An Auricular Marker for COVID-19 Nadia Volf, MD, PhD,1 Valery Salques, MD,1 and Anne Lassaux, MD2 T
1 This situation happened to our team in the scientific acupuncture department of the Paris Xl Universite, France, during the current COVID-19 pandemic. During March of 2020, we received a call from the chief of the intensive care unit of the Saint Antoine Paris Hopital inquiring if acupuncture might help reduce the dosage of sedative drugs necessary for mechanical ventilation of patients with severe forms of COVID-19. In fact, the strong oxidative shock caused by COVID-19, modifies the sensitivity of the central nervous system through the overactivation of the sympathetic nervous system. As a result, high doses of sedative drugs, such as curare, do not produce the complete sedation necessary for intubation of these patients. Published articles suggest that stimulation of auricular points might result in reduction of medications necessary for induction of the anesthesia.2–5 We needed to research and find a specific ear point corresponding to COVID-19. To assist with this task, we demonstrated in previous research that auricular causative diagnosis (ACD) is an objective tool that allows one to visualize the status of all organs, provides a functional diagnosis, and shows the origin of the pathology. The auricular causative treatment, based on the ACD, substantially increases the efficiency of auricular therapy and immediately reduces patient suffering.6 Thus, it was imperative to search for a specific auricular visual marker (AVM) in patients with COVID-19. From April to June 2020, our team cared for 34 patients with severe COVID-19, in the intensive care unit. All of these patients had similar AVMs located in the same areas of their external ears; this AVM was absent in healthy volunteers and in patients with other medical conditions. See Figure 1 comparing a normal ear to the ear of a patient with COVID-19. We observed that the entire area between the tragus and the ascending branch of the helix was involved in all of the patients who had COVID-19. An edema completely deformed the shape of the tragus, supratragus notch, and ascending branch of the helix. In more-severe clinical COVID-19 cases, the edema involving the superior tragus was more pronounced, deforming and encompassing larger areas of the tragus, the ascending branch of the helix, and completely covering the supratragus notch. This particular AVM suggests its specific correlation with COVID19. The changes appeared to be reversible; progressively diminishing and finally disappearing with each patient’s recovery. The AVM corresponded to the auricular area known as the Interferon point (Fig. 2). This point has been reported to improve immune defenses related to viral infections, especially for children, helping reduce fever and FIG. 1. Left: Ear of patient with COVID-19. Right: Ear of healthy patient. 1 Scientific Acupuncture Department, Paris XI Universite, France. 2 Anti-Pain Unit, Hopital Rothschild, Paris, France. MEDICAL ACUPUNCTURE Volume 32, Number 4, 2020 # Mary Ann Liebert, Inc. DOI: 10.1089/acu.2020.29151.vlf 174 Downloaded by 22.214.171.124 from www.liebertpub.com at 12/09/20. For personal use only. diarrhea.7–9 Stimulation of this AVM area appeared to accelerate remission of the clinical course in patients with COVID-19, reducing the need for mechanical ventilation and facilitating more-rapid extubation, resulting in a return to normal breathing. Nevertheless, controlled clinical trials and further research are needed to support our observations and substantiate the usefulness of this ear point.