









































Communication, Society and Media 
ISSN 2576-5388 (Print) ISSN 2576-5396 (Online) 

Vol. 3, No. 4, 2020 
www.scholink.org/ojs/index.php/csm 

97 
 

Original Paper 

N2N Parallel Therapy for COVID-19 Intervention for Effective 

Clinical Outcome, a Case Study 
Ghulam Yasin Naroo1*, Tanveer Ahmed Yadgir2 & Javeriya Khurshid3 

1 Rashid Hospital, Dubai, UAE 
2 Fatima College of Health Sciences, Al Ain, UAE 
3 Rashid Hospital Dubai 
* Ghulam Yasin Naroo1*,Rashid Hospital, Dubai, UAE 

 

Received: November 1, 2020   Accepted: November 11, 2020   Online Published: November 21, 2020 

doi:10.22158/csm.v3n4p97                       URL: http://dx.doi.org/10.22158/csm.v3n4p97 

 

Abstract 

Background: Although several therapeutic agents have been evaluated for the treatment of COVID-19, 

none has yet been shown to be effective. Large Randomized Control trials are required to see the efficacy 

of current medical treatment. 

Objective: Evaluating the role of N2N parallel therapy for adult COVID-19 patients with lower 

respiratory tract infection for early discharge from hospital or keeping in hospital for infection control 

only. 

Holistic Med provides a Complementary and Alternative medical platform together with an 

Integrative approach incorporating timely prescribed Conventional Medicine to achieve complete 

cure. 

Case History: A 57-years old emergency physician developed symptoms of high grade fever, cough, loss 

of appetite, body aches & fatigue. He tested positive for Covid-19 and was started on antiretroviral and 

antimalarial therapy as per the Dubai Health Authority (DHA) Protocol. He received the current medical 

treatment for four days without any improvement in his condition. His treatment was tailored by adding 

N2N Parallel Therapy for 72 hours followed by continuity of care. 

Results: Tailored treatment through the use of acute detox, ingestion of anti-oxidants, Intermittent 

Fasting, using micronutrients, oxygen supplement and intake of steroid during the 2nd phase of treatment. 

The results were promising which helped avert an ICU admission. Improvement in health was also seen 

in the form of better lab results and exercise tolerance while hospitalization. This therapy if applied will 

reduce ICU admissions, duration of hospital-stay and mortality rate. 

Conclusion: N2N Parallel Therapy is superior to the current medical treatment in terms of early 



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discharge of adult hospitalized COVID-19 patients with evidence of lower respiratory tract infection. 

Overall, to reduce morbidity & mortality. 

 

What is known about the topic?  

Global perspective on COVID-19 is increasing rapidly, with previous research suggesting numerous 

underlying factors. 

What does this study add? 

This case study will emphasize the role of N2N parallel therapy with the support of primary research 

(case study) and secondary research (literature review). These factors have not been previously 

synthesized in the international literature. This narrative clearly reviews and articulates the underlying 

problems as well as focuses on the parallel therapy for clinical implementation. This is a proposed 

parallel therapy that can reduce the number of days of hospitalization, thereby decreasing the overload 

of patients in the healthcare facilities, have better health outcome for the patient after he survives the 

virus by helping him recover, and most importantly, it can promise to reduce mortality rate once 

clinical data for it is made more evident through multiple clinical studies carried out at healthcare 

facilities worldwide (large clinical trials). 

What are the implications for practitioners (Both Clinician and researcher)?  

This study outlines the need for further research and clinical trials using parallel treatment for 

COVID-19 to enable the development of appropriate strategies to manage in the future for better 

clinical outcome. 

-Reduced workload 

-Reduced bed occupancy 

-Hope for better outcome for their patients in their wards 

-May result in further evidence and need for further research to know about human immunity in terms 

of response to viruses  

-Prevents focus of other important illnesses to be shifted to COVID-19, helping better global health 

outcomes 

 

1. Introduction 

1.1 Overview 

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent 

coronavirus that was first recognized in Wuhan, China, in December 2019. Genetic sequencing of the 

virus suggests that it is a beta-coronavirus closely linked to the SARS virus (26). While most people with 

COVID-19 develop only mild or uncomplicated illness, approximately 14% develop severe disease that 

requires hospitalization and oxygen support, and 5% require admission to an intensive care unit (26). As 



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of November 17, 2020, there have been more than 50 million reported cases and 1.3 million deaths 

worldwide. This novel Beta-coronavirus is similar to severe acute respiratory syndrome coronavirus 

(SARS-CoV) and Middle East Respiratory Syndrome coronavirus (MERS-CoV) (2,4). 

1.2 Objective 

The purpose of this case study is to evaluate the role of N2N parallel treatment of Nature Therapy in 

COVID-19 and determine the effective outcome of the treatment.  

 

2. Methodology-Secondary Research 

Literature Review 

The following Database was searched including MEDLINE, Literature (CINAHL), Cochrane library, 

Google Scholar and PubMed. Search strategy was perused with key terms such as “COVID-19 clinical 

outcome and management”, “use of parallel therapy for COVID-19 treatment”, “detox role in COVID-19 

treatment”, “Drug therapy for COVID-19” and “scope of alternative treatment in COVID-19”. 

Additional articles were found from the reference list of these studies. 

E.g., of PubMed Search Results (“COVID-19” [MeSH Terms] or “Pandemic” [All Fields] or “Drug 

Therapy” [All Fields]) and services [All Fields] and (“Alternative Therapy” [MeSH Terms] or 

(“COVID-19 Management” [All Fields] and “health” [All Fields]) or “Clinical outcome” [All Fields]). 

Inclusion criteria consisted of full text articles, studies conducted on COVID-19 treatment and pandemic 

relation, articles published in English language from the time period of 2019-2020. Peer reviewed 

articles were preferred.  

Search was broadened to other healthcare settings due to lack of evidence found on parallel or alternative 

treatment for COVID-19 and pandemic. The articles were then reviewed by title and abstract. Irrelevant 

articles were excluded. The method sections of the articles were reviewed and study design literature 

review were preferred. 

The initial search resulted in 308 hits. 221 were excluded due to unobtainable full text articles and some 

were irrelevant based on title and abstract. Some were repeated articles. 87 were then selected for further 

review. Upon inspection and thorough reading of the papers, 70 more excluded. Finally, only 10 articles 

remained which matched the search strategy and inclusion criteria. 

