Chinese Medicine for Coronavirus Disease 2019 (COVID-19): A GRADE-Assessed Systematic Review and Meta-Analysis
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Published on: April 19, 2024
Jianbo Guo1, Zongshi Qin1, Ngai Chung Lau1
1School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam, Hong Kong SAR, P. R. China.
Insights
Chinese medicine (CM) shows adjunctive benefits for COVID-19 treatment. Specific formulae like Lianhua Qingwen granules improved efficacy and lung imaging, while others shortened hospital stays and reduced fever time.
Area of Science:
- Integrative Medicine
- Infectious Diseases
- Pharmacology
Background:
- Coronavirus disease 2019 (COVID-19) presents a significant global public health and socioeconomic challenge.
- Chinese medicine (CM) has been explored for its potential therapeutic roles in managing viral infections.
Purpose of the Study:
- To systematically evaluate the efficacy and safety of Chinese medicine interventions for COVID-19.
- To assess the adjunctive effects of CM when used alongside routine treatment (RT).
Main Methods:
- A comprehensive literature search was conducted across eleven databases up to April 30, 2021, including 52 studies.
- Risk of bias was assessed using RoB 2.0 and ROBINS-I tools, with evidence certainty evaluated by GRADE.
- Meta-analysis was performed on key efficacy outcomes such as clinical improvement, symptom duration, and hospitalization length.
Main Results:
- Lianhua Qingwen granules (LHQW) plus RT significantly improved efficacy rates, reduced fever scores, and enhanced CT lung imaging.
- Qingfei Paidu decoction (QFPD) plus RT was associated with a significant shortening of hospital stay duration.
- Feiyan Yihao formula (FYYH) plus RT demonstrated improvements in clinical efficacy, reduced fever duration, and accelerated negative PCR test results.
- Adverse events reported were generally mild or absent across the included studies.
Conclusions:
- Chinese medicine formulae, particularly LHQW, QFPD, and FYYH, demonstrate adjunctive therapeutic benefits in the standard treatment of COVID-19.
- The findings suggest that CM can be a valuable addition to conventional care for COVID-19 patients.
- Further research with robust methodologies is warranted to solidify evidence for other CM interventions and outcomes.
Abstract:
Coronavirus disease 2019 (COVID-19) has caused enormous public health and socioeconomic burden globally. This study aims to evaluate the efficacy and safety of Chinese medicine (CM) against COVID-19. Eleven databases were searched on April 30, 2021, and 52 studies were included. The RoB 2.0, ROBINS-I, and GRADE tools were employed to assess the risks and evidence grades. The findings with moderate certainty in GRADE showed that compared with routine treatment (RT), Lianhua Qingwen granules (LHQW) adjunctive to RT showed significantly improved efficacy rate (relative risk (RR) = 1.19, 95% confidence interval (CI): [1.09, 1.31]), febrile score (standard mean difference (SMD) = -1.21, 95% CI: [-1.43, -0.99]), and computerized tomography (CT) lung images (RR = 1.23, 95% CI: [1.10, 1.38]); Qingfei Paidu decoction (QFPD) plus RT significantly shortened the length of hospital stay (SMD = -1.83, 95% CI: [-2.18, -1.48]); Feiyan Yihao formula (FYYH) plus RT significantly improved the clinical efficacy rate (RR = 1.07, 95% CI: [1, 1.15]), febrile time (SMD = -0.02, 95% CI: [-0.23, 0.19]), and time to negative PCR test for COVID-19 (SMD = -0.72, 95% CI: [-0.94, -0.51]). Adjunctive effects of CM with lower certainty of evidence were found, including the improvements of symptoms, laboratory findings, and mortality. No or mild adverse events were observed in most of the studies. In conclusion, the current evidence indicates that CM formulae, particularly LHQW, QFPD, and FYYH, have adjunctive effects on the standard treatment of COVID-19.
