Sage Journals: Discover world-class research

Abstract

Introduction:

The Clificol^® COVID-19 Support Project is an innovative international clinical case registry project that aimed at collecting experiences with the homeopathic treatment of COVID-19 patients. This paper describes and compares the reported findings from the six main contributing countries.

Materials and Methods:

Observational clinical case registry study of patients with confirmed or suspected COVID-19. Participating homeopaths could freely enter symptoms that informed the remedy prescription. In addition, in China, use was made of a symptom questionnaire. The analyses were primarily descriptive.

Results:

One thousand two hundred and twenty-seven cases, as available by the October 31, 2022, were used for the analyses. In total, 1606 prescriptions were analyzed, 977 of which contained data on the symptoms used in the remedy selection process. Outcome data on 1310 prescriptions were available. Overall, Bryonia alba was the most commonly prescribed remedy, and this was particularly evident in India, Spain, and Switzerland. Also, the prevalence of the 10 most commonly used rubrics in patients' prescriptions varied significantly between countries. The highest percentage of rapid recovery (66%) was observed in those patients who had their symptoms for >30 days before the initiation of homeopathic treatment.

Conclusions:

Significant experience has been obtained with the homeopathic treatment of COVID-19 patients. We observed a high level of variability between countries. Future statistical analyses of aggregated clinical case data will benefit from reducing unwanted variability as well as bias. This will further unlock the potential contribution of the Clificol project to improving homeopathy.

Introduction

The COVID-19 pandemic has provided an unprecedented challenge to conventional medicine as well as homeopathic practitioners. Official estimates put the global death toll from COVID at over 6 million people (https://www.worldometers.info/coronavirus), although the true toll is likely to be closer to triple that number, when we add up deaths not directly attributable to the virus.¹

Homeopathy has a long history of use in epidemic disease,^2–6 and the COVID-19 pandemic has led to a sharp increase in demand for homeopathy as an adjunctive treatment. This is also borne out by multiple publications of surveys,^7–9 as well as various research projects and initiatives.^10–13

The foundations for the Clificol clinical case registry were laid in the 1990s, and in the first stage of the development it was available as an off-line software platform. The second stage in the development of the Clificol clinical case registry involved taking it online (https://www.clificol.net), and the Clificol COVID-19 support project was officially launched for the global homeopathic community on a cloud-based server on May 11, 2020.

The platform is free-to-access for homeopathic practitioners, who are encouraged to share their cases and experiences, and currently 197 professional associations are supporting the project.

Initial experiences with the Clificol platform were published^14,15 as well as a more detailed analysis of the Chinese data.¹⁶ The latter analysis identified the common presence of two distinct symptom clusters that were strongly associated with the homeopathic remedies Gelsemium sempervirens and Bryonia alba. The identification of these two remedies in the context of the treatment of an epidemic disease provided some evidence for the homeopathic concept of a “genus epidemicus,”¹⁷ as introduced by the founder of homeopathy, Samuel Hahnemann, based on his experiences with the use of Belladonna in a scarlet fever epidemic in 1799.¹⁸

The analyses of the Chinese data suggested that there is more than one “Genus Epidemicus” remedy for patients with COVID-19 during the first wave. In this paper, we explore the Genus Epidemicus question in data from other parts of the world, and we present descriptive analyses of the entire clinical case registry.

IRB waiver statement

Because this was a routine practice-based case-registry project, and therefore not a research project with the aim of answering any medical research question, the Bern Kanton Ethics Committee in Switzerland waived the need for ethics approval.

Materials and Methods

Retrospective analysis of prospectively collected COVID-19 clinical case data.

Acute COVID-19 cases, treated between January 10, 2020 and October 31, 2021, were eligible. Cases from the later Omicron wave were, therefore, excluded. Eligible patients could have a confirmed COVID-19 diagnosis (positive PCR, Antibody test or Rapid Antigen test), or a suspected COVID-19 diagnosis, based on the patient having one, or more of the following symptoms: cough, sneezing, fever, dyspnea, altered smell or taste, or they are traveling from outbreak area, or they are health care personnel.