 



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Figure 1. Prisma Flow Diagram Used for Article’s Selection to Conduct Literature Review 

 

3. Case 

This section provides the details of the case in the following order: 

A 57-year old emergency physician, developed symptoms of high grade fever, mild cough, loss of 

appetite for one day. His SARS-CoV-2 PCR test results came positive. His chest X-ray showed a small 

opacity on the lower lobe of Rt. lung. After discussion with the hospital’s Infectious Team, he was started 

on antiviral and antimalarial medications as per the DHA (Dubai Health Authority) protocol. He 

continued to take current medical treatment for 2 days but his symptoms worsened and he started to have 

breathing difficulty. On the 3rd day of his treatment while he was isolated at home his respiratory rate 

was 35-40 breaths per minute with tachycardia and spikes of fever. He had general fatigue and was 

feeling very unwell. At this time, it was decided that he be admitted in the Mediclinic City Hospital. His 

baseline labs including inflammatory markers were done as well as his chest X Ray and HRCT scan were 

carried out. He continued on the same treatment although he was asked to add Azithromycin by the 

Infectious Diseases Team. His QT interval was normal on ECG, but the cardiologist of his working 

hospital (Rashid hospital) advised that it should not be added. He was given the same antiviral plus 

chloroquine treatment for the next two days in addition with oxygen by nasal cannula at 4-liter per 

minutes but there was no improvement in his health clinically.  



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On the night of his second day of admission, his condition worsened further to the point that his treating 

doctors decided to shift him to the ICU as they thought he may need ventilator support. The patient 

requested to be provided with CPAP to support his airways intermittently but was refused as it was not in 

accordance with the DHA protocol. As the patient was fearful due to the high rate of mortality of 

COVID-19’s ICU patients, he refused to be shifted to ICU and thought of adding a parallel therapy, later 

to be termed the N2N therapy. While tailoring his treatment by adding N2N Parallel Therapy to it for the 

next 72 hours and repeating lab on the following days, his inflammatory markers reduced to less than 

50% their value compared to the marker levels before the parallel therapy began. Furthermore, his NLR 

ratio dropped from 14.14 to less than 2 and clinically his condition had improved. Following this 72-hour 

time period, he started Max VO2 and did cardio along with chest expansion exercises. His health was 

improving constantly and he was able to challenge his body by increasing his cardio and sets of chest 

expansion exercises. On the last two days before his hospital discharge, he did Reverse VO2 and his body 

compliance was excellent and a final set of labs and a chest X-ray while in hospital were conducted. Then 

he went into quarantine for 14 days at a private accommodation on the sea side where he continued his 

cardio and chest exercises. His second HRCT was done in 35 days and his initial HRCT results were 

mostly reverted and he resumed his duty in the hospital as a doctor. 

Physical examination: 

Grossly within normal limits. 

Chest: No added sounds 

Heart sounds: S1+S2 

 

VITAL SIGNS: 

 

TEMPERATURE 

Dates: 5 Apr 6 Apr 7 Apr 8 Apr 9 Apr 

Temp(°C) 38.2 38 37.8 37.4 36.8 

 
OXYGEN SATURATION 

Dates: 5 Apr 6 Apr 7 Apr 8 Apr 9 Apr 10 Apr 11 Apr 

O2 by nasal 

cannula 

At 4–6 L/ 

min 

At 4–6 L/ 

min 

At4–6L/ 

min 

At 4L/min At 3L/min Intermittent 

at 3L/min 

Room air 

94% 94% and 95% 96% 96% 98% 98% 



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dropping 

further 

 

SEQUENCE OF EVENTS: 

Day 1 High grade fever, mild cough, body ache, fatigue, loss of appetite on April 1st, 2020. Corona 

RNA PCR done on April 2nd, 2020. 

Day 2 Reverse Transcription Polymerase Chain Reaction (rTPCR) positive for COVID-19 with 

high titre. 

Symptoms as Day-1 continue. 

Chest X-ray--small opacity at base of Right lung  

Self- isolate at home. 

Medical treatment-Antiretroviral(Lopinavir + Ritonavir) +Chloroquine started. + 

Paracetamol PRN 

Day 3 No improvement. Mild breathlessness and increased cough as well as symptoms as the 

previous day.  

Continue medical treatment.  

Day 4 Symptoms worsen. Started breathlessness at rest & on walking a few steps.  

RR: 35-40 HR: 100 and above. Spikes of fever.  

Admitted in hospital 

Lab and HRCT done:  

Lab shows markedly increased neutrophil / lymphocyte ratio (NLR) and other inflammatory 

markers.  

X Ray: no gross focal lesion 

HRCT Chest: There was bilateral extensive peripheral as well as sub segmental 

consolidation involving all lung lobes bilaterally especially the lower lung lobes.  

Started oxygen by nasal cannula at 4-6 liters per minute. Medical treatment continued as 

previously. 

Day 5 Continued oxygen by nasal cannula plus continuation of current medicines. No 

improvement of symptoms. Further deterioration in clinical condition with breathlessness, 

fluctuation in heart rate. Unable to sleep. Candidate for ICU.  



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Day 6-8 Continuation of current medicine. O2 by nasal cannula. 

Started N2N Parallel Therapy that includes: Acute Detox using Evian water (calculated by 

Evian formula). Antioxidant using Vitamin. C (Used oranges. each orange average equal to 

100 MG Vitamin C. It’s 2.4 gm Vitamin C on day-1, 2 gm Vitamin C on day-2 and 1.8 gm 

Vitamin C used on Day-3); Micronutrients as Zinc, Mg+ and Vitamin added.  

Day 9 Labs and X-rays done, Inflammatory markers reduced <50%. 

O2 by nasal cannula intermittent. Continue current medical treatment. 

Also continuity of care for N2N Parallel Therapy. 

Chest X ray: inhomogeneous opacities are seen in the left mid zone as well as both lower 

zones suggestive of pneumonitis 

Day 10 Started controlled aerobic exercises using Max VO2, doing cardio and core body exercises. 

Chest expansion by peak-flow.  

Improvement in general condition 

Started steroid as of phase -2: Tab. prednisolone.  

Day 11-15 Cycles of aerobic exercises using MAX VO2 continued. Chest expansion by peak-flow. 

Marked improvement in body resilience. 

Day 16-17 Cycles of exercises using Reverse VO2. 

Marked improvement in cardio. 

Day 18 Repeated lab and chest x ray: no new changes 

Discharged from Hospital. 

Day 35 Repeated Lab and HRCT chest. 

Lab is normal.  

HRCT Chest: Significant improvement of the previously bilateral pneumonitis. Only subtle 

residual changes.  

