Article type
Abstract
Background: Coronavirus Disease 2019 (COVID-19) is a rapidly spreading disease that has globally burdened healthcare systems. Numerous clinical trials have emerged to investigate the efficacy of Chinese herbal medicine (CHM) in COVID-19 treatment, leading to a proliferation of systematic reviews summarizing these studies.
Objective: This Overview aims to examine the safety and effectiveness of utilizing CHM for COVID-19 treatment while also appraising the quality of supporting evidence.
Methods: PubMed, Cochrane, Embase, Sinomed, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP were searched for systematic reviews on proprietary CHM treating COVID-19 from database inception to June 15, 2023. A secondary meta-analysis was conducted using Revman 5.3 software, AMSTAR-II and GRADE approach were used for assessing the methodological quality of the included reviews and the certainty of the evidence.
Results: We included 8 systematic reviews with a total of 8188 cases. Meta-analysis revealed that combining CHM with the standard treatment was more advantageous across multiple outcome indicators compared to using standard treatment alone.These primarily included all-cause mortality (Relative Risk (RR)=0.27，95% Confidence Interval (CI)=[0.08~0.96]，P=0.04), adverse events (RR=0.34, 95%CI=[0.20~0.59], P＜0.0001), rate of conversion to severe cases (RR=0.33, 95%CI=[0.17~0.66], P=0.002), Improvement in pulmonary imaging (RR=1.28, 95%CI=[1.12~1.46], P=0.0003). There was no significant difference in clinical symptom recovery rate (cough) and clinical symptom recovery time (cough and fatigue) between groups. Bubble plot results suggested that Buzhongyiqi Decoction, Maxingshigan-Weijing Decoction, Huashibaidu Formula, Modified Yupingfeng Powder, Modified Dayuan Drink, Shengmai Powder, Huashibaidu Formula, and Sheng Mai Powder Combined with Shenling Bai Zhu Powder may have weak to moderate effects in increasing Viral clearance rate, reducing the Rate of conversion to severe cases, lowering Adverse events, and improving pulmonary imaging.
Conclusion: Comprehensive analysis indicated that CHM showed good add-on effect in treating COVID-19. However, it is important to note that the overall quality of evidence in these studies is generally low, and further high-quality clinical trials are needed to validate these findings.
Keywords:Chinese herbal medicine; Covid-19; umbrella review; GRADE assessment; Bubble chart
Objective: This Overview aims to examine the safety and effectiveness of utilizing CHM for COVID-19 treatment while also appraising the quality of supporting evidence.
Methods: PubMed, Cochrane, Embase, Sinomed, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP were searched for systematic reviews on proprietary CHM treating COVID-19 from database inception to June 15, 2023. A secondary meta-analysis was conducted using Revman 5.3 software, AMSTAR-II and GRADE approach were used for assessing the methodological quality of the included reviews and the certainty of the evidence.
Results: We included 8 systematic reviews with a total of 8188 cases. Meta-analysis revealed that combining CHM with the standard treatment was more advantageous across multiple outcome indicators compared to using standard treatment alone.These primarily included all-cause mortality (Relative Risk (RR)=0.27，95% Confidence Interval (CI)=[0.08~0.96]，P=0.04), adverse events (RR=0.34, 95%CI=[0.20~0.59], P＜0.0001), rate of conversion to severe cases (RR=0.33, 95%CI=[0.17~0.66], P=0.002), Improvement in pulmonary imaging (RR=1.28, 95%CI=[1.12~1.46], P=0.0003). There was no significant difference in clinical symptom recovery rate (cough) and clinical symptom recovery time (cough and fatigue) between groups. Bubble plot results suggested that Buzhongyiqi Decoction, Maxingshigan-Weijing Decoction, Huashibaidu Formula, Modified Yupingfeng Powder, Modified Dayuan Drink, Shengmai Powder, Huashibaidu Formula, and Sheng Mai Powder Combined with Shenling Bai Zhu Powder may have weak to moderate effects in increasing Viral clearance rate, reducing the Rate of conversion to severe cases, lowering Adverse events, and improving pulmonary imaging.
Conclusion: Comprehensive analysis indicated that CHM showed good add-on effect in treating COVID-19. However, it is important to note that the overall quality of evidence in these studies is generally low, and further high-quality clinical trials are needed to validate these findings.
Keywords:Chinese herbal medicine; Covid-19; umbrella review; GRADE assessment; Bubble chart