Demographic characteristics such as age and sex were recorded, as well as, if available, the following COVID specific baseline data: Date when symptoms started; results of any PCR and/or antibody tests, computed tomography status, and need for oxygen and/or ICU care if hospitalized.

The data were entered into the Clificol database, which is a cloud-based, General Data Protection Regulation (GDPR) / Health Insurance Portability and Accountability Act (HIPAA) compliant international Clinical Case Registry (https://www.clificol.net).

Participating practitioners could enter the patients' symptoms as they were used to inform the remedy selection process, either as free text, or in the form of so-called repertory-rubrics, or (only in China) aided by a symptom questionnaire. The analysis team downloaded the data periodically from the platform. Any data-related queries were fed back to the concerned practitioners as appropriate. The analysis team checked that all cases had linked consultation(s) data.

We defined a “prescription episode” by grouping together a given consultation where a remedy was prescribed with any subsequent consultations in which the prescribed remedy remained unchanged. This enabled us to assess the evolution of the patient until a change in prescription and/or dismissal of the patient. Each case could, therefore, contain more than one prescription episodes.

Outcome was assessed by the treating homeopath on the Outcome Related to Impact on Daily Living (ORIDL) scale,¹⁹ which is a nine-item ordinal outcome scale ranging from “Disastrous deterioration” (−4) to “Cured/Back to normal” (+4). The speed of disease resolution was assessed by inspecting the time course of the ORIDL score in relation to the duration of COVID symptoms before the first administration of the remedy.

A rapid disease resolution was defined as an ORIDL score ≥3 (major improvement) on day 3 after initiating homeopathic treatment with no relapse or new prescription on or before day 7. This enabled us to determine which cases recovered relatively faster when prescribed a given remedy.

The remedy selection process in homeopathy was based primarily on the expression of both specific, as well as more general, acute COVID-19 related symptoms in each patient. During the decision-making process, the symptoms deemed most relevant could be converted by the homeopath into so called “symptom rubrics” and entered into “repertorisation” software, with the objective of identifying the specific homeopathic remedy that best matched the patient's symptom picture. While homeopaths could enter any symptom in the form of “free text,” the “symptom rubrics” were the most useful “standardized” bits of information used for analytical purposes.

Apart from conducting various descriptive analyses, we analyzed whether a distinct symptom picture, or symptom pictures, could be identified based on analysis of the symptom rubrics.

The data analysis was primarily descriptive and was conducted using Python (version 3.8, www.python.org), SPSS (version 27) and Microsoft Excel (version 16.56).

The participating homeopaths were asked, as part of their agreement on registering with the platform, to inform their patients that data collection would take place, and only register cases where consent was given. All data were fully anonymized in compliance with GDPR/HIPAA standards during uploading to the online platform.

Results

Patients

At the time of submission of this paper, there were 1735 acute COVID-19 cases in the fully GDPR and HIPAA compliant Clificol clinical case registry (https://www.clificol.net).

The recruitment and selection process of the prescription episodes and rubrics that were analyzed are given in Figure 1.

FIG. 1.

Overview of patient recruitment and prescription episode selection process.

One thousand one hundred and sixteen eligible cases with at least two consultations yielded 1606 prescription episodes, of which 977 had homeopathic rubrics available for analysis. In total, 1398 unique rubrics were used in the prescriptions, 96 of which were used in prescriptions for Chinese patients, and therefore excluded in the rubric analyses using PCA.

Some demographic and clinical characteristics of the cases are given in Table 1.

Table 1.

