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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 4  |  Page : 152-158

Preventive potential of meditation in COVID-19 by increasing immunity through positive change in mental attitude


1 Department of Swasthvritta and Yoga, R.G.G.P.G. Ayurvedic College and Hospital, Paprola, Kangra, Himachal Pradesh, India
2 MO, PHC Pandol, Mandi, Himachal Pradesh, India

Date of Submission11-Aug-2020
Date of Decision01-Oct-2020
Date of Acceptance03-Oct-2020
Date of Web Publication28-Dec-2020

Correspondence Address:
Shalini Thakur
Department of Swasthvritta and Yoga, R.G.G.P.G. Ayurvedic College and Hospital, Kangra, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_176_20

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  Abstract 


Objective: COVID-19 is deadliest pandemic gripping gripping the whole globe. Despite of best researches, there is no sure treatment module till now. The cure of the disease lies in the immunity of individuals. Also the attitude of the healthy persons to follow guidelines plays a key role in prevention. Positive minded persons follow guidelines more precisely & less liable to be stressed, easily curable & more resilient. This is the need of hour in COVID Pandemic, we need people who strengthen their immunity and follow the preventive measures with positivity, optimism and hope. So basically we need to keep our attitude positive. Data Source: Ayurvedic and Yogic texts, internet. Review Method: A study was taken as base which was conducted on 20 apparently healthy volunteers to assess the effect of meditation on Agya Chakra to see its transformational efficacy in increment in positivity of Mental Attitude. For this, volunteers were selected randomly and to measure their attitude, LIKERT SCALE was framed and evaluation of attitude was done before and after meditation trial of 21 days. Result: After statistical analysis, this meditation practice was found highly significant in changing the human attitude and increasing its positivity. Conclusion: This result is quite encouraging after such a short duration of trial and may be a landmark in boosting health and immunity in COVID times. It is a nondrug therapy, can be done individually in solace of lockdown, advisable for masses requiring no vigorous training as indicated by the fact that all volunteers in trial were novice.

Keywords: Attitude change, COVID-19, immunity and positivity, Likert scale, meditation


How to cite this article:
Thakur S, Guleria A. Preventive potential of meditation in COVID-19 by increasing immunity through positive change in mental attitude. J Ayurveda 2020;14:152-8

How to cite this URL:
Thakur S, Guleria A. Preventive potential of meditation in COVID-19 by increasing immunity through positive change in mental attitude. J Ayurveda [serial online] 2020 [cited 2021 Jan 25];14:152-8. Available from: http://www.journayu.in/text.asp?2020/14/4/152/304899




  Introduction Top


The COVID-19[1] pandemic or coronavirus pandemic is caused by severe acute respiratory syndrome-coronavirus-2 (SARSCoV2). As on August 15, 2020, more than 21.1 million cases of COVID19 have been reported in more than 188 countries and territories, resulting in more than 764,000 deaths; more than 13.2 million people have been recovered.

COVID19 spreads primarily when people are in close contact, that is, when a person inhales small infected droplets from an infected person, touches a contaminated surface, and then touches his/her face. Sputum and saliva carry large amounts of virus. Although COVID19 is not a sexually transmitted infection, direct contact such as kissing, intimate contact, and fecal–oral routes are suspected to transmit the virus. The virus may occur in breast milk, but whether it is transmittable to the baby is unknown.

The usual incubation period ranges from 1 to 14 days, and is most commonly 5 days. Some infected people have no symptoms, known as asymptomatic.


  Signs and Symptoms Top
[2]




  Viral Testing Top


The standard test employed in the detection of SARS-CoV-2 is RNA testing of respiratory secretions collected by using a nasopharyngeal swab, although it is possible to test other samples. This test uses real-time reverse transcription-polymerase chain reaction, which detects the presence of viral RNA fragments.

A number of laboratories have developed serological tests, which detect antibodies produced by the body in response to the infection.


  Treatment Top






  • Antiviral medications are under investigation for COVID-19, though none of them have yet been shown to be clearly effective on mortality in published randomized controlled trials
  • Hence, “prevention is better than cure” suits here. Strategies for preventing transmission of the disease include:


    • Maintaining overall good personal hygiene
    • Washing hands
    • Avoiding touching the eyes, nose, or mouth with unwashed hands
    • Coughing or sneezing into a tissue and putting the tissue directly into a waste container
    • Those who may or may not be infected by the infection are advised to wear a surgical mask in public
    • Physical-distancing measures are also recommended to prevent transmission
    • Health-care providers taking care of someone who is infected are recommended to use standard precautions, contact precautions, and eye protection measures.