 



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Figure 2(a) Exercise and Vital Signs Comparison 

 

 



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Figure 2(b) Exercise and Vital Signs Comparison 

 



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Figure 3. Exercise Using Max VO2 & Reverse VO2 Therapy 

 

Lab Results: 

FULL BLOOD COUNT 

Dates: 5 Apr 10 Apr 14 Apr 20 Apr 

WBC (K/ul) 11.2 7.2 9.4 8.1 

Neutrophils (K/ul) 9.9 4.1 7.50 4.2 

Lymphocytes (K/ul) 0.7 1.7 1.20 3.0 

RBC (M/ul) 5.06 4.42 4.22 4.30 

Hemoglobin (g/dl) 14.8 13.1 12.6 12.9 

Hematocrit/PVC% 44.3 38.3 37.3 38.2 



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Platelets (K/ul) 190.0 391.0 519.0 326.0 

 

INFLAMMATORY MARKERS 

Dates: 5 Apr 10 Apr 14 Apr 20 Apr 

Procalcitonin (ng/ml) 0.28 0.08 0.04 0.04 

CRP(mg/L) 222.11 89.69 13.49 2.91 

Serum Ferritin (ng/ml) 2081.0 783.5 514.8 593.4 

LDH(U/L) 482 272 218 221 

D-dimer (ug/ml) 0.83 0.37 0.27 0.85 

CPK (IU/L) 1163 199 140 117 

NLR 14.14 2.41   1.4 

 

LIVER FUNCTION TEST 

Dates: 5 Apr 10 Apr 14 Apr 20 Apr 

Total Bilirubin (umol/L) 27.4 16.5 12.30 15.50 

Direct Bilirubin (umol/L) 14.5 8.5 5.20 5.30 

ALP(U/L) 187 121 106 105 

ALT(IU/L) 81 48 43 104 

AST (IU/L) 83 26 16 25 

Protein total (g/L) 79 70 68 63 

Albumin (g/L) 35 28   32 

 

 

 

 



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COAGULATION 

Dates: 5 Apr 10 Apr 20 Apr 

PT (seconds) 14.4 13.9 12.9 

APTT (seconds) 33.2     

INR 1.1 1.0 0.9 

 

RENAL FUNCTION TEST 

Dates: 5 Apr 10 Apr 14 Apr 20 Apr 

Urea (mmol/L) 2.8 3.5  68 

Creatinine (mmol/L) 70.8 71.5 67.9 69.10 

eGFR (ml/min/1.73m2) 98 98 100 99 

 

ELECTROLYTES + RANDOM GLUCOSE 

Dates: 5 Apr 10 Apr 14 Apr 20 Apr 

Sodium (mmol/L) 132 138 134 131 

Potassium (mmol/L) 3.4 4.4 4.7 4.2 

Chloride (mmol/L) 95 103  -  - 

Magnesium (mmol/L)  -  -  - 0.93 

Bicarbonate (mmol/L) 24 27  -  - 

 

CARDIAC MARKER 

Dates: 5 Apr 10 Apr 14 Apr 20 Apr 

Troponin I(ng/ml) 0.009 0.04 0.04 0.007 

 

 

 



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G6PD (ug/Hb) 

5 Apr 10 Apr 

15.1 14.3 

 

SARS-coV-2 testing 

1 Apr 5 Apr 7 Apr 13 Apr 15 Apr 17 Apr 

detected detected detected Not detected Not detected Not detected 

 

IMAGING 

Day-2: X Ray (Figure 4) finding: Small opacity at base of Right Lung: 

Day 4: X Ray: No gross active focal lung lesion seen 

Day-4: HRCT Chest (Figure 5a & 5b): There was bilateral extensive peripheral as well as sub segmental 

consolidation involving all lung lobes bilaterally especially the lower lung lobes 

Day 9: Chest X Ray (Figure 6): Inhomogeneous opacities are seen in the left mid zone as well as both 

lower zones suggestive of pneumonitis 

Day-35: HRCT Chest (Figure 7a & 7b): Significant improvement of the previously bilateral pneumonitis. 

Only subtle residual changes noted. 

 



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Figure 4. Chest X Ray Small Opacity at Base of Right Lung 

 

Figure 5(a). HRCT (chest) Bilateral Extensive Peripheral as well as Sub Segmental Consolidation 

Involving both Lungs Showing Classical Ground Glass Appearances 



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Figure 5(b). HRCT (chest) Bilateral Extensive Peripheral as well as Sub Segmental Consolidation 

Involving both Lungs Showing Classical Ground Glass Appearances 

 

Figure 6. Chest X Ray Inhomogeneous Opacities Are Seen in the Left mid Zone as well as both 

Lower Zones 



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Figure 7(a). HRCT (Chest) Significant Improvement of the previously Bilateral Pneumonitis. Only 

Subtle Residual Changes Noted 

 

Figure 7(b). HRCT (Chest) Significant Improvement of the previously Bilateral Pneumonitis. Only 

Subtle Residual Changes Noted 

 

 

 



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STEROID DOSE 

Dates: 10 

Apr 

11 

Apr 

12 

Apr 

13 

 Apr 

14 

Apr 

15 

Apr 

16  

Apr 

17  

Apr 

18  

Apr 

19 

 Apr 

20  

Apr 

21 

Apr 

Prednisolone 

At 1.2mg/kg/day-April 10-14, 

then tapering. 

60mg 

morni

ng 

40mg 

eveni

ng 

60mg 

morni

ng 

40mg 

evenin

g 

60mg 

mornin

g 

40mg 

evenin

g 

60mg 

morni

ng 

40mg 

evenin

g 

60mg 

morni

ng 

40 mg 

evenin

g 

60m

g 

50m

g 

40m

g 

30m

g 

20mg 10m

g 

0m

g 

Fasting blood glucose 

mg/dl 

          140 84 78         

 

Treatment plan: 

SARS-CoV-2 outbreak is a global dramatic pandemic that is immeasurably impacting our community. 

There are measures to be taken by which to improve the condition of patients to accelerate recovery and 

to reduce the risk of morbidity and mortality. 

A) Medications: 

1) Kaletra tablet (Lopinavir 250mg + Ritonavir 50mg): two tablets BD for 2 weeks 

2) Hydroxychloroquine (200mg) BD for 5 days  

3) Paracetamol tablet (1 gm) PRN 

N2N Parallel Therapy for becoming COVID 19-free: 

My specially devised Near to Nature (N2N). 

Holistic Medecine provides a Complementary and Alternative medical platform together with an 

Integrative approach incorporating timely prescribed Conventional Medicine to achieve complete 

cure.  

Highlights of the N2N therapy: 

Management through science: N2N (Near to Nature) parallel therapy. 

Stage 1: (infectious stage, first 72 hours): At this stage the immune system is responsible for 

eliminating virus, preventing healthy cells invasion by virus and the parallel therapy is based on science 

to improve immune response which is of importance. 

Stage 2: (inflammatory stage that starts after 72 hours). Cascade of inflammation happens especially 

in the lungs though in other organs too due to release of pro-inflammatory cytokines, interleukins(IL6,18, 

1B as well as other immune cells. 

 



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Personalized Specialized Corona Maneuver 72 

➢ Acute Detox Therapy (Evian formula). 

➢ Antioxidant mega doses. 

➢ Fasting 10-12 hours as tolerable. 

➢ Oxygen 2–3L/min by nasal cannula; improves outcome in patients with room air Sat ≥94%. 

