Efficacy of Early Combination Therapy With Lianhuaqingwen and Arbidol in Moderate and Severe COVID-19 Patients: A Retrospective Cohort Study

Abstract

Objective: Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan City, China, coronavirus disease 2019 (COVID-19) has become a global pandemic. However, no special therapeutic drugs have been identified for COVID-19. The aim of this study was to search for drugs to effectively treat COVID-19. Materials and Methods: We conducted a retrospective cohort study with a total of 162 adult inpatients (≥18 years old) from Ruijin Hospital (Shanghai, China) and Tongji Hospital (Wuhan, China) between January 27, 2020, and March 10, 2020. The enrolled COVID-19 patients were first divided into the Lianhuaqingwen (LHQW) monotherapy group and the LHQW + Arbidol combination therapy group. Then, these two groups were further classified into moderate and severe groups according to the clinical classification of COVID-19. Results: The early combined usage of LHQW and Arbidol can significantly accelerate the recovery of patients with moderate COVID-19 by reducing the time to conversion to nucleic acid negativity, the time to chest CT improvement, and the length of hospital stay. However, no benefit was observed in severe COVID-19 patients treated with the combination of LHQW + Arbidol. In this study, both Arbidol and LHQW were well tolerated without serious drug-associated adverse events. Conclusion: The early combined usage of LHQW and Arbidol may accelerate recovery and improve the prognosis of patients with moderate COVID-19.

Epigallocatechin-3-gallate, an active ingredient of Traditional Chinese Medicines, inhibits the 3CLpro activity of SARS-CoV-2

“…In the height of SARS-CoV-2 outbreak in China, LHQWC was recommended again for clinical use to treat COVID-19. Subsequent clinical and experimental studies have confirmed the therapeutic benefits of LHWQC [ 35 , 50 ]. Its mode of action was by targeting virus replication and immunological regulation.…”

Efficacy and safety of arbidol (umifenovir) in patients with COVID‐19: A systematic review and meta‐analysis

“…Several studies 52 , 53 , 54 compared the efficacy of arbidol as a combination therapy with traditional Chinese medicines. The meta‐analysis of improvement rate of chest CT found no greater benefit of arbidol combined with Lianhuaqingwen compared to arbidol alone in the treatment of COVID‐19 patients (RR: 1.27; 95% CI: 0.88–1.85; p = .20; Table 2 ).…”

“…The meta‐analysis of improvement rate of chest CT found no greater benefit of arbidol combined with Lianhuaqingwen compared to arbidol alone in the treatment of COVID‐19 patients (RR: 1.27; 95% CI: 0.88–1.85; p = .20; Table 2 ). Fang et al 53 found that the simultaneous treatment of arbidol and Lianhuaqingwen was associated with higher improvement in patients with moderate COVID‐19 compared with Lianhuaqingwen alone. There are other studies 52 , 54 that reported the efficacy and safety of Shufeng Jiedu capsule combined with arbidol versus arbidol alone in patients with COVID‐19.…”

Revised Korean Society of Infectious Diseases/National Evidence-based Healthcarea Collaborating Agency Guidelines on the Treatment of Patients with COVID-19

“…There were six observational studies on umifenovir, among which PCR negative conversion was the primary endpoint in four. In studies that used lopinavir/ritonavir- or Chinese medicine-treated control group, the time to negative conversion was earlier in the favipiravir group; however, there was no significant difference between the groups in studies that did not treat the control group with antiviral drugs [ 97 98 99 100 ]. Clearance of fever and cough were assessed even when clinical endpoints were selected; more meaningful outcome of mortality, progression to severe disease, or hospital discharge was not reported [ 101 102 ].…”