhou Huatuo Acupuncture Equipment General Factory, Suzhou, China) were used for all points, and needling was performed for about 15–30 s with twisting and lifting until the Deqi reaction was achieved, before the needles were removed. Acupuncture was performed daily, as a major therapy for improving the patient’s condition—because it showed immediate effectiveness on the breath rate, SpO2, and the heart rate.
Fig. 1. Location of acupoints. (A) KI3 (Taixi), located at the posterior edge of medial malleolus, at the middle point between the tip of medial malleolus and the Achilles tendon posterior edge. Commonly used for the patient with symptoms of shortness of breath, fast breath rate, and slow absorption of lung lesions in respiratory diseases. (B) Metabolic point, located at 8 cun above the tip of the medial malleolus, the posterior margin of the tibia, used for loss of appetite, poor appetite, weak and fatigue. (C) Zhichuan point, located at middle-line of palm side of forearm, the upper 1/3 of the line connecting the wrist stripe and elbow stripe, used for lack of consciousness, heart palpitations, chest tightness, shortness of breath, etc.
Change in symptoms and signs
On admission day 1 (February 20), 10 min after the initial acupuncture treatment, the patient felt that her chest and lower abdomen were no longer tense, she could breathe easier and more deeply, and her state of mind was much more relaxed. Her bedside monitor showed that her heart rate decreased by 12 beats/min (to 96 beats/min) and the SpO2 increased by 8% (98%); also, her cyanosis of the lips and nails was less noticeable when checked 2 hours later.
The relief of symptoms through acupuncture alone was very significant, and these treatment effects could last for a few hours. After 9-day treatment (February 29), the patient’s shortness of breath showed significant improvement; she was without cough and phlegm, with no edema in either leg, and her sleep was better; the only symptom that did not improve with this treatment was her dry mouth with bitter taste.
Comments of the blogger:
This is an only case report. But this is a case of severe COVID-19, which has a high mortality. After the acupuncture treatment, the blood oxygen saturation improved to normal range, which indicates that acupuncture is very promising in helping acute lung dysfunction. Hopefully, a randomized control trial will confirm the results. However, this at least showed the potential role of non-pharmaceutical therapy in improving acute lung stress.
Reference:
Recovery of a patient with severe COVID-19 by acupuncture and Chinese herbal medicine adjuvant to standard care. J Integr Med . 2021 Sep;19(5):460-466. doi: 10.1016/j.joim.2021.06.001. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8186062/