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Required format:

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C6shhHPSGWVxNJNRSRaZJ6izPKcYxbUVsqx7KgstMZgEvTir9crgfsP3Ej6hvK38kGAxwZVSgV

Traditional, Complementary and Integrative Health and Medicine COVID-19 Support Registry

Returning?

Please contribute to this registry with de-identified data from patients/clients who have been treated for COVID-19 exposure or prevention.

Distribution of this registry has been approved by the IRB of the National University of Natural Medicine. Contributions to this registry have been made by researchers at the National University of Natural Medicine, the Canadian College of Naturopathic Medicine, the University of Sydney, the University of Technology, Sydney, the University of Toronto, the University of Texas, NYU Medical School, Harvard Medical School, the New England School of Acupuncture at MCPHS University, the Ontario College of Traditional Chinese Medicine, the Society for Acupuncture Research, the American Society of Acupuncturists, the Shen Nong Society, Southern California University of Health Sciences, Weill Cornell Medical College, The DINacharya Institute, the Clinical Ayurveda Research Working Group, the Bharati Vidyapeeth College of Ayurved, Mount Madonna College of Ayurveda, and Immanuel Hospital Berlin.

OVERVIEW: Enter one record for each case. You may enter as many cases as you would like to provide. The option to enter another record becomes available following each submission. All questions are optional except for several critical case questions.

IMPORTANT: We recommend you save the "Survey Access Code" for each registry entry, and record this code on/in the patient/client record. Linking this code to the patient/client record allows for responses to be modified if there are changes in supportive care, symptoms, management and/or case outcomes. The Survey Access Code becomes visible after you submit each response. Each record has its own unique access code, so please record each individual code and link to its respective record.

NOTE: After you submit each record, you will be given the option of downloading your responses as a PDF for your records.

Yes

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Americas (South, Central, North)

Africa

Asia (including India)

South Pacific (Australia, New Zealand, Pacific Islands)

Europe (Eastern, Western)

Medical doctor

Osteopathic doctor

Naturopathic doctor

Doctor of Chiropractic

East Asian medicine professional [e.g., Acupuncturist, Chinese, Japanese, Korean medicine]

Ayurvedic physician or practitioner

Doctor of Physical Therapy

Nurse practitioner or other advanced nursing

Nurse

Licensed acupuncturist

Nutritionist/Dietician

Licensed massage therapist

Reiki practitioner

Healing touch practitioner

Herbalist

Mindfulness meditation instructor

Yoga instructor/yoga therapist

Clinical psychologist/mental health professional

Social worker

Public health practitioner

Community health worker_non-physician

Homeopath

Other

Ayurvedic Health Counselor / Therapist

Ayurvedic Practitioner

Ayurvedic Physician

Other Ayurvedic Professional

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Yes

Unsure

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Male bodied

Female bodied

Other

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< 1 week

1-2 weeks

>2 weeks but < 1 month

1-3 months

>3 months and < 6 months

> 6 months and < 1 year

> 1 year

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No symptoms reported

Fever

Cough_dry

Cough_productive

Shortness of breath

Sore throat

Body aches/myalgia

Established pneumonia

Loss of taste or smell

Chills

Diarrhea

Nausea/Vomiting

Abdominal Pain

Fatigue

Other

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Tested_positive

Tested_negative

Suspected due to case symptoms, not tested

Suspected due to known exposure to COVID positive person through home, work, school or travel, not tested

Not applicable, supportive care

Asymptomatic

Mild/Moderate

Severe/Critical

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Lab normal (>30 ng/ml)

Insufficient (<30 ng/ml)

Deficient (< 20 ng/ml)

Unknown

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Hypertension_controlled

Hypertension_uncontrolled

Type 2 diabetes_controlled

Type 2 diabetes_uncontrolled

Coronary disease

Congestive Heart Failure

Other cardiovascular disease

COPD_non-asthma

COPD_asthma

Auto-immune or other inflammatory condition

Cancer

None known

Obesity

Blood clotting abnormalities

Other

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Yes

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Smoking history

Vaping / e-cigarette history

Patient / client has low socio-economic status

Patient/client is a front-line health worker during COVID-19 pandemic

Prevention of COVID-19

Treatment of COVID-19 (COVID-19 confirmed)

Health promotion

Recovery from COVID-19 (acute recovery support, COVID-19 confirmed)

Rehabilitation from COVID-19 (longer term recovery support, COVID-19 confirmed)

Symptom management (non-mental health; COVID-19 not confirmed)

Mental health support/symptom management

Other

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Probiotics

Prebiotics

Zinc

Vitamin D

Vitamin A

Turmeric/Curcumin

Colostrum

Hydrotherapy

Vitamin C_oral

Vitamin C_IV

Mushrooms_reishi_maitake_etc.

Homeopathy

Stress management

Other

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Elderberry

Echinacea

St. John's Wort

Olive leaf

Neem

Artemesia spp.

