Four Cases of Post Coronavirus Disease 2019 Condition, in Which the Patients Suffered from a Severe Sense of Fatigue Successfully Treated with Warming-tonifying Therapy Using Bukuryoshigyakuto

Abstract

We report four cases of post coronavirus disease 2019 (COVID-19) condition in which the patients suffered from a severe sense of fatigue that was successfully treated with warming-tonifying therapy using bukuryoshigyakuto, allowing them to return to normal social life. All four patients were unable to engage in social or school activities and had difficulty performing daily living tasks. Initially, they were treated with Kampo formulas corresponding to the yang pattern, which proved ineffective. However, their sense of fatigue was relieved after starting bukuryosigyakuto. Case 1 (36-year-old man) was a latent yin-deficiency pattern, in which an electro-acupuncture test revealed his interior cold. In Case 2 (53-year-old man), Case 3 (17-year-old woman) and Case 4 (11-year-old boy), the administration of bukuryoshigyakuto was based on the presence of severe sense of fatigue, characterized by the need to lie down almost all day and worsening symptoms after walking several dozen meters or taking a bath. There have been some case reports of tonifying therapies being effective in treating post COVID-19 conditions which are considered examples of qi deficiency or qi and blood deficiency following acute infectious disease. Kampo therapy with warming-tonifying formulas may be useful for post COVID-19 conditions that correspond to a late yin stage pattern in the six stage classification, particularly those presenting with severe sense of fatigue.