Main Demographic and Clinical Characteristics of the Patients, Stratified by Country

Characteristics	China (n = 359)	France (n = 57)	Germany (n = 54)	India (n = 262)	Spain (n = 54)	Switzerland (n = 61)	USA (n = 199)	Other (n = 181)	Total (n = 1227)
Age, mean [min, max]	41.1 [20, 69]	54.1 [15, 95]	48.3 [3, 85]	39.8 [4, 86]	46.7 [4, 70]	45.6 [13, 87]	40.9 [3, 86]	47.7 [2, 99]	43.1 [2, 99]
0–15, n [% of column total]^a	0 [0]	1 [2]	2 [4]	11 [4]	3 [6]	1 [2]	27 [14]	13 [7]	58 [5]
16–30	38 [11]	5 [9]	9 [17]	67 [26]	8 [15]	11 [18]	20 [10]	17 [9]	175 [14]
31–45	228 [64]	12 [21]	10 [19]	92 [35]	9 [17]	16 [26]	73 [37]	48 [27]	488 [40]
46–60	75 [21]	21 [37]	19 [35]	63 [24]	24 [44]	22 [36]	43 [22]	57 [31]	324 [26]
>60	18 [5]	18 [32]	14 [26]	29 [11]	10 [19]	11 [18]	36 [18]	46 [26]	182 [14]
Gender, n [%]
Female	199 [55]	42 [74]	35 [65]	85 [32]	39 [72]	39 [64]	130 [65]	110 [61]	679 [55]
Male	160 [45]	15 [26]	19 [35]	177 [68]	15 [28]	22 [36]	69 [35]	71 [39]	548 [45]
Duration of symptoms, n [%]
<2 days	0 [0]	8 [14]	3 [6]	117 [44]	25 [46]	10 [16]	45 [23]	41 [22]	249 [20]
2–6 days	10 [3]	35 [61]	15 [28]	100 [38]	16 [30]	32 [52]	88 [44]	19 [38]	366 [30]
7–9 days	35 [10]	5 [9]	9 [17]	22 [8]	8 [15]	7 [11]	21 [11]	18 [10]	125 [10]
10–14 days	67 [19]	5 [9]	10 [19]	16 [6]	3 [6]	5 [8]	17 [9]	19 [10]	142 [12]
15–30 days	159 [44]	2 [4]	11 [20]	7 [3]	2 [4]	4 [7]	14 [7]	21 [12]	220 [18]
>30 days	88 [25]	1 [2]	2 [4]	0 [0]	0 [0]	2 [3]	13 [7]	9 [5]	115 [9]
Accuracy diagnosis, n [%]
PCR/Ab/Ag confirmed	349 [97]	8 [14]	50 [93]	224 [85]	53 [98]	34 [56]	41 [21]	59 [33]	818 [67]
Suspected	10 [3]	49 [86]	4 [7]	38 [15]	1 [2]	27 [44]	158 [79]	122 [67]	409 [33]
Severity of Covid-19, n [%]
Mild	318 [89]	51 [89]	44 [81]	192 [73]	48 [89]	57 [93]	191 [96]	125 [69]	1026 [84]
Moderate	41 [11]	5 [9]	9 [17]	27 [10]	6 [11]	2 [3]	5 [3]	31 [17]	126 [10]
Severe	0 [0]	1 [2]	1 [2]	37 [14]	0 [0]	2 [3]	2 [1]	15 [8]	58 [5]
Critical	0 [0]	0 [0]	0 [0]	6 [2]	0 [0]	0 [0]	1 [1]	10 [6]	17 [1]

Percentages were rounded to the nearest integer.

The age range of treated patients varied greatly (from 2 to 99 years), with patients in India and China being relatively younger, and patients from France being relatively older. In European countries and the United States, the majority of patients were female; by contrast, in India, the majority of patients (68%) were male. The mean duration of symptoms on first prescription was 11 days, and the median duration was 5 days (because this variable was categorical, these values are estimates). The COVID-19 diagnosis was confirmed by a laboratory test in the majority (67%) of cases.

Further between-country comparisons

The homeopathic remedies most commonly prescribed in each country are depicted in Figure 2.

FIG. 2.

Most commonly prescribed homeopathic remedies, stratified by country.

