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Herbal Medicine Intervention for the Treatment of COVID-19: A Living Systematic Review and Cumulative Meta-Analysis
Lin Ang1, Eunhye Song2, Xiao-Yang Hu3
1KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.
Insights
Integrative herbal medicine shows potential benefits for treating coronavirus disease 2019 (COVID-19) symptoms when used alongside standard care. However, the evidence quality is low, and more research is needed to confirm these findings.
Area of Science:
- Integrative Medicine
- Infectious Diseases
- Pharmacology
Background:
- Integrative herbal medicine is increasingly explored for its potential therapeutic effects in managing symptoms associated with coronavirus disease 2019 (COVID-19).
- A comprehensive review of existing evidence is crucial to understand the benefits and risks of using herbal medicine as an adjunct therapy for COVID-19.
Approach:
- A systematic literature search was conducted across eleven major databases, including PubMed, CENTRAL, Embase, AMED, and several Chinese and Korean databases, from June 2020 to March 2022.
- Randomized controlled trials (RCTs) evaluating the efficacy and safety of herbal medicine in patients with PCR-confirmed COVID-19 were included, irrespective of language or patient age.
- Data extraction and quality assessments were performed independently by researchers to ensure methodological rigor.
Key Points:
- Meta-analyses indicated that herbal medicine, when added to standard treatment, significantly improved total effective rates, reduced time to fever and cough remission, and decreased fatigue and sputum production.
- Adjunctive herbal medicine also showed benefits in improving chest CT scan manifestations, reducing progression to severe COVID-19, lowering all-cause mortality, and shortening hospital stays and time to negative COVID-19 tests.
- No significant differences were observed in the remission rates of specific symptoms like sore throat or nasal congestion, nor in the incidence of adverse events between groups. The risk of bias in included RCTs was generally unclear.
Conclusions:
- Current evidence suggests that incorporating herbal medicine into standard treatment protocols may offer potential benefits for managing COVID-19 symptoms.
- Despite promising results, the overall certainty of the evidence is low, highlighting the need for high-quality research to validate these findings and assess long-term safety.
Abstract:
Background: Integrative herbal medicine has been reported to have beneficial effects in the treatment of coronavirus disease 2019 (COVID-19). Aim: To compile up-to-date evidence of the benefits and risks of herbal medicine for the treatment of COVID-19 symptoms. Methods: Eleven databases, including PubMed, Cochrane Register of Controlled Trials (CENTRAL), Embase, Allied and Complementary Medicine Database (AMED), Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Chinese Science and Technique Journals Database (VIP), Research Information Service System (RISS), Korean Medical database (KMBase), Korean Association of Medical Journal database (KoreaMed), and OASIS database, were searched from 15 June, 2020, until 28 March 2022. Randomized controlled trials (RCTs), published in any language, reporting the efficacy and safety outcomes of herbal medicine in patients of all ages with a PCR-confirmed diagnosis of COVID-19 were included in this analysis. Data extraction and quality assessments were performed independently. Results: Random-effects meta-analyses showed evidence of favorable effects of treatment with herbal medicine when added to standard treatment, versus standard treatment alone, on the total effective rate (p = 0.0001), time to remission from fever (p < 0.00001), rate of remission from coughing (p < 0.0001), fatigue (p = 0.02), sputum production (p = 0.004), improvement of manifestations observed on chest computed tomography scans (p < 0.00001), incidence of progression to severe COVID-19 (p = 0.003), all-cause mortality (p = 0.003), time to a negative COVID-19 coronavirus test (p < 0.0001), and duration of hospital stay (p = 0.0003). There was no evidence of a difference between herbal medicine added to standard treatment, versus standard treatment alone, on the rate of remission from symptoms such as a fever, sore throat, nasal congestion and discharge, diarrhea, dry throat, chills, and the rate of conversion to a negative COVID-19 coronavirus test. Meta-analysis showed no evidence of a significant difference in adverse events between the two groups. There was an unclear risk of bias across the RCTs included in this analysis, indicating that most studies had methodological limitations. Conclusion: Current evidence suggests that herbal medicine added to standard treatment has potential benefits in the treatment of COVID-19 symptoms but the certainty of evidence was low.
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