Apart from these, immunity plays a key role in prevention and recovery from disease. Immunity is the body's capacity to fight any disease and protection, which works through the immune system.

The immune system[3] is a host defense system comprising many biological structures and processes within an organism that protect against disease. To function properly, an immune system must detect a wide variety of agents, known as pathogens, from viruses to parasitic worms, and distinguish them from the organism's own healthy tissue. In many species, there are two major subsystems of the immune system: the innate immune system and the adaptive immune system. Both subsystems use humoral immunity and cell-mediated immunity to perform their functions. In humans, the blood–brain barrier, blood–cerebrospinal fluid barrier, and similar fluid–brain barriers separate the peripheral immune system from the neuroimmune system, which protects the brain.

Pathogens by rapidly evolving and adapting avoid detection and neutralization by the immune system; however, multiple defense mechanisms such as phagocytosis, antimicrobial peptides called defensins, and the complement system have also evolved to recognize and neutralize pathogens. Humans have even more sophisticated defense mechanisms including the ability to adapt over time to recognize specific pathogens more efficiently. Adaptive (or acquired) immunity creates immunological memory after an initial response to a specific pathogen, leading to an enhanced response to subsequent encounters with that same pathogen. This process of acquired immunity is the basis of vaccination.

Factors affecting immunity

Several factors are known to affect immunity. Before elaborating all in detail, let us discuss on stress and positivity.

Stress

Stress is the response of an individual to various stressors. The brain and the immune system are in constant communication that can be disrupted by any kind of physical or emotional stress.[4] Ongoing stress makes one susceptible to illness[5] and disease because the brain sends defense signals to the endocrine system, which then releases an array of hormones that not only get us ready for emergency situations but severely depress our immunity at the same time. The way it does this is by triggering chemical reactions and flooding the body with cortisol that, among other things, decreases inflammation, decreases white blood cells and natural killer (NK) cells (special cells that kill cancer), increases tumor development and growth, and increases the rate of infection and tissue damage. Some experts claim that stress is responsible for as much as 90% of all illnesses and diseases, including cancer and heart disease. Hence, it is important to be aware of the simple daily stresses in our lives, and some of the mind–body therapies that help reverse that are:[4]





  • Relaxation exercises: The link between the mind and body can be strengthened by meditation and guided imagery. They become a buffer that guards against the breakdown of organ systems
  • Positive thinking: Evidence shows that people who believe they are doing better actually do better than those who have the same physical condition but aren't as positive. Research also suggests that anxiety, hostility, and other negative states affect the immune system
  • Behavioral modification techniques: Changing how we act can often break habits that trigger stress reactions, and it also depends on positivity in attitude
  • Social support: According to researchers, people with strong social support have better overall health and are more resistant to infections and diseases.


Positivity in attitude

Researches show that:





  • A positive attitude or keeping positive expectations can improve your immune system and may help in living longer[6]
  • Optimism is a potential buffer of the effect of stressors on the immune system (Segerstrom, 2005)[7]
  • Optimism is a resilience factor in the face of stressful events[7]
  • Dispositional optimism or keeping positive expectations for future predicts better physical growth, better mood, and fewer psychiatric symptoms (in turn good immunity)[6]
  • Highest NK cell cytotoxicity and CD3T CD8 + are found in optimism (Byrnes et al., 1998)
  • In HIV-affected persons, optimism lowers HIV viral load.[6]


Hence, it can be concluded that:

Positive thinking or optimism is good for the immune system, which reduces anxiety and enhances positive emotions such as joy, interest, contentment, and love.





  • Joy triggers the urge to be creative and push limits
  • Contentment triggers the urge to save the present and integrate the current circumstances into new views of self and the world.


Through the assistance of positive emotions, in challenging circumstances, people with a positive attitude are more likely to take actions that build resources, healthy coping skills, and resilience.

This is the need of hour in the COVID pandemic; it is expected that people should follow preventive measures such as wearing masks, following social-distancing measures, repeated hand-washing practice, healthy diets, and lifestyles to control the spread and only people with positive attitude, optimism, and hope are more likely to follow these.