The figure indicates that there were significant between-country differences. In China, G. sempervirens (gels) was the most commonly prescribed remedy, particularly in the first wave.¹⁶ In India, Spain, and Switzerland, B. alba (bry) was most commonly prescribed. In France and the United States, Phosphorus (phos) was the most commonly prescribed remedy.

Analysis of symptoms/rubrics

The majority of the 1398 distinct unique rubrics were used only once or twice. In all the consultations taken together, a total of 3834 rubric entries were recorded, amounting to a median of 4 rubrics (mean = 5.1) per prescription episode (when rubrics were provided).

To obtain an impression of between-country variability in the use of rubrics, we analyzed the rubrics used in Bryonia prescriptions in the main contributing countries. To increase the size of the rubric categories, we grouped similar rubrics; for instance, the rubric “COUGH-MOTION aggravates” would be split into two rubrics “COUGH-COUGH IN GENERAL” and “GENERALS-MOTION-aggravates.”

The results of these analyses are depicted in Figure 3.

FIG. 3.

Prevalence of the most common bryonia rubrics, stratified by the main contributing countries.

The figure illustrates that there are large between-country differences. For instance, the well-known Bryonia symptom “aggravation from motion” is, indeed, on average the most commonly reported symptom, but the prevalence varies from >55% in Switzerland and Germany, to <5% in the United States and India. Similar contrasts are observed for the other symptoms as well.

We also conducted PCA to assess whether any symptom patterns or clusters were present in the recorded rubrics. This was described in detail in our paper reporting Chinese data.¹⁶ Contrary to the latter analyses, no meaningful patterns/clusters of symptoms could be identified (data not shown).

Treatment outcomes

The speed of recovery was dichotomized into “rapid” and “non-rapid” based on the post-treatment ORIDL scores. These findings were tabulated in relation to the duration of COVID symptoms before the remedy administration (Table 2).

Table 2.

Speed of Recovery, Stratified by the Duration of Symptoms at Treatment Initiation

Speed of recovery	1 Day (n = 264)	2 Days (n = 133)	3 Days (n = 127)	4–6 Days (n = 134)	7–9 Days (n = 119)	10–14 Days (n = 155)	15–30 Days (n = 244)	>30 Days (n = 134)	Total (n = 1310)
Rapid,^a n [% of column total]^b	166 (63%)	67 (50%)	60 (47%)	58 (43%)	76 (64%)	93 (60%)	161 (66%)	88 (66%)	769 (59%)
NON-rapid	98 (37%)	66 (50%)	67 (53%)	76 (57%)	43 (36%)	62 (40%)	83 (34%)	46 (34%)	541 (41%)

ORIDL score ≥3 (major improvement) on day 3 after initiating homeopathic treatment with no relapse or new prescription on or before day 7.

Percentages were rounded to the nearest integer.

ORIDL, Outcome Related to Impact on Daily Living.

Homeopathic treatment was most commonly initiated either at the onset of symptoms (1 day duration), or 15–30 days after the onset of symptoms. Overall, in 769 (59%) of prescription episodes, a rapid recovery was observed. The percentage of fast recovery was highest in patients who were treated shortly after the onset of symptoms, and in patients who were treated >15 days after the onset of symptoms.

Notably, the highest percentage of rapid recovery (66%) was observed in patients who had symptoms for >30 days. This suggests that homeopathy could possibly contribute to the management of persistent, post-acute, Covid-19 symptoms.

Discussion

Principal findings

This study reports on the experiences of homeopaths with the treatment of a wide range of COVID-19 patients of predominantly mild severity from multiple countries in the world. A wide range of remedies was used, with B. alba being the single, most consistently used remedy. A large number of rubrics were used in the remedy selection process, with a relatively high variability between countries.

We were unable to identify Genus Epidemicus (clusters of) symptoms. A majority of practitioners reported improvement in the patients symptoms shortly after the onset of homeopathic treatment.

