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Effect of Chinese Medicine in Patients with COVID-19: A Multi-center Retrospective Cohort Study
Guo-Zhen Zhao1,2, Shi-Yan Yan3, Bo Li1
1Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing Institute of Traditional Chinese Medicine, Beijing, 100010, China.
Insights
Chinese medicine (CM) significantly reduced the risk of COVID-19 deterioration and mortality in a real-world study. This traditional therapy, when combined with conventional treatment, demonstrated safety and effectiveness in hospitalized patients.
Area of Science:
- Integrative Medicine
- Infectious Disease Epidemiology
- Pharmacology
Background:
- Coronavirus disease 2019 (COVID-19) poses a significant global health challenge.
- The role of traditional therapies, such as Chinese medicine (CM), in managing COVID-19 requires rigorous evaluation.
- Understanding the effectiveness and safety of CM in diverse patient populations is crucial for evidence-based treatment strategies.
Purpose of the Study:
- To assess the efficacy and safety of Chinese medicine (CM) as an adjunct therapy for COVID-19 patients in China.
- To determine if CM treatment influences the clinical course, including deterioration and mortality rates.
- To evaluate the safety profile of CM in COVID-19 patients, focusing on liver and renal function.
Main Methods:
- A multi-center retrospective cohort study involving 2,272 COVID-19 inpatients.
- Exposure defined as a cumulative CM treatment period of at least 3 days during hospitalization.
- Statistical analysis employed inverse probability of treatment weighting (IPTW) and Cox proportional hazards regression to adjust for confounding factors.
Main Results:
- CM treatment was associated with a significantly lower rate of COVID-19 deterioration (HR: 0.52; P<0.001).
- All-cause mortality was substantially reduced in the CM group (HR: 0.29; P<0.001).
- CM use was linked to a lower proportion of patients experiencing abnormal liver or renal function, indicating a favorable safety profile.
Conclusions:
- Real-world evidence suggests that integrating full-course CM therapy with conventional treatment may safely decrease COVID-19 deterioration and mortality.
- Findings provide new evidence supporting the use of CM in COVID-19 management.
- Further prospective clinical trials are warranted to validate the efficacy and safety of specific CM interventions.
Objective:
To evaluate the effectiveness and safety of Chinese medicine (CM) in the treatment of coronavirus disease 2019 (COVID-19) in China.
Methods:
A multi-center retrospective cohort study was carried out, with cumulative CM treatment period of ⩾3 days during hospitalization as exposure. Data came from consecutive inpatients from December 19, 2019 to May 16, 2020 in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting (IPTW), and the Cox proportional hazards regression model was used for statistical analysis.
Results:
A total of 2,272 COVID-19 patients were included. There were 1,684 patients in the CM group and 588 patients in the control group. Compared with the control group, the hazard ratio (HR) for the deterioration rate in the CM group was 0.52 [95% confidence interval (CI): 0.41 to 0.64, P<0.001]. The results were consistent across patients of varying severity at admission, and the robustness of the results were confirmed by 3 sensitivity analyses. In addition, the HR for all-cause mortality in the CM group was 0.29 (95% CI: 0.19 to 0.44, P<0.001). Regarding of safety, the proportion of patients with abnormal liver function or renal function in the CM group was smaller.
Conclusion:
This real-world study indicates that the combination of a full-course CM therapy on the basic conventional treatment, may safely reduce the deterioration rate and all-cause mortality of COVID-19 patients. This result can provide the new evidence to support the current treatment of COVID-19. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific CM interventions. (Registration No. ChiCTR2200062917).
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