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1.
Phytomedicine ; : 154136, 2022.
Article in English | ScienceDirect | ID: covidwho-1804982

ABSTRACT

Background As coronavirus disease 2019 (COVID-19) continues to spread throughout countries, researchers and scientific groups have published a large number of scientific papers examining effective treatments and prevention strategies for COVID-19, including herbal medicine. It has become difficult to navigate the increasing volume of scientific material on the pandemic, and critical appraisal of these outcomes is needed. This overview of systematic reviews (SRs) aims to synthesize evidence from SRs and summarize the effects of herbal medicine interventions in the treatment of COVID-19. Methods Four databases were searched from inception up to October 20, 2021. SRs analyzing primary studies of the efficacy of herbal medications for treating COVID-19 were included. Two reviewers selected the studies and retrieved the data independently. The AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) was used to assess the methodological quality of the included SRs. Results A total of 21 SRs on herbal medicine treatments for COVID-19 were included. All SRs were published between May 2020 and September 2021. Thirteen of the SRs included only randomized controlled trials (RCTs), whereas the remaining eight included evidence from nonrandomized trials in addition to RCTs, with a significant overlap identified across the RCTs. Thirteen SRs concluded that existing evidence was insufficient to form a definite judgment, eight found that herbal therapy is useful, and none indicated that herbal medicine had no benefit. The AMSTAR 2 tool revealed that the methodological quality of the included SRs was generally low. Conclusion In this overview of SRs, we reviewed herbal medicine-related evidence from 21 SRs that were published after the discovery of COVID-19. This study shows that while there is considerable evidence demonstrating the advantages of herbal medicine interventions, the quality of the evidence is inadequate to provide solid and accurate judgments about the effectiveness of herbal medicine therapies for COVID-19. Despite the crisis caused by the pandemic, clinical studies and SRs should comply with established methodological standards.

2.
J Evid Based Med ; 15(1): 30-38, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1784678

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and safety of Qingjin Yiqi granules (QJYQ) on post-COVID-19 condition (PCC). METHOD: Patients who met the inclusion criteria were randomly assigned to two groups, the QJYQ group received QJYQ combined with standard rehabilitation treatments (SRTs) and the control group only received SRTs. The treatment course was 14 days. The primary outcomes were modified Medical Research Council (mMRC) scale and Borg scale, while the secondary outcomes included symptoms score and 6-minute walking distance (6MWD). The safety outcome was the incidence of adverse events. RESULTS: A total of 388 patients with PCC were enrolled and randomly assigned to the QJYQ group (n = 194) and the control group (n = 194). Compared to the controls, the mMRC scale was improved in the QJYQ group, which was better than that of the control group [ß (95%CI): -0.626 (-1.101, -0.151), p = 0.010]. A significant improvement in Borg scale was also observed in the QJYQ group compared to the control group [ß (95%CI): -0.395(-0.744, -0.046), p = 0.026]. There was no statistically significant difference in symptoms score and 6MWD between the two groups (p = 0.293, p = 0.724). No treatment-related adverse events were observed in either group. CONCLUSIONS: QJYQ can bring benefits to patients with PCC, mainly in the improvement of breathlessness and fatigue.


Subject(s)
COVID-19 , COVID-19/drug therapy , Humans , Treatment Outcome
3.
Frontiers in pharmacology ; 12, 2021.
Article in English | EuropePMC | ID: covidwho-1695095

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has already spread around the world. The modality of traditional Chinese medicine (TCM) combined with Western medicine (WM) approaches is being used to treat COVID-19 patients in China. Several systematic reviews (SRs) are available highlighting the efficacy and safety of TCM combined with WM approaches in COVID-19 patients. However, their evidence quality is not completely validated. Purpose: We aimed to assess the methodological quality and the risk of bias of the included SRs, assess the evidence quality of outcomes, and present their trends and gaps using the evidence mapping method. Methods: PubMed, Cochrane Library, Embase, CNKI, CBM, and Wanfang Data were searched from inception until March 2021 to identify SRs pertaining to the field of TCM combined with WM approaches for COVID-19. The methodological quality of the SRs was assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2), the risk of bias of the included SRs was assessed with the Risk of Bias in Systematic Review (ROBIS) tool, and the evidence quality of outcomes was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: In total, 23 SRs were found eligible. Twenty-one were rated of moderate confidence by AMSTAR 2, while 12 were rated at low risk using the ROBIS tool. In addition, most outcomes were graded as having moderate quality using the GRADE system. We found that the combined use of TCM and WM approaches could improve the CT recovery rate, effective rate, viral nucleic acid negative conversion rate, and the disappearance rate of fever, cough, and shortness of breath. Also, these approaches could decrease the conversion rate from mild to critical, white blood cell counts, and lymphocyte counts and shorten the time to viral assay conversion and the length of hospital stay. Conclusion: TCM combined with WM approaches had advantages in efficacy, laboratory, and clinical symptom outcomes of COVID-19, but the methodological deficiencies of SRs should be taken into consideration. Therefore, to better guide clinical practice in the future, the methodological quality of SRs should still be improved, and high-quality randomized controlled trials (RCTs) and observational studies should also be carried out.

