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Herbal medicine intervention for the treatment of COVID-19: a living systematic review and cumulative meta-analysis

Herbal medicine intervention for the treatment of COVID-19: a living systematic review and cumulative meta-analysis
Herbal medicine intervention for the treatment of COVID-19: a living systematic review and cumulative meta-analysis
Background: integrative herbal medicine has been reported to have beneficial effects in the treatment of coronavirus disease 2019 (COVID-19).

Aim: to compile up-to-date evidence of the benefits and risks of herbal medicine for the treatment of COVID-19 symptoms. 
Methods: eleven databases, including PubMed, Cochrane Register of Controlled Trials (CENTRAL), Embase, Allied and Complementary Medicine Database (AMED), Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Chinese Science and Technique Journals Database (VIP), Research Information Service System (RISS), Korean Medical database (KMBase), Korean Association of Medical Journal database (KoreaMed), and OASIS database, were searched from 15 June, 2020, until 28 March 2022. Randomized controlled trials (RCTs), published in any language, reporting the efficacy and safety outcomes of herbal medicine in patients of all ages with a PCR-confirmed diagnosis of COVID-19 were included in this analysis. Data extraction and quality assessments were performed independently.

Results: random-effects meta-analyses showed evidence of favorable effects of treatment with herbal medicine when added to standard treatment, versus standard treatment alone, on the total effective rate (p = 0.0001), time to remission from fever (p < 0.00001), rate of remission from coughing (p < 0.0001), fatigue (p = 0.02), sputum production (p = 0.004), improvement of manifestations observed on chest computed tomography scans (p < 0.00001), incidence of progression to severe COVID-19 (p = 0.003), all-cause mortality (p = 0.003), time to a negative COVID-19 coronavirus test (p < 0.0001), and duration of hospital stay (p = 0.0003). There was no evidence of a difference between herbal medicine added to standard treatment, versus standard treatment alone, on the rate of remission from symptoms such as a fever, sore throat, nasal congestion and discharge, diarrhea, dry throat, chills, and the rate of conversion to a negative COVID-19 coronavirus test. Meta-analysis showed no evidence of a significant difference in adverse events between the two groups. There was an unclear risk of bias across the RCTs included in this analysis, indicating that most studies had methodological limitations.

Conclusion: current evidence suggests that herbal medicine added to standard treatment has potential benefits in the treatment of COVID-19 symptoms but the certainty of evidence was low.
COVID-19 evidence, efficacy, integrative herbal medicine, living review, safety
1663-9812
Ang, Lin
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Song, Eunhye
9f61a1ba-d3f3-4768-abdf-b76491886f30
Hu, Xiao Yang
65904b24-3775-4b14-9532-eb703a056655
Lee, Hye Won
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Chen, Yaolong
f5a9ed5d-f256-4fe2-af09-b770c1fd660b
Lee, Myeong Soo
5ee0ac4f-e5bd-44ec-9650-21eba125f403
Ang, Lin
f80f6eda-0591-4e3a-b2b0-c05ba557f3d3
Song, Eunhye
9f61a1ba-d3f3-4768-abdf-b76491886f30
Hu, Xiao Yang
65904b24-3775-4b14-9532-eb703a056655
Lee, Hye Won
28573348-3f24-4b54-a571-b459048f05f6
Chen, Yaolong
f5a9ed5d-f256-4fe2-af09-b770c1fd660b
Lee, Myeong Soo
5ee0ac4f-e5bd-44ec-9650-21eba125f403

Ang, Lin, Song, Eunhye, Hu, Xiao Yang, Lee, Hye Won, Chen, Yaolong and Lee, Myeong Soo (2022) Herbal medicine intervention for the treatment of COVID-19: a living systematic review and cumulative meta-analysis. Frontiers in Pharmacology, 13 (6), [906764]. (doi:10.3389/fphar.2022.906764).

Record type: Article

Abstract

Background: integrative herbal medicine has been reported to have beneficial effects in the treatment of coronavirus disease 2019 (COVID-19).

Aim: to compile up-to-date evidence of the benefits and risks of herbal medicine for the treatment of COVID-19 symptoms. 
Methods: eleven databases, including PubMed, Cochrane Register of Controlled Trials (CENTRAL), Embase, Allied and Complementary Medicine Database (AMED), Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Chinese Science and Technique Journals Database (VIP), Research Information Service System (RISS), Korean Medical database (KMBase), Korean Association of Medical Journal database (KoreaMed), and OASIS database, were searched from 15 June, 2020, until 28 March 2022. Randomized controlled trials (RCTs), published in any language, reporting the efficacy and safety outcomes of herbal medicine in patients of all ages with a PCR-confirmed diagnosis of COVID-19 were included in this analysis. Data extraction and quality assessments were performed independently.

Results: random-effects meta-analyses showed evidence of favorable effects of treatment with herbal medicine when added to standard treatment, versus standard treatment alone, on the total effective rate (p = 0.0001), time to remission from fever (p < 0.00001), rate of remission from coughing (p < 0.0001), fatigue (p = 0.02), sputum production (p = 0.004), improvement of manifestations observed on chest computed tomography scans (p < 0.00001), incidence of progression to severe COVID-19 (p = 0.003), all-cause mortality (p = 0.003), time to a negative COVID-19 coronavirus test (p < 0.0001), and duration of hospital stay (p = 0.0003). There was no evidence of a difference between herbal medicine added to standard treatment, versus standard treatment alone, on the rate of remission from symptoms such as a fever, sore throat, nasal congestion and discharge, diarrhea, dry throat, chills, and the rate of conversion to a negative COVID-19 coronavirus test. Meta-analysis showed no evidence of a significant difference in adverse events between the two groups. There was an unclear risk of bias across the RCTs included in this analysis, indicating that most studies had methodological limitations.

Conclusion: current evidence suggests that herbal medicine added to standard treatment has potential benefits in the treatment of COVID-19 symptoms but the certainty of evidence was low.

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Accepted/In Press date: 23 May 2022
Published date: 20 June 2022
Additional Information: Funding Information: This work was supported by Korea Institute of Oriental Medicine (KSN2022210). This funding source did not participate in the design of this study or play any role during its execution, analyses, interpretation of the data, manuscript drafting, or decision to submit results.
Keywords: COVID-19 evidence, efficacy, integrative herbal medicine, living review, safety

Identifiers

Local EPrints ID: 468556
URI: http://eprints.soton.ac.uk/id/eprint/468556
ISSN: 1663-9812
PURE UUID: f6e7ba22-aad1-4428-98fc-6fe54a30f3de
ORCID for Xiao Yang Hu: ORCID iD orcid.org/0000-0002-3143-7999

Catalogue record

Date deposited: 18 Aug 2022 16:30
Last modified: 18 Nov 2022 02:44

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Contributors

Author: Lin Ang
Author: Eunhye Song
Author: Xiao Yang Hu ORCID iD
Author: Hye Won Lee
Author: Yaolong Chen
Author: Myeong Soo Lee

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