➢ NIV: NIV (non-invasive ventilation and strictly no contaminated vapor spread) or HFNC (High Flow 

Oxygen by Nasal Cannula) intermittent first 3 days. 

➢ Plasma transfusion of patients who have recovered COVID-19, for moderate and severe Corona 

cases during the 1st 3 days of their illness. 

➢ Micronutrients for performance enhancement. 

➢ Anti-inflammatory after 72 hours if criteria are fulfilled as in Phase 2. 

➢ Max VO2 followed by Reverse VO2—after 72 hours as tolerable.  

➢ Mental well-being. 

➢ Therapy analysis by intermittent prone position of the body & by doing exercises. 

It was a multi-pronged approach that I had carefully put together to challenge my body to slay the 

COVID-19 beast. 

1) Acute Detox therapy: The main focus of this is to clean the body, keep cells healthy and get rid of 

toxins being built up in the respiratory tracts and other organs of the body owing to the replication of the 

virus that results in apoptosis of the cells and inflammatory response of the body. 

Evian formula = 2.5ml/kg/hour for 24 hours (using Evian water to clean the body) 

For example, a person of 80kg weight needs to consume 200ml per hour for 24 hours 

I drank 6 L of Evian water daily for 4 days that I later reduced in the following days. 

Evian water is a natural source of mineral water, rich in mineral contents and neutrally balanced with a 

PH value of 7.2 for the body. 

2) Mega doses of antioxidants: Antioxidants are important to protect cells against damage caused by 

SARS-CoV-2 toxins and free radicals and help in cell regeneration and build up natural immunity. I took 

Vitamin C in the natural form of oranges each day (one medium sized orange is equal to 100 mg of 

Vitamin C). I started with 2.4 gm of vitamin C on Day -1 followed by 2 gm of vitamin C on day-2 and 

then 1.8 gm of vitamin C on day-3 & 4. 

3) Low-flow Oxygen with nasal cannula (3-6L/min): There is a general perception that oxygen 

supplementation results in an improvement in outcome of patients at room air Sat ≤ 94%. I used to take 

low flow oxygen with the nasal cannula at 4-6 L/min during the first 72 hours of starting N2N therapy. 

During the next 2 days at 3 L/min intermittently. 

Max VO2: I started this while introducing exercise in the healing process during phase 2 on Day5. I 

carried out cardio exercises, core body exercises, and mild weight-bearing exercises such as planks with 



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high flow oxygen in small intervals. Measurements were taken for heart rate and oxygen saturation 

during exercise and recovery.  

Max VO2 is oxygen by nasal cannula, an oxygen supply system capable of delivering up to 100% 

humidified oxygen at a flow rate of up to 10-litre per minute used during exercise intervals and being off 

oxygen during recovery periods.  

Reverse VO2 Therapy: An oxygen supply system capable of delivering up to 100% humidified oxygen 

at a flow rate of up to 10-litre per minute by nasal cannula. This was used during the recovery period only 

while doing cardio and core body exercises at room air meanwhile checking heart rate and oxygen 

saturation by finger pulse oximeter at interval of exercise and recovery. 

4) Intermittent Fasting 

Fasting for over 12 to 14 hours has proven beneficial in detoxification as it promotes cell regeneration. I 

used to fast every night from 10 pm until 9 am but the only exception was drinking Evian water. I did it as 

part of N2N therapy for a few days. 

5) Micronutrients: 

To have a balanced diet, I used multivitamins, Vitamin D, minerals and plant-based/seed-origin Omega 3, 

6 and 9 fatty acids. I was using multivitamin (the brand name is Centrum) that included Vitamin B 

complex and zinc, magnesium and other minerals. I took a tablet Vitamin D 50,000 IU once a week. In a 

2006 study, the prophylactic and therapeutic effectiveness of Zinc-Sulphate was noted on children with 

common cold. (7) 

6) Anti-inflammatory medications: 

Phase 2 is an inflammatory phase that starts on Day 4 of starting N2N parallel therapy. 

I started taking steroids on day 5 (delayed one day as 4th day was spent in discussion with ICU 

consultants in Rashid hospital and Dubai hospital). I started Tablet. Prednisolone 100mg daily in divided 

doses of 60mg morning and 40 mg evening for 4 days. I tapered the initial dosage on day 5 after starting 

steroids to 60mg in the morning only. It was further tapered by reducing 10mg daily until the course was 

completed. 

Our treatment protocol was aimed to pre-empt the inflammatory changes that is categorized as the 

inflammatory phase of the coronavirus which follows phase 1. It helps reduce the anatomical damage to 

lungs as well as to reduce the inflammatory cascade reaction at alveolar capillary level and so to reduce 

the micro emboli formation in capillaries. 

7) NPPV 

(Noninvasive positive pressure ventilation) On the second night of hospitalization I deteriorated and 

requested for non-invasive ventilation but was not facilitated as it was not in hospital protocol for 

COVID-19 patients. I was advised to move to ICU, a bed was arranged but I was not comfortable with 

this as I had fear due to high mortality in ICU patients who are put on ventilators. Data shows reduction in 



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the need for intubation in patients who received HFNC or NPPV [20]. 

Expected outcome of the treatment plan: there was improvement in patients and symptoms, lab results, 

oxygen saturation and lung capacity was improved. The patient was able to start his cardio, chest 

expansion and core body exercises improving his physical fitness to return to his pre-COVID fitness.  

Actual outcome: The acuity of clinical condition was reduced from high to low. Patient stayed in the 

hospital for infection control only otherwise could have discharged with continuity of care at home and 

follow-up in the clinic. Further studies are needed. 

 

4. Discussion 

4.1 Secondary Research Discussion 

Several studies have suggested number of medicines as interventions, potentially effective for the 

treatment of COVID-19 (Literature Review Table 3). Most of these suggestions are based on records of 

their effects on SARS and MERS. In addition to these medications for specific treatment as well 

suggested supportive treatment for COVID-19 need to consider. The published clinical treatment 

experience, outside the few clinical trials mentioned, mostly consists of descriptive reports and case 

series from China and other countries affected early in this pandemic. Therefore, outcomes including 

case-fatality rates must be interpreted with caution given the presence of confounding and selection bias 

as well as the shifting demographics, testing, and treatment approaches. However, no clinical study has 

demonstrated the clear effects of either specific treatment or supportive treatment on COVID-19 and 

further studies are indeed required. 