Hence, basically, we need to remain our attitude positive.

Attitude

An attitude[8] is a part of human behavior which includes a settled way of thinking or feeling about something. It involves the ideas, values, and beliefs of a person, which ultimately lead to his/her way of thinking, inclinations, and habits and finally manifest in his/her behavior. A person with negative attitude faces so many problems in all aspects of life, be it personal, professional, or social. A negative mind never yields anything positive. The only possible ray of hope is through changing negative attitudes to positive and holding and increasing their positivity. This is not easy yet possible to do, and meditation is one such method of controlling the attitude.

Maharshi Patanjali conceptualized Ashtanga Yoga and gave a concept of controlling attitudes through meditation practices, when he says,

(PatanjaliYogasutra2/11)[9]

It describes that we should control and curb the attitudes of mind through meditation because these are the attitudes which make the basis of behavior.

(Patanjali Yogasutra1/4)[9]

It refers that the behavior of people is based on their Vrittis or attitudes.

Taking this as reference, a study was conducted on twenty volunteers who were subjected to do meditation and their meditation practices were assessed based on a fixed 7-scale criteria.

Aims and objectives

The aim and objective was to evaluate the effect of meditation practices on Agya Chakra[10] in the modification of human attitude and increasing its positivity.

Plan of study

Selection of patients

In this clinical study, twenty apparently healthy volunteers attending the outpatient department of Rajiv Gandhi Government Post Graduate Ayurvedic College and Hospital, Paprola, Kangra (Himachal Pradesh), were selected on the basis of the inclusion criteria.

Selection criteria

Consent

Written and informed consent of apparently healthy volunteers was taken before inclusion in the trial.

Inclusion criteria





  1. Apparently healthy volunteers willing for taking part in the trial
  2. Those in the age group of 18–30 years irrespective of sex, race, religion, and socio-economic status
  3. Those who were willing to provide written consent before inclusion in the trial.


Exclusion criteria





  1. Volunteers not willing for taking part in the trial
  2. Volunteers aged below 18 and above 30 years
  3. Volunteers having any associated chronic ailments such as diabetes mellitus, cardiac disorders, renal disorders, alcoholic liver disease, Chronic hemolytic anemia, and psychiatric diseases
  4. Pregnant and lactating mothers.


Laboratory investigations

The routine hematological examination was done before the clinical trial to rule out any other pathological condition.

Blood: the investigations included hemoglobin (g%), total leukocyte count, differential leukocyte count, erythrocyte sedimentation rate, fasting blood sugar, blood urea, serum creatinine, serum uric acid, serum cholesterol, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase.

Study design





  • Prospective or retrospective – Prospective
  • Randomized or not – Randomized
  • Number of volunteers for trial – 20
  • Duration of trial – 3 weeks.


Meditation (Dhyana) and technique

(PatanjaliYogasutra3/1,2)[11],[12]

Dhyana or meditation is “sustained attention and application of mind to the chosen point.” Dhyana is contemplating on whatever Dharana or suggestion one has focused on. The stage preceding meditation is called Dharana. Dharana, which means “holding on,” is focusing and holding one's awareness to one object.

In Bhagvad Gita, it is said if at the time of death, when Prana is fixed on the glabellar region (Agya Chakra) with a stable mind, the person gets the divine Paramatma.[10]



Although it is very difficult to understand this method, it is evident that continuous practice since the early years of life will make this meditation method adoptable at the time of death, which cannot be assessed otherwise.

This is one of the very popular methods and lots of outcomes have been mentioned in ancient literature; for example, one gets free from sins and not affected by desires and bondages and life becomes blissful.[13]

(Shi.S. 5/151)[13]



Definitely, this happens due to change in the attitude of the practitioner; to analyze this effect, I have used meditation on Agya Chakra during my trial work on volunteers.

Each volunteer has practiced the given meditation technique as follows:

Technique of meditation[10]

Dharana – It is taken in two terms – thought and place.





  1. Thought taken: All the men and women of the world are mine brothers and sisters
  2. Place (Desha): Place (Desha) is Agya Chakra.


