Evidence Mapping of 23 Systematic Reviews of Traditional Chinese Medicine Combined With Western Medicine Approaches for COVID-19

Abstract

Background: Coronavirus disease 2019 (COVID-19) has already spread around the world. The modality of traditional Chinese medicine (TCM) combined with Western medicine (WM) approaches is being used to treat COVID-19 patients in China. Several systematic reviews (SRs) are available highlighting the efficacy and safety of TCM combined with WM approaches in COVID-19 patients. However, their evidence quality is not completely validated.Purpose: We aimed to assess the methodological quality and the risk of bias of the included SRs, assess the evidence quality of outcomes, and present their trends and gaps using the evidence mapping method.Methods: PubMed, Cochrane Library, Embase, CNKI, CBM, and Wanfang Data were searched from inception until March 2021 to identify SRs pertaining to the field of TCM combined with WM approaches for COVID-19. The methodological quality of the SRs was assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2), the risk of bias of the included SRs was assessed with the Risk of Bias in Systematic Review (ROBIS) tool, and the evidence quality of outcomes was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.Results: In total, 23 SRs were found eligible. Twenty-one were rated of moderate confidence by AMSTAR 2, while 12 were rated at low risk using the ROBIS tool. In addition, most outcomes were graded as having moderate quality using the GRADE system. We found that the combined use of TCM and WM approaches could improve the CT recovery rate, effective rate, viral nucleic acid negative conversion rate, and the disappearance rate of fever, cough, and shortness of breath. Also, these approaches could decrease the conversion rate from mild to critical, white blood cell counts, and lymphocyte counts and shorten the time to viral assay conversion and the length of hospital stay.Conclusion: TCM combined with WM approaches had advantages in efficacy, laboratory, and clinical symptom outcomes of COVID-19, but the methodological deficiencies of SRs should be taken into consideration. Therefore, to better guide clinical practice in the future, the methodological quality of SRs should still be improved, and high-quality randomized controlled trials (RCTs) and observational studies should also be carried out.

Use of Chinese herbs to treat symptoms likely related to COVID-19: Survey analysis of licensed acupuncturists in the United States

“…The incidence of long-hauler syndrome among COVID-19 infected individuals is estimated to be between 33-60%. 38,39,40 Our study detailing the use of CHM for symptoms likely related to COVID-19, along with the systematic reviews and metanalyses published after our study was completed 31,9 suggesting that CHM may be an effective treatment for COVID-19 infection, supports the need for further investigation.…”

“…As was reported in studies conducted in China, 23 the CHM was usually taken for 20 days or less with little side effects. Almost half of the participants experienced difficulty obtaining the Chinese herbs and this was likely related to greatly increased demand due to usage in China and other Asian countries, 9,31,2 and pandemic related interruptions to the supply chain, and delivery services being delayed.…”

“…The extensive information about the use of CHM for past viral epidemics including SARs, and H1N1 influenza 6,9 was used by 60% of the participants. Fifty-six percent of these participants reported that they used this information because there was no specific information about the use of CHM for COVID-19 at the time.…”

“…More recently CHM was successfully utilized during the 2003 SARs epidemic and the 2009-10 flu season associated with H1N1 virus. 8,6,9 The broad symptom picture that COVID-19 infected patients can present with are encompassed by TCM diagnostic patterns and organ relationships, 1 and the use of TCM theories has provided insight into the pathology associated with COVID-19 infection. 10 East Asian medicine (EAM) has been practiced throughout Asia for thousands of years, and more recently all over the world.…”

Clinical Evidence and Potential Mechanisms of Complementary Treatment of Ling Gui Zhu Gan Formula for the Management of Serum Lipids and Obesity

“…TCM herbal formulae have been proven safe and effective as a complementary and alternative medical treatment for various chronic diseases [ 8 ], even for the ongoing outbreak of coronavirus disease 2019 (COVID-19) [ 9 ]. Increasing evidence shows that certain classic TCM formulae are clinically reliable for the improvement of hyperlipidemia and obesity.…”