Case Report: A 73-year-old suspected COVID-19 patient with severe dyspnea fully recovers after reciting nine true words from Falun Gong [version 1; peer review: awaiting peer review]

Background: The most common severe symptoms of coronavirus disease 2019 (COVID-19) are breathing difficulty and respiratory failure. Unfortunately, mortality of COVID-19 patients with severe breathing difficulties is high. Clinical finding and diagnosis: This report describes the case of a woman in her seventies, who could not taste anything except a metallic taste, had pains all over, low-grade fever, and who soon developed severe breathing difficulties in 15 days. At the time, her doctors described her as having suspected COVID-19 and advised her to self-quarantine at home. Interventions and outcomes: When the patient had her initial symptoms, her treating physician prescribed Tylenol which she took for 13 days. The patient initially felt better, but then developed severe fatigue, achiness within a week, and then severe breathing difficulties. The patient was sometimes unable to breathe and could not walk from her bed to the bathroom. She started feeling fearful of death after 15 days had lapsed. She then started to recite the nine Chinese characters "Fa-Lun Da-Fa Hao, Zhen-Shan-Ren Hao” daily. After she started reciting these nine true words (NTW) frequently and sincerely, the patient felt her lungs opened and she was able to breathe longer and deeper. Within three days of constantly reciting the NTW, her breathing returned to normal and all symptoms ceased. Conclusions: This suspected COVID-19 patient gained significant clinical benefits after sincerely reciting the nine-character true words from Falun Gong. Open Peer Review Reviewer Status AWAITING PEER REVIEW Any reports and responses or comments on the article can be found at the end of the article. Page 1 of 11 F1000Research 2021, 10:166 Last updated: 12 AUG 2021


Introduction
Coronavirus disease 2019 (COVID-19) is a severe global pandemic causing huge threats to humankind. As of February 11, 2021, over 107 million cases of COVID-19-caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-have been reported globally, including more than 2.3 million deaths since the start of the pandemic according to a world health organization (WHO) report 1 .
A severe complication of COVID-19 is acute respiratory distress syndrome (ARDS). Once ARDS occurs, patients often have difficulty breathing and this is difficult to treat, leading to high mortality. The median time from symptom onset to dyspnea can be as short as eight days 2 . For patients with acute hypoxemic respiratory failure, despite receiving oxygen therapy, mechanical ventilation support, or extracorporeal membrane oxygenation (ECMO), the mortality rate in critically ill patients has been reported as high as 49% in China 3 and 50-52% in the US 4,5 .
Since the start of the global crisis in January 2020, the Falun Gong website Minghui has reported an increasing number of Chinese reports of COVID-19 patients, who remarkably improved or completely recovered after repeatedly reciting the nine true words (NTW) from Falun Gong (FLG), a spiritual meditation practice with its roots in Buddhist and Taoist philosophies 6,7 . The NTW refers to nine Chinese characters: "Fa-Lun Da-Fa Hao" and "Zhen-Shan-Ren Hao" (法輪大法好, 真善忍好) (see extended data for Chinese pronunciation 8 ). In English, the two Chinese expressions mean, "Falun Dafa is great" and "Truthfulness-Compassion-Forbearance is good", respectively.
We report here a suspected COVID-19 patient in her seventies with severe symptoms, and who surprisingly recovered after sincerely reciting the NTW. This is the first medical report on the effect of reciting the NTW for a suspected COVID-19 case.