Limitations

A significant minority of the COVID-19 cases were unconfirmed, which is unsurprising given that a considerable number of cases were entered during the first wave when tests were only available to a limited extent. Due to this, it cannot be ruled out that some non-COVID-19 cases were included.

A further weakness was that it took relatively long to analyze the data. As a result, we were unable to promptly feed back findings to the participating practitioners. The remedy Aspidin was often prescribed In India, but not at all in any of the other countries. It appeared that the use of this remedy was promoted by some practitioners as a more general remedy for patients with respiratory symptoms.

As a result, these prescriptions were not based on a repertorization of symptoms, introducing a selection bias in favor of a particular remedy. It is important to quickly feed back data to participating practitioners to facilitate discussion and correction during the data collection phase. We intend to improve this aspect in the future.

Between-country differences in the homeopathic remedies prescribed were significant. Some of these differences could be explained by differences in demographic characteristics as well as different COVID-19 variants being dominant to a varying extent in different countries. Also, there is likely to be variability in the symptomatic expression of COVID in different countries.²⁰

Further, some of the differences between China and the other countries could be explained by the different symptom collection methods (symptom questionnaire vs. free/unrestricted symptom selection). Apart from this, individualization of treatment in homeopathic practice is likely to be influenced by the homeopathic school in which the homeopathic practitioner was educated as well as individual practice styles.

Finally, in the absence of previous experience with the treatment of COVID-19, practitioners may have been influenced in their remedy selection by remedies that are promoted by particular homeopathic opinion leaders. While some variability between countries is natural and to be expected, we clearly observed “unwanted” variability (also referred to as “noise”), and this limited our ability to identify patterns in the data.

Strengths

This was the largest multinational collaboration on collecting experiences with the homeopathic treatment of COVID-19 patients. The project was facilitated by the urgency associated with the need to explore treatment options for COVID-19 patients. Due to the pure observational character of this study, selection bias due to non-consent of patients to the anonymized collection of their data was unlikely.

In practical terms, the project was enhanced by the decision to launch the COVID-19 Clificol patient registry module on a cloud-based platform. It enabled systematic collection and comparison of homeopathic experiences with the treatment of COVID-19 patients.

The Clificol database has the further advantage of being built as a relational database (using PostgreSQL, currently version 11.13), which enables handling large amounts of cases along with their different consultations with different associated homeopathic rubrics. Also, this enables different ways to enter, access, present, and analyze the data (e.g., as a practitioner entering cases, quick overviews for practitioners, automatic analyses, and researcher-level access). The data remain safe on servers that are regularly backed up. In this way, the data are “future-proof” and can be reused for different purposes and different projects in the future.

Limitations and strengths in relation to other studies

A variety of other studies of homeopathy in COVID-19 were conducted. These include therapeutic^21,22 as well as prophylactic^23,24 clinical trials, cohort studies,^25–28 case series^29–32 case reports,³³ and prognostic factor research.^11,12,34 Overall, the available data suggest that homeopathy can potentially make positive contributions to the management of COVID-19, which is in line with the available data on homeopathy in other epidemics.

The Clificol project is clearly not suitable for proving or confirming the effects of homeopathy. However, it can complement other studies in a synergistic way. For instance, Clinical Case registries can be used to identify potentially promising, or otherwise interesting, cases; or it can provide useful preliminary information on how to conduct prospective observational studies or clinical trials. In conclusion, the Clificol clinical case registry aims at being an important element of a homeopathic “research eco-system.”³⁵

Meaning of the study: possible implications for clinicians and researchers

A cloud-based clinical case registry such as Clificol offers an unprecedented opportunity for enhancing international collaboration in the homeopathic community. The ability to describe and compare homeopathic practice in different countries around the world in a transparent way enables the exchange of experiences as well as the ability to learn from homeopaths' collective experience.

