**4.1 Methodology**

Databases such as PubMed, Scopus, Embase, Google Scholar, Web of Science, and Cochrane were searched without time limitation to find relevant articles exploring the impact of CAM in COVID-19. The terms and words searched included "COVID-19", "SARS-CoV-2", "CAM", "micronutrients", "phytochemical", "Ayurveda", "extract", "essential oil", "herbal medicines", "In vitro", "In vivo", "clinical trial" etc.

## **4.2 Ayurveda and yoga as the prophylactic and adjuvant therapy of COVID-19**

To develop a preventive and curative intervention for COVID-19, the Ministry of Ayurveda, Yoga, and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH), Government of India (GoI), formulated an interdisciplinary AYUSH research and development task force and guidelines for initiating, monitoring, coordinating efforts and conducting clinical studies of diverse traditional medicines against COVID-19 [49].

Visualizing the severity and infectivity of COVID-19, the Ministry of AYUSH, GoI recommended certain immunity boosters like lukewarm water, Kadha, (an ayurvedic preparations containing curcumin, ginger, cumin seeds, fennel seeds, cloves and honey) and homeopathic medicine 'Arsenic Album 30C' [50]. Ayurveda defined NPIs in addition to pharmacological as preventive measures in combating COVID-19. NPIs recommended by the Ministry of AYUSH include sadvritta (Sad means 'good' and vritta means 'regimen'), healthy lifestyles, enough sleep, adequate physical activity, avoidance and isolation from infected persons [51]. Certain medicines suggested by Ayurveda include turmeric (*Curcuma longa*), garlic (*Allium sativum*), Ajwain or Carom (*Trachyspermum Ammi*) as a disinfectant for the prevention of COVID-19 [52].

The nose, mouth and eyes, are the main entry portals for the droplets consisting of the virus, SARS-CoV-2. Before reaching and final attack on the lungs, the virus stays in the nose and throat region for hours. The virus is coated with fatty acid which helps in adhering the virus to the moist mucosal layers and thus facilitates its entrance into the host cells by attaching to definite receptors [53]. Ayurveda mentioned various interventions that interfere in these entry portals [54] for virus invasion to the lungs by improving the innate immunologic response of the mucus membranes. These measures work as "physiological masks" or "local prophylaxis" for obstructing the viral invasion. The common recommendation for respiratory

#### *The Role of Complementary and Alternative Medicines in the Treatment and Management... DOI: http://dx.doi.org/10.5772/intechopen.100422*

diseases written in Ayurvedic texts [55] includes consumption of hot food, hot water, steam inhalation, gargling, local applications and herbal decoctions with medicated water. These may be useful for relief in mild cases [53]. Ayurveda recommended drinking hot and warm water for improving the digestion of Ama. Ama is a pro-inflammatory mediator of weaken metabolic disorders and is associated with augmented susceptibility to infections [56].

Warm oils and liquids are employed as mouth rinses (Kavala) or gargles (gandusha) to thoroughly clean the mouth and throat [57]. The oily decoctions coat the mucosa as biofilm as well as rinse the oral cavity, tonsillar area, and pharynx. These decoctions also have supplementary benefits of antioxidant, immunomodulatory, and antimicrobial [58]. It is well known that host mucosal immunity plays a vital role in controlling infectious agents [59]. Literature regarding Yoga advocates Jala neti which implies rinsing of the nasal passage with saline water [60]. Randomized controlled trials (RCTs) reported the effectiveness of saline water in upper respiratory infections [61].