Lemon balm

Andrographis

Licorice

Thyme

Hydrotherapy

Homeopathy

Other

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Eucalyptus_steams

Essential oils_other

Osha

Garlic

Elecampane

Angelica

Yerba santa

Yarrow

Mullein

Yerba mansa

Breathing exercises

Chlorophyll

Exercise_physical activity

Hydrotherapy

Homeopathy

Other

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NAC_oral

NAC_IV

NAC_nebulized

Bioflavonoids

Fish oil

Resolvins

Tumeric/curcumin

Boswellia

Pomegranate

Vitamin C_oral

Vitamin C_IV

Glutathione_oral

Glutathione_IV

Glutathione_nebulized

Anti-inflammatory diet

Hydrotherapy

Homeopathy

Stress management

Other

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Telehealth-only

Telehealth & in-person visits

In-person visits only

Hospital

Acupuncture

Moxibustion

Dietary therapy

Herbal medicine

Lifestyle recommendations

Manual therapies (e.g., anma, cupping, gua sha, shiatsu, tuina)

Qi gong / Tai ji quan

Telehealth instruction in self-care (e.g., self-acupressure, self-moxa)

Other

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Yes

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STANDARDIZED A: Standardized protocol based on biomedically-defined disease stage (e.g. asymptomatic, mild/moderate, severe)

STANDARDIZED B: Standardized protocol based on an East Asian medicine differential diagnosis

SEMI-STANDARDIZED A: Standardized protocol based on biomedically-defined disease stage with individualized modifications

SEMI-STANDARDIZED B: Standardized protocol based on East Asian medicine diagnosis with individualized modifications

INDIVIDUALIZED: An individually-tailored treatment based primarily on the patient/client's symptoms and East Asian medicine diagnosis

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Dietary recommendations

Herbal medicine (e.g,, herbal teas/spices; single herbs; herbal blends; herbal-mineral-metal formulations, etc.)

Lifestyle recommendations (e.g., nasya, gandusha, specific daily routine, etc.)

Manual therapies (e.g. massage; steam inhalation; dhoomapana etc.)

Meditation

Yoga / yoga therapy, pranayama

Other

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Herbal teas/spices

Single herbs

Herbal blends

Herbal-mineral metal formulations

I would like to provide additional details

Expand

Nasya

Gandusha

Specific daily routine

Other

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Massage

Steam inhalation

Dhoomapana

Other

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Yes

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STANDARDIZED A: Standardized protocol based on biomedically-defined disease stage (e.g. asymptomatic, mild/moderate, severe)

STANDARDIZED B: Standardized protocol based on an Ayurvedic diagnosis

SEMI-STANDARDIZED A: Standardized protocol based on biomedically-defined disease stage with individualized modifications

SEMI-STANDARDIZED B: Standardized protocol based on an Ayurvedic diagnosis with individualized modifications

INDIVIDUALIZED: An individually-tailored treatment based primarily on the patient/client's symptoms and Ayurvedic medicine diagnosis

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Prescription anti-virals_non-chloroquine

Prescription anti-virals_chloroquine

Anti-hypertensives_non-ACEI

Anti-hypertensives_ACEI

Lipid-lowering medications

Other cardiovascular medications

Corticosteroids_oral

Corticosteroids_topical

NSAIDs

Acetaminophen

Antibiotics

Anti-asthma medications

Other immunosuppressant medications

Cancer treatment_chemotherapy

Cancer treatment_radiation

Cancer treatment_other

Other prescription medications

Unknown

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Hypertension management, changing medications

Hypertension management, other

Glucose management

COPD management

Anxiety/stress management

Immune compromise management

Digestive support

Health education on risk reduction through public health measures

Health education on lifestyle measures

Other

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Did not become infected with COVID

Full recovery_remained outpatient

Partial recovery_remained outpatient

Hospitalization_ICU

Hospitalization_other

Death

Patient/client remains under care_outcomes to be added at a later date

Other

Not applicable

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REMINDER: Please record the "Survey Access Code" for this record in the patient/client record so the outcome can be updated. The survey access code becomes visible after submitting each record. Thank you!

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To your knowledge, was there any increase in symptomology or unexpected/unintended change in clinical status that may be considered harmful?

NOTE: The following should NOT be considered harmful:

(1) Minor, expected gastro-intestinal upset, headache, minor skin rash or sweating associated with herbal medicine.

(2) Minor fatigue, minor bruising, or localized, controlled bleeding associated with acupuncture.

Please note this record is not linked to you or your practice unless you provide contact information below so please enter accurate information to help others.

Yes

Unsure

Not applicable

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Acupuncture adverse event

Herbal medicine adverse event

Other

reset

Expand

Yes

Unsure

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Expand

Licensed/registered to practice acupuncture

Licensed/registered to practice herbal medicine

Not licensed/registered

Other

Expand

Yes

reset

Expand

You have selected an option that triggers this survey to end right now. To save your responses and end the survey, click the button below to do so. If you have selected the wrong option by accident and do not wish to leave the survey, you may click the other button below to continue, which will also remove the value of the option you just selected to allow you to enter it again and continue the survey.

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