The Clificol project further enhances the shift from “opinion-based” practice to “data-based” practice. It will enable homeopaths to tap into their collective experience. In addition, a clinical case registry, such as Clificol, makes it possible to identify cases of interest for further qualitative exploration, including in the form of clinical case reports in line with the latest reporting guidelines.³⁶ It can, therefore, facilitate synergy between quantitative and qualitative approaches.

Unanswered questions and future research

A patient registry project such as Clificol is likely to raise the awareness of unanswered questions. It is worth emphasizing that Case registries are not designed with the aim of answering research questions. On the contrary, one of the main strengths of case registries is their ability to generate questions and hypotheses,³⁵ apart from the ability to describe real-world clinical practice.

Another aspect that is emerging on the horizon is the ability to statistically detect patterns in aggregated data that would otherwise not be easily detectable by the human brain. We are, therefore, catching a first glimpse of the potential of the “big data revolution” by applying algorithmic methods and machine learning to identify common symptom patterns associated with COVID-19 infection.¹⁶

Our vision is to further expand the Clificol clinical case registry in a modular way, based on clinical indications. A module for recording experiences with the treatment of long COVID patients is already available, and further modules are under development.

We also aim at further exploring the use of multiple regression analyses to identify which symptoms are predictive of successful outcome. This work will build on prognostic factor research as developed and implemented by Rutten et al.^11,12,34 The advantage of multivariate regression analyses is that better control for confounding variables is possible, enabling more accurate and precise estimates of the prognostic value of individual symptoms for particular homeopathic remedies.

However, for these kinds of analyses, relatively large datasets are required. Aided by the Clificol and other case registry projects as well as cloud-based technology, the latter has become more practically feasible.

In addition to this, it is increasingly recognized that decision making and the symptom selection process in homeopathy can be affected by various biases, and this is also beginning to be explored in the context of the treatment of COVID-19 patients.³⁷

Conclusions

Footnotes

Acknowledgments

The completion of this case registry project would not have been possible without the contributions and support of the national coordinators, governance committee and scientific committee. We would like to thank Hélène Renoux, Stefanie Jahn, Abhishek Joshi, Farokh Master, Raj Manchanda, Marc Lluís Clapers, Gisela Etter, Alastair Gray, Jennifer Jacobs, Elizabeth Rice, Sandy Yiu, Joanne Lee, and Chailyn Chow for their invaluable input and support throughout the research process. And we would like to extend our sincere thanks to Mr. Su Sam Leung who generously shared his insights with us.

Authors' Contributions

A.T.: conceptualization, methodology, formal analysis, writing-review and editing, and visualization. Y.F.: conceptualization, methodology, formal analysis, writing-review and editing, visualization, and project-administration. R.v.H.: conceptualization, methodology, formal analysis, writing-original draft, and writing-review and editing. A.T.: conceptualization, methodology, writing-review and editing, visualization, and project-administration. All authors agree to the contents of the manuscript.

Author Disclosure Statement

No competing financial interests exist.

Funding Information

No funding was received for this article.

Abbreviations Used

References

Wang

, Paulson

, Pease

, et al. Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 2020–2021. Lancet, 2022; 399(10334):1513–1536; doi: 10.1016/S0140-6736(21)02796-3

Malan

. Belladonna versus scarlatina. Lancet, 1848; 52(1307):330.

Leary

. Cholera and homœopathy in the nineteenth century. Br Hom J, 1987; 76:190–194.

Jahn

. Homeopathy in the 1918 influenza pandemic. Am J Hom Med, 2015; 108:160–170.

Bracho

, Varela

, Fernandez

, et al. Large-scale application of highly-diluted bacteria for Leptospirosis epidemic control. Homeopathy, 2010; 99:156–166.

Nayak

, Chadha

, Jain

, et al. Effect of adjuvant homeopathy with usual care in management of thrombocytopenia due to dengue: A comparative cohort study. Homeopathy, 2019; 108:150–157.