Case report
This is the case of a 73-year-old Jewish-American woman, living in New York, United States. The patient sent researchers a copy of her medical records that explained her past physical condition and medical history. This included the following information: in April 2019, she had dyspnea on exertion and chest pain. She had a left and right coronary angiography and was diagnosed as having less than 70% stenosis, and hypercontractile global left ventricular function. Her nuclear stress test reported as normal. She was diagnosed with coronary atherosclerosis and coronary artery disease. The patient was put on atorvastatin (20mg) orally once per day and acetoxybenzoic acid (81 mg) orally once per day which she has taken daily since then. Her dyspnea on exertion resolved within one month and did not recur.
Before this, the patient had a history of several other conditions: in 2007, she had a malignant neoplasm of the colon, for which she received surgery and chemotherapy; in 2009 a colorectal cancer gene MYH G382D mutation was tested positive; in 1994 she had an umbilical hernia; and in 1978, she had a noncancerous thyroid nodule and received hemithyroidectomy. Additionally, the patient had a closed fracture of the foot in 2013, lower back pain from 2011 to present, restless leg syndrome diagnosed in 2018, cataract surgery in both eyes in 2019, and malaise and fatigue in 2019. Her body mass index was 24.7 to 25.6 before 2020. Figure 1 shows the patient's timeline of symptoms. In mid-March 2020, the patient's brother and his family went to stay in their home nearby hers to avoid the COVID-19 epidemic in New York City and she visited them often. Then, on March 25, she found that she could not taste anything except a metallic taste in her mouth. Upon experiencing the loss of taste, she had an urge for sweets to remove the metallic taste, which lasted two to three weeks. Then her craving for sweets changed to savory foods. Two days later, on March 27, her whole body was achy, and she could not get out of bed. She did not have a cough but had a low-grade fever.
On March 28, 2020, she went to an urgent care center in Southampton, New York. Her antigen test of the influenza virus was negative. She was suspected to have COVID-19 though did not receive a test at the peak of her symptoms. The doctor told her to self-quarantine and to take 6-8 grams of Tylenol orally per day for 13 days from Mar 28 to Apr 9. She felt better as her symptoms seemed to improve.
But on April 6, 2020, the patient had severe fatigue and achiness again. She also experienced shortness of breath. Four days later, on April 10, the patient had a video consultation with her doctor. She reported shortness of breath but without chest pain on exertion, dizziness, leg edema, or palpitations. She also reported a decline in energy level and that she was not feeling well. At the time, she had a normal sense of smell. She reported no ear symptoms, nasal or sinus symptoms, hoarseness or voice change. Her doctor diagnosed her again as a suspected COVID-19 case. Following the doctor's advice, she quarantined at home, stopped Tylenol, and started Ibuprofen 400 mg three times a day for seven days, but she gradually developed severe breathing difficulties. Sometimes she was unable to breathe and felt the fear of death. She said: "That kind of fear is huge because you are alone and there are no relatives next to you. I was thinking, if I cannot catch my breath in the next few minutes, I couldn't call anyone to take me to the hospital because I was afraid that they might also be infected. The fear of being infected to their loved ones is extremely tortuous." She felt her chest was heavily congested but did not have any sputum. She could not even walk from her bed to the bathroom. She said, "This virus isolates people from the world and makes people feel the fear of loneliness. You must deal with this disease alone. No one can help you." From March 28 to April 11, she lost about five to 10 pounds of her body weight, down to 130 pounds.
The patient stated that on April 15, 2020, her friend contacted her and told her to recite the NTW: "Fa-Lun Da-Fa Hao, Zhen-Shan-Ren Hao" from Falun Gong spiritual meditation practice. The words mean "Falun Dafa is good" and "truthfulness, compassion, and forbearance is good".
The following are some comments from the patient about her experience reciting the NTW: "I'm Jewish and I believe in authentic Judaism. I do not know what these words mean. But I felt that I'd better say it accurately so that I can connect with God." When she recited the mantra word-by-word, she found her condition rapidly improved. "My lungs opened. I can inhale longer and deeper," she said. "No matter who created this mantra, it really helps people to breathe correctly." She continued, "I started saying the mantra slowly because I wasn't sure if I was pronouncing the words correctly since my prayers in Hebrew must be exact." So, she respectfully and sincerely recited the Falun Gong words and found that she was able to inhale deeper into her chest. "I think the mantra chanting triggers a healing process that enhances the intake of oxygen and air into my chest," she added.
The patient recited the NTW many times a day, whenever she had difficulties breathing, at roughly every hour during the day. Each recitation lasted for about 5-10 times. In the beginning she was saying the mantra very frequently. She quickly realized that oxygen was getting into her lungs when she was saying the mantra and it was clearing congestion that was solidified in her chest. Upon realizing that the mantra was clearing her chest, she started repeating the mantra more often to quicken the recovery. After three days of reciting the NTW in this manner, the patient was already able to breathe normally. Once her chest was cleared, she recited the mantra less often. She stated that she would recite the NTW before she fell asleep or if she woke up in the middle of the night, and this has become a habit every night. On April 24, she felt no fatigue or weakness anymore, and felt like a normal person.
In early May 2020, the patient's SARS-CoV-2 RNA test in a drive-in lab was negative. On May 9, 2020, her SARS-CoV-2 IgG antibody test (Abbott SARS-CoV-2 IgG test kit) was reported as negative. She reported that it took her two months to regain the taste of food.
The patient also reported other beneficial effects from reciting the NTW besides helping her to fully recover. "I want to say that [chanting] the mantra cured more than one ailment of mine. I had several different types of illnesses, but all symptoms are gone." She reported that her earlier heart disease and other medical conditions disappeared. Previously her heartbeat was 44 to 46 beats per minute. After sincerely reciting the NTW, her heart rate has been maintained at 50 to 54 beats since May 20, 2020. "This mantra is good for people with breathing problems, with vascular problems," she said. "I dare say that it is good for everybody, not just coronavirus patients," she added.
The healing experience of chanting the NTW has left a lasting impact for the patient. "I don't know what is behind this, this is my experience," she said. Since fully recovering from suspected COVID-19, the patient still repeats the NTW a few times a day. "Before going to sleep, when I wake up, when I am walking, when I have bad thoughts, or when I am depressed, I always recite these nine words." "Before I did not believe in miracles. But repeating the Falun Gong mantra has changed my energy level." she said. She reported being full of energy, walking two miles every day, and resuming her work. What had touched her was that reciting the NTW had helped her get rid of her anxiety and depression. Reciting "Fa-Lun Da-Fa Hao, Zhen-Shan-Ren Hao" has even changed her way of life as an older person. She sincerely hopes that sharing her experience and her case will be helpful for other senior people as well.
After her full recovery, the patient became interested in the meditation practice and started to learn Falun Gong from July to August 2020.

