Effectiveness and Safety of Lianhua Qingwen Capsules for COVID‐19: A Propensity‐Score Matched Cohort Study

Abstract

As a traditional Chinese medicine, Lianhua Qingwen capsules have been widely used to treat Coronavirus Disease 2019 (COVID-19). This study was aimed to demonstrate the association between treatment with Lianhua Qingwen capsules and the clinical outcomes of hospitalized patients with COVID-19. This retrospective study was conducted at four hospitals in Central China. Data of hospitalized COVID-19 patients were collected between December 19, 2019 and April 26, 2020. Based on whether Lianhua Qingwen capsules were used, patients were classified into Lianhua Qingwen and non-Lianhua Qingwen (control) groups. To control for confounding factors, we used conditional logistic regression in a propensity-score matched (PSM) cohort (1 : 1 balanced), as well as logistic regression without matching as sensitivity analysis. A total of 4918 patients were included, 2760 of whom received Lianhua Qingwen capsules and 2158 of whom did not. In the PSM model, after adjusting for confounders, the in-hospital mortality was similar between the Lianhua Qingwen group and the control group (6.8% vs. 3.3%, adjusted OR, 0.66 [95% CI, 0.38-1.15], p = 0.138 ). The negative conversion rate of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection was higher in the Lianhua Qingwen group (88.3% vs. 96.1%, adjusted OR, 4.02 [95% CI, 2.58-6.25], p < 0.001 ). The incidence of acute liver injury was comparable between the two groups (14.0% vs. 11.5%, adjusted OR: 0.85 [95% CI, 0.71-1.02], p = 0.083 ), and the incidence of acute kidney injury was lower in the Lianhua Qingwen group (5.3% vs. 3.0%, adjusted OR: 0.71 [95% CI, 0.50-1.00], p = 0.048 ). Treatment with Lianhua Qingwen capsules was not significantly associated with in-hospital mortality in COVID-19 patients. In the Lianhua Qingwen group, the negative conversion rate of SARS-CoV-2 infection was higher and the incidence of acute kidney injury was lower than in the control group.

Impact of Lianhua Qingwen on viral shedding in omicron mild/asymtomatic patients: a real-world study

“…Prior research in the field has predominantly concentrated on assessing the effectiveness of LHQW in ameliorating clinical symptoms, with limited insights into its impact on VS ( 11–13 , 15 , 16 , 18 , 19 ). For instance, Academician Zhong’s recent publication reports findings from an international, multicenter, double-blind, randomized controlled study, primarily focusing on the alleviation of COVID-19 symptoms by LHQW, encompassing nasal congestion, sore throat, cough, fever, and other related symptoms ( 20 ).…”

“…These distinctions in both the viral variants and the study populations were pivotal in understanding the differing outcomes observed. Conversely, another study encompassing a large adult population of 4,918 cases demonstrated that the LHQW treatment group exhibited improvements in the nucleic acid conversion rate ( 19 ). Numerous systematic reviews and meta-analyses have underscored the substantial efficacy of LHQW in the treatment of COVID-19 ( 14 , 15 , 22 ), reporting enhancements in clinical symptoms and a reduction in the progression to severe or critical conditions, but they did not specifically monitor VS.…”