Efficacy and Safety of Lianhua Qingke Tablets in the Treatment of Mild and Common-Type COVID-19: A Randomized, Controlled, Multicenter Clinical Study

Abstract

Background. Lianhua Qingke (LH) tablets is an effective traditional Chinese medicine against various viral infections, especially in relieving coughing. However, its effects on COVID-19 are unknown. Methods. To examine the therapeutic effectiveness of LH tablets in COVID-19 patients with mild and common types, a randomized, multicenter, controlled study was carried out. COVID-19 cases were randomized to undergo routine treatment with or without LH tablets (4 tablets, three times a day) for 14 days. The primary endpoints were the rate of achieving clinical symptom resolution and the corresponding time. Results. There were 144 participants in the full analysis set (72 each in the LH and control groups). The LH group participants had elevated symptom alleviation rate at 14 days compared with control cases (FAS: 98.61% vs. 84.72%, p = 0.0026). In comparison with control group participants, the LH group participants had reduced median time to clinical symptom alleviation (median: 4 vs. 7 days, p < 0.0001). Higher resolution rates of coughing (98.44% vs. 84.51%, p = 0.0045) and expectoration (100% vs. 82.35%, p = 0.0268) were observed in the LH group. Times to recovery of fever (median: 2 vs. 3 days, p = 0.0007), coughing (median: 4 vs. 7 days, p < 0.0001), and expectoration (median: 3 vs. 6 days, p < 0.0001) were also notably shorter in the LH group. Moreover, the LH group had elevated improvement rates in chest computed tomography signs (FAS: 86.11% vs. 72.22%, p = 0.0402) and clinical cure at day 28 (FAS: 83.33% vs. 68.06%, p = 0.0326). However, no differences were found in the laboratory test and viral assay. Serious adverse events were not detected. Conclusion. These preliminary findings indicate LH tablets may be effective in symptomatic COVID-19, especially in relieving coughing. This trial was registered in Chinese Clinical Trial Registry (ChiCTR2100042069).

Lianhua Qingke ameliorates lipopolysaccharide‐induced lung injury by inhibiting neutrophil extracellular traps formation and pyroptosis

“…LHQK has been recommended for acute tracheobronchitis, cough, expectoration with a dry throat, and chest distress. Previous studies have proved the therapeutic effects of LHQK on ALI induced by bacteria and smoking exposure, and pneumonia caused by HCoVs (HCoV‐229E and SARS‐CoV‐2) in an animal model and human patients 23‐26,64,65 . Clinical studies shown the effects of LHQK on relieving cough and expectoration in symptomatic COVID‐19 cases 25,64,65 .…”

“…Additionally, the assessment of lung pathology also revealed that LHQK effectively attenuated LPS-induced alveolar septum thickening, alveolar-space broadening, and alveolar wall destruction (Figure 1n-p). immunomodulatory capacities of LHQK, 25,53 we wonder whether LHQK has an impact on LPS-induced lung inflammation. To address this question, we evaluated the concentration of total protein, the protein level of Mucin protein (Muc5AC), and the concentration of proinflammatory cytokines (IL-6, TNF-α, and IL-1β) in plasma and BALF of mice.…”

“…Experimental and clinical evidence have proved that LHQK exhibits excellent clinical efficacy in the treatment of ALI, including bacteria and smoking‐induced ALI, and pneumonia caused by HCoVs (HCoV‐229E and SARS‐CoV‐2). 23 , 24 , 25 , 26 Wang et al, 24 analyzed and identified 14 major active compounds of LHQK from 22 common characteristic fingerprints, including neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, isoforsythiaside, phillygenin, hesperidin, baicalin, arctiin, aloe‐emodin, glycyrrhizic acid ammonium salt, rhein, emodin, 1,8‐dihydroxy‐3‐methylanthraquinone, and physcion. However, the underlying mechanisms of LHQK in ALI remain largely unexplored.…”

Lianhua Qingke Preserves Mucociliary Clearance in Rat with Acute Exacerbation of Chronic Obstructive Pulmonary Disease by Maintaining Ciliated Cells Proportion and Protecting Structural Integrity and Beat Function of Cilia

“…Experimental and clinical evidence has demonstrated the therapeutic effects of LHQK in reducing sputum production 23 and viscosity. 24 In addition, LHQK has been proven to be effective in promoting sputum expulsion in both animal models and patients. 25 This study investigated the therapeutic effects and underlying mechanisms of LHQK in a rat model of AECOPD induced by cigarette smoke (CS) exposure and lipopolysaccharide (LPS) intratracheal instillation.…”

Efficacy and safety of chinese herbal medicine for treating mild or moderate COVID-19: A systematic review and meta-analysis of randomized controlled trials and observational studies

“…There were 22 studies published in Chinese(Ai X. Y. et al, 2020; Jin W. et al, 2020; Zhang C. T. et al, 2020;AI et al, 2020b; Yu P. et al, 2020;Wang Y. L. et al, 2020;Ding et al, 2020;Duan et al, 2020;Fu et al, 2020;Lin et al, 2020;Sun et al, 2020; Hu F. et al, 2021; Wang L. Q. et al, 2021;He et al, 2021;Li et al, 2021;Ping et al, 2021;Qiu et al, 2021;Sun S et al, 2021;Wu et al, 2021;Yan et al, 2021) (2 registered prospectively(Jin W. et al, 2020;Sun Y et al, 2021)) and 13 published in English which were all registered(Xiao M. Z. et al, 2020; Wang J. B. et al, 2020;Xiong et al, 2020; Liu J. et al, 2021;An et al, 2021; Hu K. et al, 2021; Zhang X. Y. et al, 2021;Ma et al, 2021;Ni et al, 2021;Xu et al, 2021;Zeng et al, 2021;Zhao et al, 2021;Zhang et al, 2022). Twenty-four OBs(Chen et al, 2020a; Frontiers in Pharmacology frontiersin.org…”