Discussion
This patient had typical symptoms of COVID-19 that included fever, taste impairment, whole body pains, and severe breathing difficulties during 15 days since the symptom onset. The prevalence of smell and taste loss among COVID-19 patients has been found to be high globally (41% to 48%); hence health workers must consider the loss of smell and taste as suspicion indices for empirical diagnosis of SARS-CoV-2 infection 9,10 . In this case report, the patient's featured symptoms supported the diagnosis of a severe COVID-19 condition. However, this was not confirmed via testing; she missed a test for SARS-CoV-2 RNA at the peak of her symptoms, and her antibody test at a drive-in lab which was not certified by the FDA for COVID-19 was negative. The Abbott SARS-CoV-2 IgG test kit used for her antibody test has a statement: "Negative results do not rule out SARS-CoV-2 infection, particularly in those who have been in contact with the virus".
According to a large case series analysis in China, 14% of COVID-19 patients had severe symptoms (with dyspnea, respiratory frequency ≥30 breaths/min, etc.) and 5% were critical (with respiratory failure, septic shock, and/or multiple organ dysfunction or failure). The mortality rate was 2.3% in all cases and 49.0% in critical cases. For older people, it was 8% for those aged >70 years and 14.8% for those aged ≥80 years 3 . Case fatality was elevated among those with pre-existing comorbid conditions; it was 10.5% for cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6.0% for hypertension, and 5.6% for cancer 3 . Another retrospective study including the first 200 COVID-19 patients admitted to a tertiary medical center in New York also found increasing age was independently associated with higher in-hospital mortality 11 .
A noteworthy observation is that the patient in the current report was in her seventies, with a past disease history of coronary artery disease and cancer. She developed severe breathing difficulties in 15 days during her disease course. Even if she had received treatment for COVID-19 in a hospital, her predicted mortality would haven been high due to her three high risk factors of being elderly, having a history of cardiovascular disease, and a history of cancer. This is the likely reason that her doctor recommended her to self-quarantine at home.
The patient developed severe breathing difficulties within 15 days since the symptom onset and was even unable to breathe sometimes. During this critical period of time, she was self-quarantined and stayed home alone without any anti-viral treatment. It is reasonable to conclude that she would have had a very low chance of spontaneous recovery if she had not recited the NTW. The only significant factor to help alleviate her symptoms and recover from breathing difficulties was chanting the NTW, based on objective observations and the patient's detailed report.
Scientific researchers have identified the potential of religious mantra reciting to regulate physiological function and promote health [12][13][14][15][16][17] . It is suggested that Falun Gong exudes a powerful positive energy field that can act as a means of warding off illnesses and maintaining fitness 18,19 . A study presented at the American Society of Clinical Oncology's (ASCO) annual meeting in 2016 showed the significant benefits of practicing Falun Gong on end stage cancer, including significantly prolonged survival, and improved quality of life 20 . Many Falun Gong practitioners have reported experiencing this strong, high-energy field, which can translate into extraordinary healing effects 21 . Scientists from the Baylor College of Medicine in Houston, Texas, similarly found people who practiced Falun Gong's four standing and one sitting exercise sets had enhanced phagocytosis function, and their gene expression profiles indicated significantly enhanced anti-viral immunity 22 . From the perspective of energy medicine, the action of a healing energy field could be fast and instantaneous 23 .
This US patient in her seventies reported her surprising recovery from suspected COVID-19 by sincerely reciting the nine Chinese characters from Falun Gong. Although the precise mechanism of illness recovery from reciting the NTW is not yet adequately understood, its effects are suggested in this case. Reciting the NTW is easy to learn, safe, and without conflict with any conventional treatment.
The strength of this case report is that the patient has proactively provided adequate details on how reciting the NTW had helped her recover from the suspected COVID-19 breathing difficulties. Adequate real-world data obtained directly from the patient and also her medical records helped to solidify the causality relationship between reciting the NTW and her recovery. However, the limitation is that as she was not hospitalized and hence there was a lack of medical assessment on her respiratory function or medical imaging when she had severe breathing difficulties and after she recovered.

