1. Effect and safety of Chinese herbal medicine granules in patients with severe coronavirus disease 2019 in Wuhan, China: a retrospective, single-center study with propensity score matching
- Author
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Fang Yan, Ailan Chen, Zehuai Wen, Wang Yuanyuan, Wenwei Ouyang, Chicheng Fu, Jianwen Guo, Jun Chen, Danwen Zheng, Zou Xu, Ding Banghan, Fang Li, Yuntao Liu, Li Zhou, Tianzhu Liu, Yi Wang, Qu Fang, Cecilia Stålsby Lundborg, Bo Liu, Zhongde Zhang, and Qingquan Lv
- Subjects
Male ,CHM: Chinese herbal medicine ,medicine.medical_treatment ,RRR: relative risk reduction ,Pharmaceutical Science ,Single Center ,0302 clinical medicine ,Drug Discovery ,0303 health sciences ,IQR: interquartile range ,Mortality rate ,Middle Aged ,CT: computerized tomography ,ECMO: extracorporeal membrane oxygenation ,030220 oncology & carcinogenesis ,Molecular Medicine ,Female ,Chinese herbal medicine ,NNT: number needed to treat ,China ,medicine.medical_specialty ,Fever ,Coronavirus disease 2019 (COVID-19) ,RR: respiratory rate ,Article ,03 medical and health sciences ,Internal medicine ,Fibrinolysis ,ARR: absolute risk reduction ,medicine ,Humans ,In patient ,Propensity Score ,Aged ,Retrospective Studies ,030304 developmental biology ,PSM: propensity score matching ,Pharmacology ,NTproBNP: N-terminal prohormone of brain natriuretic peptide ,COVID-19: coronavirus disease 2019 ,TCM: traditional Chinese medicine ,business.industry ,SARS: severe acute respiratory syndrome ,COVID-19 ,Retrospective cohort study ,COVID-19 Drug Treatment ,WHO: World Health Organization ,Complementary and alternative medicine ,Propensity score matching ,Usual care ,business ,Drugs, Chinese Herbal ,propensity score matching Abbreviations AEs: Adverse events - Abstract
Background Chinese herbal medicine (CHM) has been used for severe illness caused by coronavirus disease 2019 (COVID-19), but its treatment effects and safety are unclear. Purpose This study reviews the effect and safety of CHM granules in the treatment of patients with severe COVID-19. Methods We conducteda single-center, retrospective study on patients with severe COVID-19 in a designated hospital in Wuhan from January 15, 2020 to March 30, 2020. The propensity score matching (PSM) was used to assess the effect and safety of the treatment using CHM granules. The ratio of patients who received treatment with CHM granules combined with usual care and those who received usual care alone was 1:1. The primary outcome was the time to clinical improvement within 28 days, defined as the time taken for the patients’ health to show improvement by decline of two categories (from the baseline) on a modified six-category ordinal scale, or to be dischargedfrom the hospital before Day 28. Results Using PSM, 43 patients (45% male) aged 65.6 (57–70) yearsfrom each group were exactly matched. No significant difference was observed in clinical improvement of patients treated with CHM granules compared with those who received usual (p = 0.851). However, the use of CHM granules reduced the 28-day mortality (p = 0.049) and shortened the duration of fever (4 days vs. 7 days, p = 0.002). The differences in the duration of cough and dyspnea and the difference in lung lesion ratio on computerized tomography scans were not significant.Commonly,patients in the CHM group had an increased D -dimer level (p = 0.036). Conclusion Forpatients with severe COVID-19, CHM granules, combined with usual care, showed no improvement beyond usual care alone. However, the use of CHM granules reduced the 28-day mortality rate and the time to fever alleviation. Nevertheless, CHM granules may be associated with high risk of fibrinolysis.
- Published
- 2021