 

Table 1. Literature Review for Selected Studies onTreatment and Clinical Outcomes COVID-19 

Source Study Setting & 

Country 

Sample Size 

(No. of 

Patient) 

Age, 

median 

(IQR), y 

ICU 

status/comp

lications, 

No. (%) 

Treatments, No. (%) Discharged 

alive, 

No. (%) 

Deaths, 

No. (%) 

Supportive 

Care 

Specific 

Treatment 

Huang et 

al., 

2020(10) 

Wuhan Jinyintan 

Hospital, China 

(12/16/19-1/2/20) 

41 

Hospitalized 

49 (41-58) ICU: 13 

(32); 

ARDS: 12 

(29); MI: 

5 (12); AKI: 

3 (7); shock: 

3 (7); 

secondary 

NIV/HFNC: 10 

(24); MV: 2 (5); 

ECMO: 2 (5); 

KRT: 

3 (7) 

Antivirals 

(oseltamivir): 

38 (99); 

Anti-bacterials: 

41 (100); 

corticosteroids:9 

(22) 

28 (68) 6 (15) 

  



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infection: 4 

(10) 

Patel et 

al.,  

2020 (21) 

Temple University 

Hospital  

in Philadelphia, 

Pennsylvania, 

(10/3/ 2020- 24/04/ 

2020 

445hospitali

zed only 104 

met 

inclusion 

criteria 

average age 

was 60.6 

ICU: 104 

DM:35(34) 

HTN: 46 

(45) 

CKD:15 (14) 

CVD:23 (22) 

NIV/HFNC:104 

(100) 

Intubation 37 

(36) 

Remdesivir 9(9) 

Sarilumab 40(39)  

Anakinra 12 

(11.7) 

Pulse Steroids 66 

(64.7)  

Hydroxychloroqu

ine 22 (21) 

Azithromycin 59 

(57) 

Antibiotics 76 

(73) 

 48 (47%) 15 (14.4%) 

Chen et 

al., 2020 

(3) 

Wuhan Jinyintan 

Hospital, China 

(1/1/20-1/20/20) 

99 

Hospitalized 

Mean (SD), 

55.5 

(13.1) 

ICU: 23 

(23); 

ARDS: 17 

(17); 

AKI: 3 (3); 

shock: 4 

(4); VAP: 1 

(1) 

  

NIV: 13 (13); 

MV: 4 

(4); ECMO: 3 (3); 

KRT: 9 (9) 

Antivirals 

(oseltamivir, 

ganciclovir, or 

lopinavir/ 

ritonavir): 

75 (76); 

antibacterial: 70 

(71); antifungals: 

15 (15); 

corticosteroids: 

19 

(19); IVIG: 

27 (27) 

31 (31) 11(11) 



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Wang et 

al., 

2020(27) 

Zhongnan 

Hospital, Wuhan, 

China 

(1/1/20-1/28/20) 

138 

Hospitalized 

56 (42-68) ICU: 36 

(26); 

ARDS: 27 

(20); 

MI: 10 (7.2); 

arrhythmia: 

23 

(17); AKI: 5 

(3.6); shock: 

12 (8.7) 

NIV: 15 (10.9); 

MV: 17 (12); 

ECMO: 4 (2.9); 

KRT: 2 (1.5) 

Antivirals 

(oseltamivir): 

124 (90); 

antibacterial: 

moxifloxacin: 

89 (64), 

ceftriaxone: 

34 (23), 

azithromycin: 

25 (18); 

corticosteroids: 

62 (45) 

47 (34) 6 (4.3) 

Yang et 

al., 2020 

(28) 

Wuhan Jinyintan 

Hospital, China 

(12/24/19-1/26/20) 

52 (All ICU) Mean (SD), 

59.7 

(13.3) 

ICU: 52 

(100); 

ARDS: 

35 (67); MI: 

12 (23); 

AKI: 15 

(29); 

bacterial 

infection: 

8 (15) 

NIV: 29 (56); 

MV: 22 

(42); ECMO: 6 

(12); 

KRT: 9 (17) 

Antivirals: 23 

(44); 

antibacterial: 49 

(94); 

corticosteroids: 

30 (58); IVIG: 28 

(54) 

NR 32 (62) 

Young et 

al., 

2020 (2) 

4 

Singapore(1/23/20-

2/3/20) 

18 

Hospitalized 

  

47 (31-73) ICU: 2 (11); 

ARDS: 0 

(0); 

secondary 

bacterial 

infection: (0) 

Supplemental 

oxygen: 6 (33); 

MV: 1(6) 

Antivirals 

(lopinavir/ 

ritonavir): 5 

(42); other 

antivirals or 

antibacterial: 

NR 

8 (75) 0 



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Kujawski 

et al., 

2020 (11) 

US-confirmed 

Hospitals cases 

 (1/20/20-2/5/20) 

12 (Only 7 

hospitalized) 

53 (21-68 ICU: 1 (8); 

culture-posit

ive 

secondary 

bacterial 

infection: 0 

(0) 

Supplemental 

oxygen: 4 (33) 

Antivirals 

(remdesivir): 

3 (25); 

antibacterials: 

5 (42); 

corticosteroids: 

2 (17) 

100 (100) 0 

Guan et 

al., 2020 

(8) 

National Chinese 

cases 

(12/19/19-1/29/20) 

1096 

Hospitalized 

47 (35-58) ICU: 55 (5); 

ARDS: 

37 (3.4); 

AKI: 

6 (0.5); 

shock: 12 

(1.1) 

  

Oxygen: 454 

(41); 

NIV: 56 (5); MV: 

25 (2); ECMO: 

5 (0.5); KRT: 9 

(0.8) 

Antivirals 

(oseltamivir): 393 

(36); 

antibacterials: 

637 (58); 

antifungals: 

31 (2.8); 

corticosteroids: 

204 

(19); IVIG: 144 

(13) 

55 (5) 15 (1.4) 

 

Used Abbreviations in above table: AKI, acute kidney injury; ARDS, acute respiratory distress 

syndrome; COVID-19, coronavirus disease 2019; ECMO, extracorporeal membrane oxygenation; 

HFNC, high-flow nasal cannula; ICU, intensive care unit; IQR, interquartile range; IVIG, intravenous 

immunoglobulins; MI, myocardial infarction; MV, invasive mechanical ventilation; KRT, kidney 

replacement therapy; NIV, noninvasive ventilation; NR, not reported; VAP, ventilator-associated 

pneumonia. 