Devos

, Serneels

, et al. Survey COVID-19 first peak 2020—Viewpoint of Belgian homeopathic medical doctors. Int J High Dilution Res, 2021; 20:51–74; ISSN 1982-6206

Devos

, Van Wassenhoven

, Serneels

, et al. Survey COVID-19 first peak 2020. Int J High Dilution Res, 2021; 20:05–05; ISSN 1982-6206

Rao

, Kaur

, Peters

, et al. Pandemic response in pluralistic health systems: A cross-sectional study of COVID-19 knowledge and practices among informal and formal primary care providers in Bihar, India. BMJ Open, 2021; 11:e047334; doi: 10.1136/bmjopen-2020-047334

10.

Varanasi

, Nayak

, Khurana

. Clinical repurposing of medicines is intrinsic to homeopathy: Research initiatives on COVID-19 in India. Homeopathy, 2021; 110:198–205.

11.

Rutten

, Smedley

, Ives

, et al. Data Collection during the COVID-19 pandemic: Learning from experience, resulting in a Bayesian Repertory. Homeopathy, 2021; 110:94–101.

12.

Manchanda

, Miglani

, Gupta

, et al. Homeopathic remedies in COVID-19: Prognostic factor research. Homeopathy, 2021; 110:160–167.

13.

Adler

, Adler

, Hotta

, et al. Homeopathy for Covid-19 in Primary Care: A structured summary of a study protocol for a randomized controlled trial. Trials, 2021; 22:109; doi: 10.1186/s13063-021-05071-5

14.

KLA

, Fok

YYY

. Updates from China: Clinical and research experience of homeopathy in the pandemic. Int J High Dilution Res, 2021; 20(1):08–08; ISSN 1982-6206

15.

Tournier

, Fok

YYY

. Preliminary analysis of the Clificol COVID-19 support project. Int J High Dilution Res, 2021; 20:06–07; ISSN 1982-6206

16.

Tournier

, Fok

, van Haselen

, et al. Searching for the Genus Epidemicus in Chinese patients: Findings from the Clificol COVID-19 Clinical Case Registry. Homeopathy, 2023; 112(1):30–39; doi: 10.1055/s-0042-1750380

17.

Jacobs

. Homeopathic prevention and management of epidemic diseases. Homeopathy, 2018; 107:157–160; doi: 10.1055/s-0038-1649487

18.

Seiler

HP.

The Development of Samuel Hahnemann's Practice as a Physician [Die Entwicklung von Smeul Hahnemanns ärztlicher Praxis]. Haug Verlag: Heidelberg; 1988.

19.

Reilly

, Mercer

, Bikker

, et al. Outcome related to impact on daily living: Preliminary validation of the ORIDL instrument. BMC Health Serv Res, 2007; 7; doi: 10.1186/1472-6963-7-139

20.

Tournier

, Fok

, van Haselen

, et al. The symptomatic expression of infection with the Omicron variant in Chinese patients; findings from the Clificol COVID-19 clinical case registry. Qeios, 2022;10.32388/Y8F40K.3; doi: 10.32388/Y8F40K.3

21.

Nayak

, Gupta

, Chaudhary

, et al. Efficacy of individualized homeopathy as an adjunct to standard of care of COVID-19: A randomized, single-blind, placebo-controlled study. Complement Ther Clin Pract, 2022; 48:101602; doi: 10.1016/j.ctcp.2022.101602

22.

Kaur

, Kaushik

, Singh

, et al. Homoeopathy as an adjuvant to standard care in moderate and severe cases of COVID-19: A single-blind, randomized, placebo-controlled study. Homeopathy, 2022;EFirst; doi: 10.1055/s-0042-1755365

23.

Talele

, Vaidhya

, Chowdhary

, et al. Randomized double-blind, placebo-controlled feasibility study, evaluating the efficacy of homeopathic medicines in the prevention of COVID-19 in a quarantined population. Homeopathy, 2021; 111(01):049–056; doi: 10.1055/s-0041-1735235

24.

