Therapeutic mechanisms and impact of traditional Chinese medicine on COVID-19 and other influenza diseases

Abstract

Coronavirus disease 2019 (COVID-19), first reported in Wuhan, China, has rapidly spread worldwide. Traditional Chinese medicine (TCM) has been used to prevent and treat viral epidemics and plagues for over 2,500 years. In the guidelines on fighting against COVID-19, the National Health Commission of the People's Republic of China has recommended certain TCM formulas, namely Jinhua Qinggan granule (JHQGG), Lianhua Qingwen granule (LHQWG), Qingfei Paidu decoction (QFPDD), Xuanfei Baidu granule (XFBD), Xuebijing injection (XBJ), and Huashi Baidu granule (HSBD) for treating COVID-19 infected individuals. Among these six TCM formulas, JHQGG and LHQWG effectively treated mild/moderate and severe COVID-19 infections. XFBD therapy is recommended for mild COVID-19 infections, while XBJ and HSBD effectively treat severe COVID-19 infections. The internationalization of TCM faces many challenges due to the absence of a clinical efficacy evaluation system, insufficient research evidence, and a lack of customer trust across the globe. Therefore, evidence-based research is crucial in battling this infectious disease. This review summarizes SARS-CoV-2 pathogenesis and the history of TCM used to treat various viral epidemics, with a focus on six TCM formulas. Based on the evidence, we also discuss the composition of various TCM formulas, their underlying therapeutic mechanisms, and their role in curing COVID-19 infections. In addition, we evaluated the roles of six TCM formulas in the treatment and prevention of other influenza diseases, such as influenza A (H1N1), severe acute respiratory syndrome (SARS), and Middle East respiratory syndrome (MERS). Furthermore, we highlighted the efficacy and side effects of single prescriptions used in TCM formulas.

Pathogenesis of SARS-CoV-2 and Mycobacterium tuberculosis Coinfection

“…These immune cells overproduce cytokines like IL1, IL10, IL18, IFNα, and IL6 ( 152 , 153 ). In brief, COVID-19 coinfection with TB promotes cytokine storms that cause multiple organ injuries, particularly to the lungs, heart, or liver ( 5 , 150 , 151 ). These two pathogens induce cytokine storms with similar features but different magnitudes and outcomes.…”

“…This unusual cytokine production may destroy host immune responses, i.e., low lymphocyte infiltration into infected lungs and multiple organ damage ( 192 ). Because SARS-CoV-2 is a novel CoV and has no specific treatment ( 5 ), suspected people must be tested accurately to prevent virus transmission. Apart from traditional diagnostic testing for detecting viral antigens or antiviral antibodies, the nucleic acid detection method has been developed for routine testing ( 193 ).…”

“…The emergence of β-CoVs (SARS-CoV in 2002 and MERS-CoV in 2012) demonstrated the emerging possibility of new pathogenic CoVs in humans via zoonotic transmission ( 1 , 2 ). The pathogenic CoV, SARS-CoV-2, causes coronavirus disease 2019 (COVID-19), first reported in Wuhan, China, in late 2019, resulting in severe global public health issues and substantial economic losses ( 3 – 5 ). Bats act as a reservoir for CoVs; therefore, it is speculated that the SARS-CoV-2 originated in horseshoe bats before transmitting to humans via an unknown intermediate host ( 6 ).…”

Computer-aided drug design combined network pharmacology to explore anti-SARS-CoV-2 or anti-inflammatory targets and mechanisms of Qingfei Paidu Decoction for COVID-19

“…The other 56 components were both anti-inflammatory and anti-SARS-CoV-2. Among these components, Quercetin, Wogonin, and Emodin were able to interfere with various stages of the coronavirus entry and replication cycle (59,81,82). Kaempferol could be used as an antiviral drug against the 3a Channel Protein of Coronavirus (55).…”

TCM2COVID: A resource of anti‐COVID‐19 traditional Chinese medicine with effects and mechanisms

“…Accumulated clinical evidence shows that TCM has a significant positive impact on COVID‐19 patients, by reducing clinical symptoms, promoting recovery, improving chest images, and inhibiting disease progression [ 14 , 15 ]. Meanwhile, an increasing number of studies on therapeutic mechanisms have shown that TCM treatment not only targets the virus but also improves the whole body [ 16 , 17 , 18 , 19 ]. In addition, many natural products (NPs) and derivatives (such as Proscillaridin A, Scutellarein, Phillyrin, Quercetagetin, and Dihydromyricetin) from TCM herbs have been shown to exhibit activity against SARS‐Cov‐2 by in vitro assays and/or in silico methods (network pharmacology analysis, molecular docking, and virtual screening, etc.)…”