4.2 Case Study Discussion 

Covid-19 continues to be a pandemic costing lives daily on the global level as it also remains a constant 

threat to Healthcare professionals' lives and those dealing with chronic illnesses and also the aged who 

have weak immunity there is a constant shift in treatment protocols on a weekly basis in countries around 

the world. This study aimed to make a difference by showcasing how a combination of other treatments 

can make a whole lot of difference in the absence of an approved therapy for COVID-19. The study was 

conducted as a personal experience of an emergency physician who was hospitalized after being 

diagnosed with covid-19. It offers a non-invasive therapy with limited to no side effects that was taken by 

this doctor through his medical experience which then resulted in immediate surprising recovery from 



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symptoms. The changes in labs and imaging at a time when his health was worsening even though he was 

on treatment as per hospital protocols. The therapy has proven its effectiveness in a short duration of time 

bringing into attention the power of the simple yet effective important factors that need to be taken into 

account as these may be the only factors that make a difference why the vaccine is waited upon for the 

treatment. This study gives a chance to doctors to give their patients more than what is being offered at 

the hospital. If replicated in large trials it may significantly reduce the number of deaths. This therapy can 

be practiced at home for mild cases. Moderate cases can be treated in non-hospital settings but provision 

of oxygen, portable monitoring facility and mobile x-ray and Lab are supportive facilities. It can help to 

reduce hospital bed occupancy so general community care isn’t compromised. Hospital admissions could 

be only for severe category patients. Parallel therapy (N2N) is based on science and is a supportive 

treatment for COVID 19 with anticipated outcome of reduced number of days of stay in hospital, reduced 

further complication, and reduced mortality rate. For that purpose, we are recommending a large study on 

this proposed N2 parallel therapy in accordance with national level guidelines. It discusses the state of the 

art based on science clearly de-marketing phase 1 and phase 2 as well as usage of various treatments such 

as acute detox, anti-oxidants, intermittent fasting, micro-nutrient and anti-inflammatory like usage of 

steroid and its timings to help anti-inflammatory effect. 

Medications like Kaletra and Hydroxychloroquine that’s considered earlier as the mainstay of treatment 

for COVID-19 patients as per Dubai Health Authority protocols have been found to have more side 

effects than benefits according to research now. Currently the above medications are not in practice and 

have been obsolete from treatment protocols for COVID-19 patients. Now I realize that usage of these 

medications by me had just a placebo effect. 

Acute detox is a milestone of cleaning the body as a result cells remain healthy, immune system works in 

a natural way and invasion of viruses into the cells is protected. Ingesting large amounts of natural 

(mountain spring water) like Evian water for natural detoxification is important. The Evian Formula is 

helpful to calculate the water needed for individual patients. The reason for suggesting Evian water is 

because according to hydrogeologists, the mountains overlooking Evian water spring, France are in an 

exceptional geological setting, where they block clouds allowing snow and rain to trickle down the 

glacial rocky that naturally filter and enrich the water with minerals in a process that takes 15 years. 

Natural source of mineral water, rich in mineral contents and neutrally balanced at 7.2 for the body (6). 

Oxidation is a process that produces free radicals which cause damage to the human body. Evian has an 

additional ability to slow down oxidation or aging process as recognized tests conducted using an 

Oxidation Reduction Potential electrode device show. Make sure an adequate urine output and precaution 

for cardiac patients. 

Antioxidants can be divided into carotenoids, phenolic compounds and vitamins. Vitamin C is a powerful 

antioxidant in its role in controlling infection and promoting wound healing especially mega doses 



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improve immunity and flu symptoms, however precaution should be taken and mega doses should not be 

continued for a longer number of days as oxalate can get deposited in the kidney and may cause renal 

failure (25). In a small study it has shown benefit, however in the large study it has not proven to be 

useful. 

A 2013 meta-analysis of 24 trials (10,708 participants) found no evidence that daily vitamin C 

supplementation prevents the common cold in the general community (risk ratio 0.97, 95% CI 0.94-1.00. 

(17). However, daily vitamin C supplementation may shorten the duration of the common cold in 

children. In meta-analysis of 14 trials (2530 cold episodes), daily vitamin C (at least 200 mg/day) by 

children shortened the duration of the common cold by 14 percent (95% CI 7.3-21 percent); no serious 

adverse effects were reported (16). 

L-Glutathione is another powerful antioxidant, a co-factor in phase-1 hepatic detoxification involved in 

synthesis of DNA and protein, amino-acid transport, enzyme activation, and immune system functioning. 

(14) It can be given along with micronutrients after checking baseline micronutrients, which is well 

recognized for its ability to clean the body and keeps cells healthy. Glutamate is a precursor of 

Glutathione. Observational evidence suggests that it may reduce respiratory infection in athletes. 

Micronutrients are the basic ammunition for the body’s immune system to generate and fight back. 

Animal origin omega 3 fatty acids should be avoided as it increases LDL cholesterol and can cause 

weight gain. Vitamin D is a secosteroid that has a wide spectrum of immunomodulatory, 

anti-inflammatory ant fibrotic, and antioxidant actions. It inhibits expressions of cytokines (IL), TNF and 

deficiency is associated with over-expression of these cytokines that propels activation of inflammatory 

cascade in the lungs It is recognized that SARS-CoV-2 binds to ACE 2 receptors in the respiratory tract 

that's the way how the virus enters host cells. Vitamin D has an immuno-modulatory effect at ACE2 

receptors and helps reduce binding hence protect cells against viral invasion (20). A majority of those 

who succumbed to COVID 19 were above the age of 65 or have Type 2 Diabetes and it is these people 

who often suffer from severe Vitamin D deficiency.) 

As for intermittent fasting, the Japanese cell biologist Yoshinori Ohsumi, who won the Nobel Prize for 

medicine in 2016, propounded the theory of Autophagy. Autophagy, meaning “cell devouring”, is the 

process in which in the absence of external sources of food, the body in order to eat, recycles its own 

damaged cells, triggering cell regeneration as new cells replace the dead cells which are recycled or is 

metabolized. (13). It is a process of cellular housekeeping and definitely helps in clearing the backlog of 

toxins. Fasting eliminates toxins from our body and is a good way to detox and reboot our system. The 

changes in metabolism: the fasting brings changes in the metabolism and slows it down putting the body 

in starvation mode. It resets the immune system providing many potential benefits (22). Valter Longo and 

his colleagues at USC found that fasting lowers white blood cell count and triggers the immune system to 

start producing new white blood cells which are healthy and combat better to defend the body.) It also 



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stimulates the liver to get rid of toxins and combats viral infections, although more studies are needed.  

Phase 2 of SARS-CoV-2 (begins after 72 hours that’s on day 4: counting day 4 with N2N parallel therapy) 

is an inflammatory phase mediated by macrophages and release of inflammatory mediators as cytokines, 

cascade of inflammation in alveoli that disrupt the alveoli-capillary membrane leading to respiratory 

distress. A delicate balance between inflammation and anti-inflammation is essential for lungs’ 

homeostasis. The classical radiological changes that appear in chest imaging ground glass appearances 

that mimic more triggered by inflammatory cascade in all cases. It is important to intervene during phase 

2 before an anatomical damage of the alveoli sacs happens. 

