Role of Ayurveda in Pandemic Situation (COVID-19) and Involvement of Pranwah Srotas with Its Treatment: Review Article

Pandemic disease affects the whole world.COVID-19 is a Pandemic disease which deteriorates an individual's life, not only in a specific country but the whole world is suffering. Individuals health, life, economy affected by this Corona virus. It is proven that corona virus can infect people of all ages, but there are people with high risk of contamination who are elderly, individuals with a compromised immunity system and people with health conditions like diabetes, heart disease, kidney failure, asthma, lung disease etc. It is highly contagious that's why it is more dangerous than other viruses of its family. we can prevent from this viral disease by taking such precautions no antibiotics is beneficial in corona virus infection so we can prevent ourselves from this virus by taking preventive measures. Sushrut has mentioned aupsargik rog (communicable disease) in Ayurveda. Ayurveda is an ancient science, which believe in preventive measures for healthy persons and treat a patient by medicines which is described in ayurvedic textbook and Aachar rasayan. Review Article Preeti and Madhu; JPRI, 33(51A): 148-152, 2021; Article no.JPRI.75520 149


INTRODUCTION
COVID-19 is a contagious disease, it is highly transmissible. This feature makes it a very dangerous disease. It belongs to the family coronaviridae.
Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is the virus strain that causes coronavirus disease  in 2019.It belongs to the large family RNA virus. There are 7 members, 4 produce common cold while other 3 produce lethal respiratory syndrome. SARS in 2004, MERS in 2013 noted and newest member coronavirus produced COVID-19 first noted in December 2019in Wuhan, China. Its name is SARS-CoV-2 due to its resemblance with SARS virus. It shows a serious effect on the respiratory tract, but it is totally different from SARS Virus in view of replication, it replicates more frequently in the upper respiratory tract than SARS virus.Surface protein forms knobs on surface of SARS-CoV-2 Which bind with ACE 2 receptor which present on bronchial epithelial cells and internalized by endocytosis RNA replicated and nuclear capsid with RNA and vesicle formed, virus enclosed in vesicle and then undergoes exocytosis and released into extracellular fluid where it can infect adjacent cells as well as infect new host. Virus can replicate in nasal passage and oropharynx during first 24 to 48 hours of infection during this period patient is asymptomatic as the virus can migrate to the bronchi and then into the alveoli. And then it induce inflammation and symptomatic disease the inflammatory response of virus cause breakdown of the alveoli fall and leaky serum into the alveoli which acutely blocking the exchange of oxygen in the lungs. Over the time passage alveoli wall become fibrotic and this condition interfere with oxygen exchange.
Transmission: Transmission of SARS-CoV-2 can occur through direct, indirect or close contact with infected people through infected secretion such as saliva and respiratory secretion or their respiratory droplet. Cough originate droplet with virion spread into surrounding but the droplet cannot project beyond 2 meter or 6 feet. Aerosols below 10 microns remain in air for 3 hours. Only close contact with an infected person inhales the droplet. Virus can present in stool but it is difficult to culture, and hosts can infect 2 to 2.5 people [1].

Srotas:
Srotas are the channel present in the body which convey body elements from one place to another place. Srotas is derived from Sanskrit root "sru gatau" dhatu means oozing, flowing, permeate etc "sravnat srotansi" [2]. The structure through which Sarana Karma that is flowing, moving, oozing and permeation takes place those channels are known as srotas. by these channels conduction of respective elements to their respective destination can be possible."Srotamsi Khalu Parinampadhyamananam Dhatunam Abhivahinibhavyantaya Ayanarthen" [3] those channels play important role in carrying dhatus. Srotas play important role in physiological and pathological process in the the body. Stagnation in srotas leads to development of diseases. Pranvaha srotas is most important srotas among all the srotas because it carries pran vayu which necessary element to sustain life.In ayurved Dash pranayatan are described where pran resides, sankhau, marmatrayam (hriday, basti, nabhi), guda, shukra, oja,rakta [4].
Pranavahasrotas Involvement: pranvahsrotas is that channel present in our body which carries prana or oxygen. There are two moola present in pranwahsrotas and according to Chakrapani "The commentator Adhamalla, in his commentary "Gudharth Sandipani" over the above verse describes that "Nabhisthapranpavana" means "Nabhistha-Iti-Hridayasth" Heart with vessels is called Nabhi in Ayurveda, not only lungs concern with the respiration but lungs along with heart are responsible for respiration [5]. In the diseases of Pranavaha srotas, similar symptoms are found as it is in connection with an organ like heart, lungs. The treatment protocols for diseases of Pranvahahasrotas includes general Snehan Karma (Oleation) and Swedan Karma (Sudation) therapies, Vamana (emesis), Dhumapana (medicated smoking) therapy, Rasayan therapy (Rejuvenation Therapy), Dushti of that srotas leads to death of a person because impairment in pranvahsrotas lead to interference in passage of oxygen which definitely cause diseases related to pranvahsrotas and can lead to death.symptoms of dusht (impaired) pranvahsrotas are atisrustha swas (too long breathing), kupita swas (aggravated breathing), alpa alpa (shallow breathing), shashabd swas( breathing associated with abnormal sound like wheeze), sashula swas( breathing associated with pain) [6].
Cardiopulmonary System: Cardiopulmonary system consist of two system one is cardiovascular system and other is pulmonary system. Cardiovascular system transport the blood to the whole body part and pulmonary system exchange gases between environment and body.Both system are interdependent. Because they help each other in transportation of oxygen with the help of blood .pathogenesis of one system leads to vitiation of another system. Clinical symptom like Chest pain, Orthopnea, Fatigue, Palpitation and Sign like Pyrexia Clubbing, Edema etc. can be seen [7]. And in the lung diseases various sign and symptom we can observe like Cough, Pyrexia, Dyspnea ,Tachypnea, Cyanosis, abnormal breath sound and Sign of heart failure [8].

