An updated meta-analysis of Chinese herbal medicine for the prevention of COVID-19 based on Western-Eastern medicine

• Published in: Frontiers in pharmacology 2023-11, Vol.14, p.1257345-1257345
• Main Authors: Hu, Siying, Luo, Dan, Zhu, Qikui, Pan, Jie, Chen, Bonan, Furian, Michael, Harkare, Harsh Vivek, Sun, Shoukai, Fansa, Adel, Wu, Xiaoping, Yu, Baili, Ma, Tianhong, Wang, Fei, Shi, Shihua
• Format: Article
• Language: English
• Subjects: Chinese herbal medicine; COVID-19; immunity; meta-analysis; Pharmacology; prevention; WE medicine
• ISSN: 1663-9812; 1663-9812
• DOI: 10.3389/fphar.2023.1257345

Background and aims: Chinese herbal medicine (CHM) was used to prevent and treat coronavirus disease 2019 (COVID-19) in clinical practices. Many studies have demonstrated that the combination of CHM and Western medicine can be more effective in treating COVID-19 compared to Western medicine alone. However, evidence-based studies on the prevention in undiagnosed or suspected cases remain scarce. This systematic review and meta-analysis aimed to investigate the effectiveness of CHM in preventing recurrent, new, or suspected COVID-19 diseases. Methods: We conducted a comprehensive search using ten databases including articles published between December 2019 and September 2023. This search aimed to identify studies investigating the use of CHM to prevent COVID-19. Heterogeneity was assessed by a random-effects model. The relative risk (RR) and mean differences were calculated using 95% confidence intervals (CI). The modified Jadad Scale and the Newcastle-Ottawa Scale (NOS) were employed to evaluate the quality of randomized controlled trials and cohort studies, respectively. Results: Seventeen studies with a total of 47,351 patients were included. Results revealed that CHM significantly reduced the incidence of COVID-19 (RR = 0.24, 95% CI = 0.11–0.53, p = 0.0004), influenza (RR = 0.37, 95% CI = 0.18–0.76, p = 0.007), and severe pneumonia exacerbation rate (RR = 0.17, 95% CI = 0.05–0.64, p = 0.009) compared to non-treatment or conventional control group. Evidence evaluation indicated moderate quality evidence for COVID-19 incidence and serum complement components C3 and C4 in randomized controlled trials. For the incidence of influenza and severe pneumonia in RCTs as well as the ratio of CD4 + /CD8 + lymphocytes, the evidence quality was low. The remaining outcomes including the disappearance rate of symptoms and adverse reactions were deemed to be of very low quality. Conclusion: CHM presents a promising therapeutic option for the prevention of COVID-19. However, additional high-quality clinical trials are needed to further strengthen evidential integrity.