Finally, WHO (World Health Organization) has agreed with the role of anti-inflammatory to curb 

COVID-19. Still there is a flaw as the timing of starting anti-inflammatory during treatment has not been 

specified. Our understanding from the beginning, based on science is that anti-inflammatory has an 

important role in phase 2. I used Tab. prednisolone 100 milligram per day for four days that i then tapered 

and the results were promising. Interestingly in- hospital protocol steroids were not included for 

COVID-19 patients. I requested the medical team that it is an important treatment as part of N2N therapy 

in phase 2 of the staging and received the course of steroids and arranged this medicine from Rashid 

Hospital and completed its course. 

According to Dr. Angel Atienza in Valencia, Spain, the use of anti-inflammatory drugs started on the 6th 

day of the disease. Her research has never been explained why particularly the second phase of treatment 

starts from sixth day. We believe that phase 2 should be categorized as one that starts after 72 hours of 

N2N therapy i.e. Day 4 (not the proposed Day 6 according to Dr. Angel) on the criteria of necessary 

findings of inflammatory markers<50% when compared to day-1 after diagnosis. This should be done 

after N2N therapy of intensive detox, anti-oxidant doses, intermittent fasting, micronutrients, oxygen 

supplement, as it is then the right time to prescribe high doses of anti-inflammatory medications. Our 

treatment protocol aims to pre-empt the inflammatory changes during phase 2 to curb inflammatory 

cascade. 

The choice of medications among different anti-inflammatory drugs are steroid or Tocilizumab 

(immunosuppressant) and anakinra (anti-interleukin) and methotrexate (12). Our choice of steroid was 

tablet prednisolone 1.2 mg/kg body weight in preferably the full dose to be given in the morning hours. In 

case there are gastritis-like symptoms, PPI (proton pump inhibitor) like tablet omeprazole 40mg can be 

given. It is noted that many physicians in their practice divide steroid doses in the morning and evening. 

The fact is by doing so leads to imbalance of hormones that leads to metabolic complications such as 

iatrogenic high blood sugar. I was taking steroids in two daily divided doses until the 5th Day of my 

diagnosis when my fasting glucose results became 8.1 mmol/L. Therefore, I stopped the evening dose 

and on the next day the fasting glucose dropped to 4.3 and the following days it remained within normal 

limits as I had started taking steroids in a single morning dose. 



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Anti-inflammatory treatment at this stage potentially reduces the inflammatory response and prevents the 

progression to ARDS. For many COVID-19 patients in the critical stage, this inflammation results in 

Acute Respiratory Distress syndrome (ARDS) and eventually they cannot even survive with ventilator 

support. Also clinically the patient feels far better in terms of his chest comfort/breathing/lung 

capacity/limited mobility/response to max VO2 followed by reverse VO2 therapy during his cardio and 

other exercises. Objectively, the patient can be off oxygen for hours without desaturation at rest and 

minimal to moderate exertion.  

The studies have shown that patients with COVID-19 with mild illness with saturation ≥94% at room 

air still can benefit with supply of oxygen with nasal cannula. The reason is though room air saturation 

is normal there is a local hypoxia at alveolar capillary level. By doing this therapy it reduces the 

inflammatory process in alveoli as well as cascade of inflammatory reactions at alveolar capillary level. 

In severe COVID-19 cases where breathing is labored, and blood oxygen levels are dropping, the patients 

are first provided non-invasive ventilation through C-PAP and Bi-PAP (18). Early reports from the 

Lombardy region of Italy indicated that about 50 per cent of patients on non-invasive ventilation were 

able to avoid the use of full mechanical ventilation.  

Regular and steady exercise routine is to be introduced slowly while in hospital during phase -2. (16). 

The exercises can be as little as a 10-minute walk with oxygen support within the room, to be gradually 

increased from 10-15 to 30-45 minutes in the room both with and without oxygen support. This has to be 

supplemented with other weight-bearing exercises such as planks, side planks lasting 1 to 2 minutes 

(duration to be gradually increased) as exercises are known to have a direct impact on building the body’s 

immunity and improving lung capacity. 

As patients progress, higher amounts of oxygen are needed (19). Options at this point in COVID-19 

patients are high-flow oxygen via nasal cannula (HFNC) or the initiation of noninvasive ventilation (NIV) 

(9). Both modalities have been used variably (15). Protection of healthcare workers is paramount and full 

PPE and negative pressure rooms are warranted. In retrospective cohorts, rates for HFNC use ranged 

from 14 to 63 percent while 11 to 56 percent were treated with NIV While respiratory rate decreased with 

a relatively low exhaled tidal volume, non-invasive strategy could be working and intubation delayed. 

We also suggest starting with CPAP using the lowest effective pressures (e.g., 5 to 10 cm H2O). There is 

a risk of exposure to healthcare workers due to increased risk of aerosolization (1). The rationale of this 

approach is based on direct evidence and observation in the field as well as evidence of its efficacy to 

reduce use of ventilators with acute respiratory distress with severe to critical COVID-19 patients. 12 out 

of 15 COVID-19 patients treated with NIV and pronation (median total of two cycles, three hours) 

experienced an improvement in the peripheral oxygen saturation (20, 5). 

Categories of COVID-19 patients: 

       A) COVID-19 acute respiratory syndrome – Asymptomatic through critical. 



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       B) Stroke cases secondary to thromboembolic phenomenon related to COVID-19. 

      C) Life-threatening acute inflammatory condition potentially related to COVID 19. 

As per statistics, about 80-85 percent of the patients who are afflicted with COVID-19 recover fully. The 

virus acts differently in people with different immune systems. The stronger your immune system, the 

higher are your chances of recovering faster from it. People who are below 60, follow a physically active 

lifestyle and do not have comorbidities, tend to have stronger immune systems that helps combat the 

virus. 

i) Asymptomatic testing positive: These are usually the younger population who after being exposed to 

the virus, show no symptoms at all. The maximum impact they have is of feeling a mild discomfort and if 

they are found positive, they can easily self-quarantine at home and recover with little or no prophylactic 

medication. It is important these individuals self-isolate to prevent the community transmission of the 

virus. The only way to know how many people are asymptomatic would require a mass antibody 

screening, which once rolled out, will give an idea of the invasiveness from this virus. Eventually, as 

most virologists around the world say, when the virus spreads really wide and people develop antibodies, 

we might develop herd immunity (herd immunity is achieved usually through vaccination). But in the 

absence of vaccination as the virus spreads, it becomes less virulent in mass transmission. When a 

sufficiently large population is exposed to such a contagious virus, it develops antibodies resulting in the 

entire community being protected from a severe outbreak. 

ii) Mild: These patients manifest the illness with mild influenza-like symptoms—low-grade fever (not 

more than 37.8 C), headache, sore throat and fatigue but they do not have symptoms of breathlessness. 

