Tehran University of Medical Sciences Traditional and Integrative Medicine 2476-5104 11 3 2026 10 01 2517 2517 Nezhat Shakeri Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Kiana Davar 2Department of Statistics, Faculty of Mathematical Sciences, Shahid Beheshti University, Tehran, Iran Roshanak Mokaberinejad Department of Traditional Medicine, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Maryam Azimi Gastroenterology and Hepatology Research Center, Kerman University of Medical Sciences, Kerman, Iran AND Department of Traditional Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman, Iran 2025 11 08 2026 06 02 The COVID-19 pandemic has spurred considerable interest in assessing the effectiveness of both traditional and complementary treatments for managing the disease. Traditional medicine incorporates various adjunctive therapies, such as hot water footbaths, to alleviate symptoms of illnesses, including COVID-19. However, there is no existing research examining the impact of this treatment on hospitalization duration and patient survival. This study aims to explore the effects of hot water footbaths on the length of hospitalization and survival time of COVID-19 patients. This clinical trial, conducted in May 2020, involved 68 patients hospitalized at Shahid Mofattah Hospital in Varamin City, Tehran Province. Patients were randomly assigned to either the intervention or control group in a 1:1 ratio. The intervention group received hot water footbaths (immersion of feet in water at 42 °C, 10 cm above the ankles for 20 minutes, followed by 5 minutes of warmth) once daily for one week, in addition to standard treatment. The control group received only the conventional treatment. The primary outcomes assessed were the duration of hospitalization and patient survival time from the point of admission. To account for the competing risk of death and hospital discharge, the stratified Cox Lunn-McNeil alternative method was used for data analysis. Propensity score matching was applied to control for confounding variables. The intervention group showed a significantly lower risk of death (HR=24.3) compared to the control group (p value = 0.0005). No significant differences were found between the groups in terms of hospitalization duration. Additionally, no adverse effects related to the hot water footbath were reported. Hot water footbath may serve as a beneficial complementary treatment to extend the survival time of COVID-19 patients. https://jtim.tums.ac.ir/index.php/jtim/article/view/2517