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

Returning?

A A A

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, Immanuel Hospital Berlin, and the Institute for Functional Medicine.

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.

Due to the importance of collecting accurate information, all contributors are asked to respond to the following attestation statement.

Attestation Statement:
I confirm the information provided here accurately reflects the course of care and outcomes for the case described.

* must provide value

Yes

reset

What world region do you practice in?

Americas (South, Central, North)

Africa

Asia (including India)

South Pacific (Australia, New Zealand, Pacific Islands)

Europe (Eastern, Western)

Please specify which country you practice?

If other, please specify practice location by country:

What is your medical and/or complementary medicine background?

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

Have you received training in functional medicine through the IFM Functional Medicine Certification Program (IFMCP)?

Yes

reset

What type of Ayurvedic professional are you?

Ayurvedic Health Counselor / Therapist

Ayurvedic Practitioner

Ayurvedic Physician

Other Ayurvedic Professional

Please provide more details on your background as an Ayurvedic professional:

Expand

Please provide more details on your background:

Expand

If you are not a MD or DO,* was this patient/client under concurrent care by a MD or DO?

*United States only: DO credentialed by the American Osteopathic Association Commission.

Yes

Unsure

reset

Enter patient's/client's age in years:

Sex

Male bodied

Female bodied

Other

reset

How long has/was this patient been under your care toward prevention of, or for COVID?

< 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

reset

Case Symptoms:

* must provide value

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

Specify other case symptoms:

Expand

COVID-19 Status

* must provide value

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

Severity:

Asymptomatic

Mild/Moderate

Severe/Critical

reset

Do you have vital signs or other objective clinical data?

Yes

reset

Height:

Units

inches

reset

Weight:

Units

lbs

reset

Body Mass Index (BMI) (autocalculated):

View equation

Body Mass Index (BMI) (autocalculated):

View equation

Systolic blood pressure (mmHg)

Diastolic blood pressure (mmHg)

Heart rate (beats per minute):

Respiratory rate (breaths per minute):

Lymphocyte count (absolute):

High-sensitivity C-reactive protein (hs-CRP):

Lactate dehydrogenase (LDH):

D-Dimer:

Vitamin D status, if checked?

Lab normal (>30 ng/ml)

Insufficient (<30 ng/ml)

Deficient (< 20 ng/ml)

Unknown

reset

Enter 25-OHD status, if available:

Comorbidities:

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

Specify other co-morbidities:

Expand

Was the patient/client pregnant?

Yes

reset

Please specify approximate weeks of gestation?

Patient/client characteristics

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

What is your therapeutic goal? (select one or more)

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

Please specify your therapeutic goal:

Expand

Supportive Care: Immune support

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

Please specify probiotics product name OR species and strain when known:

Please specify homeopathic remedy(ies) used:

Expand

Specify other immune support used:

Expand

Supportive Care: Anti-viral

Elderberry

Echinacea

St. John's Wort

Olive leaf

Neem

Artemesia spp.

Lemon balm

Andrographis

Licorice

Thyme

Hydrotherapy

Homeopathy

Other

Please specify homeopathic remedy(ies) used:

Expand

Please specify other anti-viral support used:

Expand

Supportive Care: Respiratory Health

Eucalyptus_steams

Essential oils_other

Osha

Garlic

Elecampane

Angelica

Yerba santa

Yarrow

Mullein

Yerba mansa

Breathing exercises

Chlorophyll

Exercise_physical activity

Hydrotherapy

Homeopathy

Other

Please specify essential oils used:

Expand

Please specify homeopathic remedy(ies) used:

Expand

Specify other respiratory support:

Expand

Supportive Care: Inflammation

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

Please specify homeopathic remedy(ies) used:

Expand

Specify other inflammation support:

Expand

Care site: (check all that apply)

Telehealth-only

Telehealth & in-person visits

In-person visits only

Hospital

Components of care provided (check all that apply):

Please note: An optional link will be provided at the end of the survey in case you would like to provide additional clinical details about this case.

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

Please describe other components of care provided:

Expand

Did you provide care based on an East Asian medicine diagnosis?

Yes

reset

Which of the following best describes your approach to care:

NOTE: "Standardized protocol" refers to a predetermined East Asian medicine herbal formula or treatment approach defined specifically for treating patients with COVID-19 symptoms.

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

reset

Components of care provided (check all that apply):

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

Please specify other components of care:

Expand

If using herbal medicine, please specify:

Herbal teas/spices

Single herbs

Herbal blends

Herbal-mineral metal formulations

I would like to provide additional details

Please provide additional details on the use of herbal medicines:

Expand

If using lifestyle recommendations, please specify:

Nasya

Gandusha

Specific daily routine

Other

Please specify other lifestyle recommendations:

Expand

If using manual therapies, please specify:

Massage

Steam inhalation

Dhoomapana

Other

Please specify other manual therapies:

Expand

Did you provide care based on an Ayurvedic diagnosis?

Yes

reset

Which of the following best describes your approach to care:

NOTE: "Standardized protocol" refers to a predetermined Ayurvedic care approach proposed/defined specifically for treating patients with COVID-19 symptoms.

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

reset

Pharmaceutical drugs being used by my patient/client:

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

Please specify other prescription medications used:

Expand

Other contributions to health:

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

Please specify digestive support:

Expand

Please specify details on lifestyle measures recommended:

Expand

Please specify other support:

Expand

Case outcome:

* must provide value

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

reset

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!

Please specify outcome:

Expand

Which of the following symptoms have resolved?

Fatigue

Fever

Cough

Dyspnea

Diarrhea

Pain

Cognitive impairment/'Brain fog'

Renal complications

Vascular complications

Cardiovascular complications

Other

Please describe other symptoms that have resolved:

Expand

Indicate level of recovery from fatigue:

Partial

Complete

reset

Indicate level of recovery from fever:

Partial

Complete

reset

Indicate level of recovery from cough:

Partial

Complete

reset

Indicate level of recovery from dyspnea:

Partial

Complete

reset

Indicate level of recovery from diarrhea:

Partial

Complete

reset

Indicate level of recovery from pain:

Partial

Complete

reset

Indicate level of recovery from cognitive impairment/'brain fog':

Partial

Complete

reset

Indicate level of recovery from renal complications:

Partial

Complete

reset

Indicate level of recovery from vascular complications:

Partial

Complete

reset

Indicate level of recovery from cardiovascular complications:

Partial

Complete

reset

Indicate level of recovery from other complications:

Partial

Complete

reset

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

reset

If yes, was the adverse event associated with any of the following:

Acupuncture adverse event

Herbal medicine adverse event

Other

reset

Please describe the other adverse event:

Expand

Did this event resolve favorably?

Yes

Unsure

reset

Provide any additional details you think are necessary to provide context and/or details about changes in symptoms and/or resolution:

Expand

How many years have you been in clinical practice as an East Asian medicine professional?

Please indicate your licensure / registration status (check all that apply)

Licensed/registered to practice acupuncture

Licensed/registered to practice herbal medicine

Not licensed/registered

Other

Please specify your licensure / registration status:

Expand

Ideally each case would be entered as separate records in this registry. We recognize this may not be feasible. If you used exactly the same protocol for multiple patients, and all patients had the identical outcome, please specify the number of patients supported through your protocol:

How many years have you been in clinical practice as an Ayurvedic Medicine professional?

Are you formally certified or registered in your nation?

Yes

reset

Please provide any additional details you would like to share about this case?

Expand

Provide contact information if you give consent to be contacted by the investigators for more information about this case:

Expand

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.