It was chosen to meditate on Agya Chakra (glabellar region) which is very popular among practitioners (in accordance to meditation on one Desha as described in Patanjali Yogasutra 3/1,2).[11],[12]

The process of meditation was divided into two parts:





  1. Focus at night: Volunteers were asked to take suggestion and meditate on their chosen Pradesha, that is, Agya Chakra with the same thought as given in Dharna at night before going to sleep
  2. Cleaning at morning: Volunteers were asked to clean their Pradesha (place where they were meditating) with the thought that “all the impurities, grossness, and heaviness are melting and going out in the form of smoke from the front” and imagine that as this process is going on, the structures behind are glowing”. This was advised to done in the morning earliest. This was a kind of active meditation.


Time of practice: 10 min morning and 10 min at night.

Follow-up: After 3 weeks (on the day of completion of individual meditative practice).

Total duration of trial: 3 weeks.

Assessment was done on the basis of grading pattern of Likert scale adopted before and after practicing the technique of meditation to assess the attitude.

Criteria for assessment of attitude

It was done on the basis of a Likert scale.[14],[15] The Likert scale is a semantic scale to measure the attitude. It consists of the following steps:





  1. Statement collection: In this, various statements are framed on all the aspects touching human lives such as self, family, education, society, learnings, and love.
  2. Direction judging: For this, a questionnaire was made of 365 questions and was distributed to the judges. Judges were selected from all the fields such as politics, administration, army, medical, Ayurveda, police, academics, engineering, students, and business community. Eminent personalities from the above-said fields were selected and they were requested personally to be the part of work and contribute as a judge. They were requested to judge the statement in terms of positive and negative.



  Questionnaire Top


Evaluation of meditation practices to modify mental attitude (judges' copy to develop the Likert scale)





  1. Life is very complicated and painful



  2. Family members, friends, and relatives are not supportive



  3. Discarding the neutral statements: After collection of questionnaires from various judges, all of them are sorted.Only direct + or – are kept. Neutral, not attempted, ambiguous, unclear statements are discarded and if one of the judges has attempted any of the questions in these terms, such questions were considered invalid from the whole compilation.
  4. Formatting the items to measure intensity: In order to measure the intensity of the statement judged, percentage of positive or negative is calculated. The percentage was calculated as:


No. of positive or negative questions ÷ total no. of valid questions ×100

After % calculation, only those statements are kept finally whose % score was 90% or above to it. In this order, the total number of questions was reduced to 134. Now, this was the Likert scale ready to be given to the volunteers under trial.

Final Likert scale questionnaire





  1. Life is very complicated and painful.



    (a) Strongly agree (b) Agree (c) Neutral (d) Disagree (e) Strongly Disagree

  2. Family members, friends, and relatives are not supportive.



    (a) Strongly agree (b) Agree (c) Neutral (d) Disagree (e) Strongly Disagree etc.------Q.134

  3. Scoring: Now, each question is given five options and each option carries a score corresponding to it in order of increasing positivity. For example, in a positive statement, the score with options are:


Strongly agree – 5, Agree – 4, Neutral – 3, Disagree – 2, Strongly disagree – 1

Now, this questionnaire was given to the volunteers before starting the meditation practice, and they were requested to attempt the questions instantly and naturally and honestly. After that, the formats were collected and data were noted down in a table as before-trial score. Then, all the volunteers were subjected to meditation practices for 21 days with duration of 10 min in the evening and morning. Again after 21 days, on the day of completion of trial, again the Likert scale questionnaire was given to them and requested to attempt simultaneously as requested before. And, all the data were noted down as after-trial score of the individuals. Along with, the difference between before- and after-trial scores was noted down.

Final assessment of results

The improvement was assessed on the basis of increment of the positive attitude score. The volunteers were assessed before and after meditation for positive inclination of attitude on the basis of scoring pattern, and percentage increment in positivity was calculated.

Statistical analysis





  • The data collected and compiled from this clinical trial were sorted out, processed further by subjecting to statistical method, that is, Wilcoxon signed-rank test
  • This test was done: On evaluation of increment in positivity of attitude after meditation process, it incorporates the after-trial and before-trial values, indicating change in attitude and increment in positivity
  • The obtained results were interpreted as highly significant at P < 0.001, moderately significant at P < 0.01, significant at P < 0.05, and insignificant at P > 0.05.



