Chinese Herbal Medicine Used With or Without Conventional Western Therapy for COVID-19: An Evidence Review of Clinical Studies

Abstract

Objective: To present the evidence of the therapeutic effects and safety of Chinese herbal medicine (CHM) used with or without conventional western therapy for COVID-19.Methods: Clinical studies on the therapeutic effects and safety of CHM for COVID-19 were included. We summarized the general characteristics of included studies, evaluated methodological quality of randomized controlled trials (RCTs) using the Cochrane risk of bias tool, analyzed the use of CHM, used Revman 5.4 software to present the risk ratio (RR) or mean difference (MD) and their 95% confidence interval (CI) to estimate the therapeutic effects and safety of CHM.Results: A total of 58 clinical studies were identified including RCTs (17.24%, 10), non-randomized controlled trials (1.72%, 1), retrospective studies with a control group (18.97%, 11), case-series (20.69%, 12) and case-reports (41.38%, 24). No RCTs of high methodological quality were identified. The most frequently tested oral Chinese patent medicine, Chinese herbal medicine injection or prescribed herbal decoction were: Lianhua Qingwen granule/capsule, Xuebijing injection and Maxing Shigan Tang. In terms of aggravation rate, pooled analyses showed that there were statistical differences between the intervention group and the comparator group (RR 0.42, 95% CI 0.21 to 0.82, six RCTs; RR 0.38, 95% CI 0.23 to 0.64, five retrospective studies with a control group), that is, CHM plus conventional western therapy appeared better than conventional western therapy alone in reducing aggravation rate. In addition, compared with conventional western therapy, CHM plus conventional western therapy had potential advantages in increasing the recovery rate and shortening the duration of fever, cough and fatigue, improving the negative conversion rate of nucleic acid test, and increasing the improvement rate of chest CT manifestations and shortening the time from receiving the treatment to the beginning of chest CT manifestations improvement. For adverse events, pooled data showed that there were no statistical differences between the CHM and the control groups.Conclusion: Current low certainty evidence suggests that there maybe a tendency that CHM plus conventional western therapy is superior to conventional western therapy alone. The use of CHM did not increase the risk of adverse events.

Therapeutic effects and safety of oral Chinese patent medicine for COVID-19: A rapid systematic review and meta-analysis of randomized controlled trials

“…In order to complete this review as soon as possible without compromising the quality of our research, this rapid review was carried out on the basis of our previous research, 27 an evidence review of clinical studies regarding CHM for COVID-19. In the previous research, 27 we systematically searched for clinical trials of CHM which included oral CPM, Chinese herbal medicine injection and prescribed herbal decoctions used for COVID-19. We screened studies included in the previous research 27 to identify RCTs that only use oral CPM for COVID-19.…”

“…In the previous research, 27 we systematically searched for clinical trials of CHM which included oral CPM, Chinese herbal medicine injection and prescribed herbal decoctions used for COVID-19. We screened studies included in the previous research 27 to identify RCTs that only use oral CPM for COVID-19. Since the previous search date was up to April 30 th , 2020, the official start date of this rapid review was November 2 nd , 2020, we updated and searched for publications during the period between April 30 th , 2020 and November 2 nd , 2020.…”

Sex-tailored pharmacology and COVID-19: Next steps towards appropriateness and health equity

“…Compared with the conventional Western medicine-treated group, patients in the TCM-treated group showed significant improvements in lung computed tomography, clinical cure rate, ranging from mild to critical cases, length of hospital stay, total score of clinical symptoms and inflammatory biomarkers, with no evidence of severe adverse effects, discomfort or abnormal liver and kidney function [180] . Furthermore, a recent review of clinical studies suggested that TCM in combination with conventional Western treatment may be superior than conventional Western therapy alone in shortening the duration of main symptoms, reducing the aggravation rate and increasing the recovery rate [181] . Consistently, the combination of Chinese and Western medicines appears to be the mainstream for treatment of COVID-19 in China [182] .…”

Therapeutic effects and safety of oral Chinese patent medicine for COVID-19: A rapid systematic review and meta-analysis of randomized controlled trials

“…In the previous research, 27 we systematically searched for clinical trials of CHM which included oral CPM, Chinese herbal medicine injection and prescribed herbal decoctions used for COVID-19. We screened studies included in the previous research 27 to identify RCTs that only use oral CPM for COVID-19. Since the previous search date was up to April 30th, 2020, the official start date of this rapid review was November 2nd, 2020, we updated and searched for publications during the period between April 30th, 2020 and November 2nd, 2020.…”