Mukherjee

, Ganguly

, Das

, et al. Homeopathic medicines used as prophylaxis in Kolkata during the COVID-19 pandemic: A community-based, cluster-randomized trial. Homeopathy, 2021; 111(02):97–104; doi: 10.1055/s-0041-1734026

25.

Jethani

, Gupta

, Wadhwani

, et al. Clinical characteristics and remedy profiles of patients with COVID-19: A retrospective cohort study. Homeopathy, 2021; 110(2):86–93; doi: 10.1055/s-0040-1718584

26.

Daruiche

PSJ

, Canoas

, Figueira

KAG

, et al. Homeopathy for COVID-19 prevention: Report of an intervention at a Brazilian Service Sector Company. Homeopathy, 2021; 111(02):105–112; doi: 10.1055/s-0041-1733972

27.

Nayak

, Nahar

, Bhalerao

, et al. Effectiveness of Arsenicum album 30C in prevention of COVID-19 in individuals residing in containment Zones of Delhi—A prospective, community-based, parallel cohort study. Homeopathy, 2022; 111(04):261–270; doi: 10.1055/s-0042-1745755

28.

Holandino

, Oliveira

, Vilhena

, et al. Homeopathy and the COVID-19 pandemic: quasi-experimental observational study. Int J High Dilution Res, 2021; 20:09–10; ISSN 1982-6206

29.

Michael

, Michael

, Gernot

, et al. Adjunctive homeopathic treatment of hospitalized COVID-19 patients (COVIHOM): A retrospective case series. Complement Ther Clin Pract, 2021; 44; doi: 10.1016/j.ctcp.2021.101415

30.

Clapers

, Velat

, Clapers

, et al. Analysis of homeopathic Genus Epidemicus for COVID-19 patients in Spain. Homeopathy, 2021; doi: 10.1055/s-0041-1727204

31.

Laville

. Retrospective descriptive study of a cohort of 16 patients with suspected COVID-19 [in French]. La Revue d'Homéopathie, 2021; 12:22–30.

32.

Takacs

, Frass

, Walder

, et al. Adjunctive homeopathic treatment of hospitalized COVID-19 patients (COVIHOM): A retrospective case series. Complement Ther Clin Pract, 2021; 44:101415; doi: 10.1016/j.ctcp.2021.101415

33.

Waisse

. Severe acute thromboinflammation: Case report of individualized homeopathic treatment. Homeopathy, 2021; 110(02):132–136; doi: 10.1055/s-0040-1721064

34.

Rutten

, Miglani

, Gold

, et al. Generalizability of homeopathic prognostic factor research outcome in COVID-19 treatment: Comparison of data. Homeopathy, 2021; 111(03):157–163; doi: 10.1055/s-0041-1732307

35.

van Haselen

. Collecting experiences related to the homeopathic adjuvant treatment of Covid-19 (Erfahrungen sammeln in Bezug auf die homöopathische Begleittherapie bei Covid-19). Allgemeine Homöopatische Zeitung, 2021; 266:4–7.

36.

van Haselen

. Homeopathic clinical case reports: Development of a supplement (HOM-CASE) to the CARE clinical case reporting guideline. Complement Ther Med, 2016; 25:78–85; doi: 10.1016/j.ctim.2015.12.019

37.

Manchanda

, Miglani

, Chakraborty

, et al. Impact of bias in data collection of COVID-19 cases. Homeopathy, 2022; 111(1):57–65.

Homeopathic Treatment of COVID-19 Patients: Findings of the Clificol International Clinical Case Registry

Abstract

Introduction:

Materials and Methods:

Results:

Conclusions:

Introduction

IRB waiver statement

Materials and Methods

Results

Patients

Further between-country comparisons

Analysis of symptoms/rubrics

Treatment outcomes

Discussion

Principal findings

Limitations

Strengths

Limitations and strengths in relation to other studies

Meaning of the study: possible implications for clinicians and researchers

Unanswered questions and future research

Conclusions

Footnotes

Acknowledgments

Authors' Contributions

Author Disclosure Statement

Funding Information

Abbreviations Used

References