Aupsargik( communicable) roga in Ayurveda:
COVID-19 is a contagious disease we can prevent from this by following some preventive measures. In ayurved contagious disease is already mentioned under aupsargik rog Acharya Sushrut has mentioned aupsargik rog as they are contagious disease which spread through direct contact or contaminated object of patient by physical contact, expired air, eating with infected patient in same vessel, sharing bed ,using clothes,use infected person mala (garland ) and lepan (face mask or paste). Aupsargik rogs are belong to that category which can spread from one person to person [9].

Causes of Epidemic or Janpadodhwansh:
Root cause of vitiation of factors are pragyapradh (intellectual blasphemy), that also arises from misdeeds of previous life. Adharma (sinful act). God deserts the people of that place and water, air, earth, drugs, food impaired. A sinful act is at the root cause of destruction of the community by weapon due to other people also getting destroyed by Rakshas (demons which are invisible like virus and bacteria) and varieties of other creatures [10].

Motive of Ayurveda:
Aim of Ayurveda is first to prevent the health of a healthy person and giving curative treatment to patients. The policy of Ayurveda is first prevention and then treatment [11].

Preventive aspect in COVID -19 -Prevention of Covid-19 can be done by the help of Yoga and asanas and by adoption of preventive measures and by improving our lifestyle.
Achar Rasayan chikitsa or Good Deed: Design therapy adopted with a good lifestyle and preventive measure to improve physical health. Palan of achar rasayan like satya (truthfulness), daya (mercy) dana (donation to righteous person), bali (sacrifices of sins, bad habits), devatarchana (prayer), sadvritta (good deeds and follow proper ritucharya and dincharya like having proper diet, maintain cleanliness), adoption of preventive measures, mantradi raksha(protection of self by mantra) are comes under good deeds. [12].
Yoga: Yoga like Pranamayam. It is very effective in COVID-19 situation, because we can define it as controlling the motion of exhalation and inhalation,So it is direct affect our lungs and make it healthy. It is a combination of meditation and asanas which helps us to become fit physically and mentally. Pranayam make lungs healthy and also we can use pranayam in preventive measures for regulation and to control our breath [13].

Asanas -Uttanasana (forward bend): This
Yoga exercise is a great way to relieve congestion and protect the sinuses and mucus membranes, which are the first form of defense [14].
Shalbhasana: This asana improve the lung capacity of the individual and increase respiratory efficiency [15].
Bhujangasana: It will helps in improving the circulation of heart and lungs by stretching shoulder, chest, abdomen and lungs [16].

Use of swedan for bronchodilation mentioned in
Charak chikitsasthan chapter 17 Swedan(steam bath) is described in Charak samhita for hikka and swasa rog. First of all we have to apply tila tail mixed with sendha namak on patients chest region and do little massage for a while with it and then use nadi sweda (it is a type of swedan) over the chest for a few minutes to release mucus which is stuck in lungs passage.With use of this abhyang and Swedan, thick mucus will be liquified and come out very easily and after clearance of passage patient gets relief.

MATERIALS AND METHODOLOGY
Data on COVID-19 is collected by the internet and review of Ayurvedic literature is collected by Ayurveda samhita like Charak samhita and Sushrut Samhita, Textbooks of Yoga and modern medicine book.

DISCUSSION
COVID-19 is a pandemic disease which transmits person to person very frequently. Patient can be asymptomatic for a week but he or she can be carrier for virus and transmit droplet with virion to their surrounding as virus can survive in fomite for few hours and in air upto 3 hrs.so we can prevent transmission of virus through isolation or keeping a particular distance from a person. We don't have to share bed, clothes and garlands with others. In COVID-19 involvement of respiratory tract occurs and there is involvement of pranvahsrotas according to Ayurveda.Because we can correlate pranvahsrotas with cardiopulmonary system.As we see similarity in sign and symptoms of cardiopulmonary system with dushti of pranvahsrotas As SARS-CoV-2 is named due to the severe acute respiratory syndrome. Treatment of pranavaha srotas which is given in ayurvedic text book we can give in COVID-19, and can use immunity booster to boost immunity to prevent from COVID -19 because it is highly transmissible and can affect 2 person in same time,it is highly contagious due to its replication.There is variation in clinical presentation,Few shows symptoms and some are asymptomatic and play role as carrier for virus.

CONCLUSION AND SUMMARY
Whole world is suffering from COVID-19 and it is spread from human to human by doplet produced by infected people whether they are symptomatic or asymptomatic. It is related to SARS virus but very dangerous than SARS virus in view of replication. So we only can be in healthy state by taking some precaution which is described in aupsargik rog and by increasing our immunity, it is proven that some person has been asymptomatic even after exposure to virus. Involvement of pranvahsrotas is present in that disease and can be cured by medicine which is described in ayurved for swas. Aupsargic rog which is communicable disease described in Ayurveda which is science of sages that is the proof that they had knowledge about communicable disease and janpadodhwans (Epidemic) that's why they give preventive measures even before origin of communicable disease in this modern era. Significance of study: Significance of study: The study highlights the efficacy of "Ayurveda" which is an ancient tradition, which has been used in India. This ancient concept should be carefully evaluated in the light of modern medical science and can be utilized if found suitable.

CONSENT
It is not applicable.

ETHICAL APPROVAL
It is not applicable.