Conclusion
This case report described in detail the clinical course of a suspected COVID-19 case that recovered by reciting the ninecharacter true words from Falun Gong. The patient's severe breathing difficulty symptoms disappeared quickly after she sincerely recited the mantra. Her recovery was accompanied with greatly improved psychosocial functioning and better quality of life. This severe suspected COVID-19 case gained clinical benefits through reciting "Fa-Lun Da-Fa Hao, Zhen-Shan-Ren Hao". In the face of the unprecedented global threat from COVID-19, reciting the nine true words could be a supplementary option to help patients and healthy people, in addition to conventional measures.

Data availability
Underlying data All data underlying the results are available as part of the article and no additional source data are required. All original data was obtained from the hospital physicians at the request of the patient who then shared the information with authors for publication. This project contains the following extended data:

Extended data
-Audio S1: The pronunciation of the Nine True Words from Falun Gong. The Nine True Words refers to nine Chinese characters: "Fa-Lun Da-Fa Hao" and "Zhen-Shan-Ren Hao" (法輪大法好, 真善忍好). In Engsh, the two Chinese expressions mean, "Falun Dafa is Good" and "Truthfulness-Compassion-Forbearance is Good", respectively.

Consent
We read about this case in a newspaper article. We contacted the patient to ask if we could interview her for a case report. The patient gave her informed oral consent to take part in the interview over the phone and afterwards was sent an informed consent form to sign and return. Written informed consent for publication of her clinical details was also obtained from the patient. The researchers ensured the patient could contact them for subsequent support or help, should talking in depth about her experiences trigger any distress.

