Understanding COVID-19

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The following discussion outlines the symptoms and treatment principles for treating COVID-19. This discussion is taken from practitioners of Chinese medicine in the hospitals of Wuhan, China. 

The Main Disease Factor is damp-heat with a pestilent toxin, and the pathological features are dampness, heat, stasis, toxin, and vacuity.

The disease has 4 stages that require different treatment:

  • Early-stage
  • Middle stage
  • Severe Stage
  • Recovery stage

EARLY STAGE

Clinical Presentation (symptoms)
Low-grade fever or no fever, Slight aversion to cold, Sensation of heaviness and stiffness in the head and body, Muscle pain and soreness, Fatigue, Cough with scant phlegm, Dry mouth with little intake of fluids, Possible oppression of the chest and blockage/congestion in the epigastrium, No sweating or difficulty sweating, Possible nausea and poor appetite, Diarrhea and loose stool
Pale red tongue with a white, greasy coating
Pulse: floating, slightly rapid
Clinical Features

Damp-evil is stuck in the lung, making qi movement through this pivot difficult (interferes with the Qi dynamic of the lung)
Treatment

Transforms dampness and release toxins, Diffuse the lung to vent the toxin
Formula
Modified Huo Po Xia Ling Tang and Xiao Chai Hu Tang

Clinical Presentation (symptoms)
Fever or high fever, Cough, Phlegm that is yellow or thick, Fatigue, Headache, Pain and soreness in the whole body, Dryness and bitter taste in the mouth, Heart vexation (irritability) Constipation and reddish urine.
Tongue: Red with yellow or yellow or greasy coat that is not moist (has no luster)
Pulse: Slippery and rapid

Clinical Features
Heat-evil obstructing the lung; lung loses the ability to diffuse and descend

Treatment
Clear heat and resolve toxins, diffuse the lung to vent pathogen

Formula		Modified Ma Xing Shi Gan Tang and Da Yuan Yin 

MIDDLE STAGE

Clinical Presentation (symptoms)
Fever or high fever, Cough, Phlegm- thick, copious, yellow, Chest oppression, Wheezing, Thirst, Foul breath, Constipation and distention in the abdomen
Tongue: Dark Red with thick, yellow turbid coating
Pulse: Slippery and rapid or deep and tight

Clinical Features
Damp-heat closes down the lung; Fu-organ Qi (Large Intestine) is blocked

Treatment
Clear heat and diffuse the lung; open the fu (large intestine) and drain heat 

Formula
Modified Xuan Bai Chengqi Tang  and Huang Lian Jie Du Tang

Clinical Presentation (symptoms)
Fever or sensation of heat in the body that does not dissipate, Sweating that is not smooth (not regular or feels blocked)Wheezing with rough breathing, Dry cough or chocking coughPerhaps pain in the throat, Oppression in the chest and blockage in the chest/epigastrium, Dry mouth with reduced fluid intake, Bitter taste or feeling of stickiness in the mouth, Sticky and stuck stool
Tongue: Dark red with yellow-greasy coating
Pulse: Slippery and rapid

Clinical Features
Damp-heat harboring toxin: blocked and congested lung qi

Treatment
Clear heat and transform dampness, diffuse the lung and release toxin
Formula
Modified Ma Xing Shi Gan Tang and Gan Lou Xiao Du Dan with Sheng Jiang San

SEVERE STAGE

Clinical Presentation (symptoms)
There is internal blockage and external separation (detachment) with high fever and agitation and vexation, Cough with rough breathing that causes nostrils to flare, Sound of phlegm rattling in throat, Feeling of suffocation and desperation, Voice breaks when speaking, Skin rashes with papules and spots appear, Patients may lose consciousness or be delirious, Sweating with cold limbs, Dark-purple lips, Dark-red tongue with yellow-greasy coat Deep, fine pule that seems about to give out

Clinical Features		Qi and yang collapse

Treatment		Benefit qi and return yang to secure what is separating

Formula		Modified Shen Fu Tang 

RECOVERY STAGE

Clinical Presentation (symptoms)
Fever is already gone or only a low-grade fever remains, Fatigue, Flustered, Dry mouth, Spontaneous sweating, Abdominal distention, Irregular bowel movements,
Pale-red tongue with a white coat or scant coat
Vacuous (empty/scallion) and rapid pulse

Clinical Features
Dual vacuity of qi and yin; latent pathogen has not been fully resolved

Treatment		Benefit qi and nourish yin to dispel the pathogen

Formula		Modified Er Chen Tang and Wang Shi Qing Shu Yi Qi Tang