  Results Top


Presentation of data

The data collected and compiled from this clinical trial were sorted out, processed, and presented in the following sections:





  1. Demographic profile [Table 1]
  2. Effect of meditation practices [Table 2] and [Table 3].
Table 1: Demographic profile

Click here to view
Table 2: Before trial and after trial score of positivity in attitude of 20 volunteers on Likert scale

Click here to view
Table 3: Statistical analysis of change in positive inclination of attitude

Click here to view



  Discussion Top


Meditation and change in attitude

As shown in [Table 3], a highly significant effect, as indicated by P < 0.0001115 in this trial, was observed in the change of attitude after doing meditation, that is, meditation process was found to be significant for changing human attitude.





The following conclusions can be drawn from this research work:





  1. Meditation practices have shown highly significant effect on the change of attitude or increase in the positivity of attitude of volunteers. Though the time and duration of the trial was very short, still it was proved highly significant and there was a marked change in attitude in this trial. This establishes the transformational quotient of meditation on behavioral patterns
  2. In the present scenario created by the COVID pandemic, where everybody is under the constant impending danger of being infected, loosing jobs, depleted funds, isolation, lack of social activities, etc., there is every possibility of building all kinds of stress around humankind. One who is saved from outdoor infections is becoming prone to mental disorders indoors. The lockdown has not only restricted humans to their places but also increased their vulnerability of falling prey to anxiety, depression, and ultimately suicide. Definitely, there is surge in mental health-related issues during this period of COVID-induced lockdown.
  3. Nobody knows when this COVID danger ends; only positive attitude and optimism can make people survive in this grim situation. Practicing positive thinking is not easy to inculcate, but results are well-worth the efforts. Meditation is an amazing tool which can be used with positive suggestion to do so. Positivity increases the resilience and survival skills in individuals and wards off anxiety, negativity, and pessimism.


At the end, I must say it is hope which sustains life, let us unlock it……….

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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COVID-19-Pandemic. Available from: https://en.wikipedia.org/wiki. [Last edited on 2020 Nov 20].  Back to cited text no. 1
    
2.
Interim Clinical Guidelines for managements of Patients with Confirmed Coronavirus Disease(COVID-19), USCenters for Disease Control and Prevention(CDC). Archived from the original on 2 March 2020; Retrieved 19 April 2020.  Back to cited text no. 2
    
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Immune-System. Available from: https://en.wikipedia.org/wiki. [Last edited on 2020 Nov 20].  Back to cited text no. 3
    
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Andrew Goliszek-How Stress Affects the Immune System. Available from: https://www.psychologytoday.com.  Back to cited text no. 4
    
5.
McLeod SA. Stress, Illness and the Immune System. Simply Psychology; 2010. Available from: https://www.simplypsychology.org/stress-immune.html. [Last updated on 2010].  Back to cited text no. 5
    
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A Positive Boost to Immune System. Available from: https://www.uq.edu.aw>2014/09. [Last accessed on 2014 Sep 15].  Back to cited text no. 6
    
7.
Segerstrom SC. Optimism and immunity: do positive thoughts always lead to positive effects? Brain Behav Immun 2005;19:195-200.  Back to cited text no. 7
    
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Attitude (in psychology). Available from: https://en.m.wikipedia.org>wiki.attitude. [Last accessed on 2020 Oct 10].  Back to cited text no. 8
    
9.
Omanand Teerath, Patanjal Yogapradeep. 21sted. Gorakhpur: Geeta Press, Samvat; 2059.  Back to cited text no. 9
    
10.
Maharaj S. Shreemadbhagvadgeeta. 1st ed. Delhi: VishwaJagriti Prakashan; 1999.  Back to cited text no. 10
    
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Iyenger BK. The Illustrated Light on Yoga. 22nd Impressions. United Kingdom: Harper Collins Publishers Limited; 2016.  Back to cited text no. 11
    
12.
Taimini IK. The Science of Yoga. 13th reprint 2015. Chennai: The Theosophical Publishing House; 2015.  Back to cited text no. 12
    
13.
Shrivatsa. Shiv Samhita. Delhi: ChaukhambaOrientalia; 2018.  Back to cited text no. 13
    
14.
Likert Scale. Available from: https://www.surveymonkey.com>Likert.  Back to cited text no. 14
    
15.
Likert Scale. Available from: https://en.m.wikipedia.org>wiki.likert. [Last edited on 2020 Nov 14].  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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Introduction
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Treatment
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