These patients can take Vitamin C natural treatment such as hot water, green tea, etc., along with 

symptomatic treatment which is available over the counter, like mild painkillers. 

iii) Moderate: This marks the progression of the disease to the lower respiratory tract, affecting the 

lungs—its bronchioles and alveoli. Such patients have fever (higher than 37.8 C), a sore throat, nasal 

congestion, inflammation of the lungs, feel breathless and tend to have an increased heart rate, may suffer 

from diarrhea, vomiting, lack of appetite, lack of a sense of smell and taste. This category of people 

cannot self-isolate at home and must seek medical attention when they test positive. 

iv) Severe: This usually happens to people in advanced age, 60 and above, and those with comorbidities. 

Such cases present with fever that spikes high, body ache, severe throat and nasal congestion and 

pneumonitis. They have trouble breathing and might be taking anything from 20-40 breaths per minute. 

(A normal adult takes in about 12-18 breaths per minute.) Such patients have to be closely monitored in 

hospitals and administered antivirals and be on oxygen support. 

v) Critical: The critical cases are wherein the symptoms spiral out of control from the severe stage, with 

escalating pneumonitis that makes the patients unable to breathe independently, requiring intubation, 

along with a strict medical schedule. This category has been observed to have a higher mortality rate as 



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multiple organ failure is of a higher incidence here. 

Life-threatening acute inflammatory syndrome in children potentially related to COVID-19. Recently, 

more than 85 children in New York manifested a lethal inflammatory syndrome that may be linked to 

COVID-19 infections. More than 100 cases of this illness have emerged in at least six countries. The 

syndrome resembled the Kawasaki disease, which is an inflammatory disease of the blood vessels in 

children with rashes on the chest and abdomen and high fever, swollen hands, lymph glands and swelling 

on the mouth and lips. 

Some universal measures that can be implemented across the globe include: 

National strategic coordinated response: Reduction rate of contamination by OUR action. 

i) People trust and information sharing. 

ii) Find and isolate. 

iii) Disinfection for circuit breaking. 

 

5. Limitations 

The major limitation with our study is that it has been applied to only one case, so the results cannot be 

generalized. Further randomized clinical trials required for large sample size to develop Nature therapy 

as parallel treatment for COVID-19 intervention. 

 

6. Strengths 

Overall study has shown very surprising results, as well indicates potential to explore the individual 

items to understand nature therapy perception for utilization of parallel treatment for effective outcome in 

more depth.  

 

7. Conclusion 

The COVID-19 widely recognized global emergency, thus the role of the parallel treatment and other 

clinical trials has changed and continues to evaluate regularly. The literature, therefore, points to the 

development of extended alternative management in line with government policies and supported by 

formal clinical protocols to treat and further prevent the complication of COVID 19. The basic steps can 

be adopted by “public health education initiatives' ' in collaboration of government and public health 

organizations together to adopt health as center of care by focusing physical, mental and social 

well-being. 

We as a global community need to acknowledge that there is a need for further research in development 

of policies, procedures and collaboration for enhancement of nature therapy as a key role for managing 

not only COVID-19 though other such infectious diseases too. 

Lastly, we strongly recommend the definition of health components to be considered while treating the 



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COVID-19 as physical health, mental health and social wellbeing. 

 

8. Acknowledgements 

We thank all the healthcare workers who contribute in this study and the reviewers for their time and 

constructive feedback.  

This case study is approved by the Medical Research & Ethical Committee, Mediclinic Hospitals Dubai, 

UAE. 

 

9. Conflict of Interest 

As the authors of this study we declare that we have no conflict of interest. This work for further 

consideration for clinical trials. 

 

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Appendix 

A. Abbreviation 

BIPAP Bilevel Positive Airway Pressure 

CPAP Continuous Positive Airway Pressure 

DHA Dubai Health Authority 

N2N therapy Near to Nature Therapy 

NIV Non-Invasive Ventilation 

N2N Parallel Therapy Near to Nature Parallel Therapy 

NPPV Noninvasive positive pressure ventilation 

HFNC  High Flow oxygen by nasal cannula 

 

 

https://www.covid19treatmentguidelines.nih.gov/critical-care/oxygenation-and-ventilation/
https://www.ncbi.nlm.nih.gov/pubmed/32105632


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Author with Affiliation 

Dr Yasin Naroo 

FRCP (Glasgow), FRCP (Ireland), Assoc. FRCEM (London), MRCS (Edinburgh) A&E, 

Consultant Emergency Medicine, Rashid Hospital Trauma Centre Dubai 

Senior Lecturer Dubai Medical College 

Senior Faculty, American College of Surgeons, American Heart Association 

Yasin Naroo graduated from the Quaid-i-Azam Medical College Bahawalpur in Pakistan. He did his 

initial training in the Bahawal Victoria Hospital in Bahawalpur with Professor Tehseen Cheema, a 

renowned hand and orthopedic surgeon in Asia. Subsequently, he joined the teaching faculty at his alma 

mater and worked as a demonstrator in the Pathology & Physiology department. He then went to the 

UK to earn his MRCP from the Royal College of Physicians London. He returned to Pakistan and 

joined the Mayo Hospital Lahore that is affiliated with the King Edward Medical University, working 

with Professor Hafeez Khan, a renowned figure in medicine and cardiology in the state of Punjab in 

Pakistan. 

In 2001, Dr Naroo joined the Rashid Hospital Dubai in the Emergency Medicine department and has 

been working there to date. In his long and distinguished career with the Rashid Hospital, Dr Naroo has 

undertaken many additional responsibilities including as Team Leader, Medical Team, from December 

2002 until 2005. He has been a part of many hospital committees, including the Sterling Committee for 

Trauma Centre, to improve hospital standards. He has worked closely for the JCI accreditation and has 

played a key role in formulating and implementing medical disaster management protocols for the 

Dubai Health Authority (DHA). 

Dr. Naroo has authored many scholarly works and textbooks: Heart Miles - Beyond Pheidippides; 

Textbook of Critical Care Including Trauma & Emergency Care; The 5-Minutes Clinical Consult; 

Acute Coronary Syndrome; and Ischemic Heart Disease. He has played a leading role in regional and 

international publications such as Circulation, Global Heart Journal, US-China Medical Science, 

HKJEM, International Journal of Current Research, BMMR, Heart Views Journal and the Emirates 

Medical Journal. 

He serves on the PAROS (Pan-Asian Resuscitation Outcomes Study) executive committee to analyze 

data in Asian countries for OHCA (Out of Hospital Cardiac Arrest). He has been the recipient of a 

number of honors for his extensive research and has lectured widely on topics of emergency medicine. 

A deeply committed family man, Dr Naroo has four children, two daughters and two sons, three of 

whom are married, with his youngest son in college. A passionate sportsman all his life, Dr Naroo has 

run many marathons and is an ardent believer in health and fitness. His more than three decades of 

experience as a physician, and all his learnings in life as an individual, were put to a severe test when 

he contracted COVID-19. As he fought and vanquished the unseen enemy, he gained new perspectives 



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that changed him forever, both as a doctor and a human being. 