Comments on this article Version 1
Author Response 23 Jul 2021 Yuhong Dong, SunRegen Healthcare AG, Allschwil, Switzerland

Post No. 3:
Jeremy Clark: In the Discussion section of the paper, the following sentence appears: "Many Falun Gong practitioners have reported experiencing this strong, high-energy field, which can translate into extraordinary healing effects [21]"However, the cited paper does not support this. The citation only details one such reported case of "extraordinary healing." The use of the word "Many" in this sentence with regard to healing properties is misleading and false. This is particularly concerning as the author of this study also wrote the referenced study. One would expect medical researchers to have read and understood the works cited in their papers, especially when they wrote said works themselves.
The principal researcher conducted in-depth interviews and had thorough conversation with the patient with terminal prostate cancer in Reference [21]. The patient stated that when he was watching the nine-session lecture video of FLG 1 , he felt as if substantial high-energy matter was plugged into his two lower legs. This case report [21] is one medically well-documented case study reported in the English-speaking community. Many FLG practitioners have personally experienced this strong high-energy field that was usually accompanied by extraordinary healing effects. And there are numerous testimonials that are published in Chinese in different sources. Some of these were translated into English and published (for example, on en.minghui.org) and many were not. Moreover, "high-energy" field/matter is better understood as highly organized energy that attunes one's health to a normal condition. Another study under the auspices of the University of California found that FLG practice could lead to long-term psychological benefits [6][7] . FLG practice also results into enhanced immunity. U.S. scientists at Baylor College of Medicine found that FLG practitioners' phagocytosis and the function of killing bacteria is significantly enhanced, and the expression of genes related to anti-viral immunity has increased significantly, indicating significantly enhanced anti-viral immunity 8 .

More Experiences from those who practice Falun Gong
Falun Dafa Video & Audio materials. https://en.falundafa.org/falun-dafa-video-audio-9session.html First, the patient's self-evaluation in the causality between reciting the mantra and her unexpected recovery is informative and important. According to the patient's statement, "My lungs opened. I can inhale longer and deeper" when she started reciting the mantra word-by-word, the causality between her reciting the mantra and recovery is obvious, and that has attracted our attention to this case. It is reasonable to infer that the statement "My lungs opened. I can inhale longer and deeper" would not emerge without her reciting the mantra.
Second, the patient had typical symptoms of COVID-19 that included fever, taste impairment, whole body pains, and severe breathing difficulties for 15 days since the symptom onset. In this case report, the patient's featured symptoms supported the diagnosis of a severe COVID-19 condition.
The fundamental pathophysiology of severe COVID is severe acute respiratory distress syndrome (ARDS). People of an older age (>65 years) are more likely to develop ARDS than those of a younger age. Older patients (>65 years) with comorbidities and ARDS are at increased risk of death. The median duration from worsening of symptoms to death was 7 (IQR 3-11) days. ( Ref 1) In the current case study, the patient developed shortness of breath, heavily congested chest without sputum within 15 days after symptom onset. All these symptoms indicated the possibility of developing ARDS in her lungs. She had a fear of death during that time. Given her acute symptoms and if without any effective treatment, she would have died within a median duration of 7 days. The lungs of ARDS are normally embedded with fluid and immune cells, which are an outcome of viral invasion in the lower lung tissue, imbalanced immune responses, and cytokine storm. The chances of a spontaneous recovery from Day 21 after symptom onset of a severe COVID patient would be very slim. So, it is illogical to consider her recovery as merely coincidental.
The patient was already able to breathe normally after three days of reciting the NTW. This cannot be coincidental. mortality rate. It is explained that the patient was in her 70s and had pre-existing conditions which would lower her chance of survival, but no such data is quantified. Some calculations of her suspected mortality rate would strengthen the case of this paper.
If you read the report carefully, you will find the explanatory data provided in the 2nd paragraph of the "Discussion" section of the paper as follows: "According to a large case series analysis in China, the mortality rate was 2.3% for all cases. For older people, it was 8% for those aged >70 years 3 . Case fatality was elevated among those with pre-existing comorbid conditions; it was 10.5% for cardiovascular disease, and 5.6% for cancer 3 . Another retrospective study including the first 200 COVID-19 patients admitted to a tertiary medical center in New York also found increasing age was independently associated with higher inhospital mortality 11 . " The patient was in her 70s and had pre-existing conditions of coronary artery disease and cancer, all of which would contribute in a synergistically manner to lower her chance of survival significantly. Her predicted mortality would have been high due to her three high risk factors of being elderly, having a history of cardiovascular disease, and a history of cancer. This is the likely reason that her doctor recommended her to self-quarantine at home.