4.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321465

ABSTRACT

Background: Previous studies showed that the effect of antivirals for COVID-19 was promising but varied across patient population, and was modest among severe cases. Chinese Medicine (CM) was extensively used and reported effective in China, awaiting further evidence support. We aimed to evaluate the real-world effectiveness of add-on semi-individualized.Methods: A retrospective total sampling cohort of 1788 adult confirmed COVID-19 patients were recruited from all 2235 consecutive records retrieved from 5 hospitals in Wuhan during15 January to 13 March 2020. Consultation notes, laboratory/imaging investigations, pharmacy and prognosis records were linked by an electronic medical record system and verified by at least 2 researchers independently. The mortality of add-on semi-individualized CM users and non-users was compared by weighted hazard ratios of multivariable Cox regression and by propensity score matching. Change of biomarkers was compared between groups and the frequency of CMs used was analysed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. Sensitivity analyses were conducted to test the robustness.Findings: The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a significant mortality reduction of 58% (HR=0.42, 95%CI: 0.23 to 0.77, p=0.005) and 66% (HR=0.34, 95%CI: 0.15 to 0.76, p=0.009) among all and severe/critical COVID-19 cases with dose-dependent response, after inversely weighted with propensity score calculated by age, gender, history of hypertension, diabetes, coronary artery disease and disease severity. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients received add-on CM had a trend of stabilized D-dimer level after 3-7 days of admission compared to baseline.Interpretation: Add-on semi-individualized CM was associated with reduced mortality demonstrating dose-dependent response, especially among severe/critical COVID-19 patients. Chinese medicine could be considered as an add-on regimen for trial use.Funding Statement: This work is partially supported by the National Key Research and Development Program (2017YFC1703506 and 2020YFC0841600). Declaration of Interests: No financial relationships with any organisations that might have an interest in the submitted work in the previous three years;no other relationships or activities that could appear to have influenced the submitted work.Ethics Approval Statement: This study was approved by the ethics review board of Hubei Provincial Hospital of Traditional Chinese Medicine (HBZY2020-C01-01). Written consent was waived due to the retrospective nature.

5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-315384

ABSTRACT

Background: Characteristics of registered systematic reviews (SRs) on traditional Chinese medicine (TCM) for coronavirus disease 2019 (COVID-19) remain unclear. This study aimed to analyze research collaboration, interventions, and outcomes in registered SRs of TCM associated with COVID-19. Methods: : PROSPERO was searched to obtain SRs of TCM related to COVID-19 up to July 1, 2020. VOSviewer 1.6.14 software was used to generate network maps for countries, institutions, and provinces. Results: : A total of 80 SRs were included, which were registered by 81 institutions from 6 countries. China (76, 95.00%) was the country with the highest output. 21 provinces in China contributed to the registration of SRs, Sichuan (25, 30.12%), Beijing (13, 15.66%), and Shaanxi (7, 8.43%) were the top three productive provinces. The top three productive institutions were Chengdu University of traditional Chinese medicine (18, 24.66%), Shaanxi University of traditional Chinese medicine (7, 9.59%), and Beijing University of traditional Chinese medicine (6, 8.22%). Collaborations among countries, provinces, and institutions were sparse. Interventions investigated included traditional Chinese medicine, integrated Chinese and Western medicine, acupuncture, and Taijiquan, but the description was brief, and no specific implementation plan was provided. The most frequently used primary outcome was clinical efficiency (45, 56.25%), and the most frequently used secondary outcome was the adverse event (50, 62.5%). The expression of the outcomes was not standardized. Conclusions: : Although there were some collaborations between provinces and institutions, cooperation between countries should be further strengthened. The identified deficiencies in interventions and outcomes should be given more attention by future researchers.

6.
J Ment Health ; : 1-10, 2022 Jan 04.
Article in English | MEDLINE | ID: covidwho-1604963

ABSTRACT

BACKGROUND: The coronavirus (COVID-19) pandemic has seen a global surge in anxiety, depression, post-traumatic stress disorder (PTSD), and stress. AIMS: This study aimed to describe the perspectives of patients with COVID-19, their family, health professionals, and the general public on the impact of COVID-19 on mental health. METHODS: A secondary thematic analysis was conducted using data from the COVID-19 COS project. We extracted data on the perceived causes and impact of COVID-19 on mental health from an international survey and seven online consensus workshops. RESULTS: We identified four themes (with subthemes in parenthesis): anxiety amidst uncertainty (always on high alert, ebb and flow of recovery); anguish of a threatened future (intense frustration of a changed normality, facing loss of livelihood, trauma of ventilation, a troubling prognosis, confronting death); bearing responsibility for transmission (fear of spreading COVID-19 in public; overwhelming guilt of infecting a loved one); and suffering in isolation (severe solitude of quarantine, sick and alone, separation exacerbating grief). CONCLUSION: We found that the unpredictability of COVID-19, the fear of long-term health consequences, burden of guilt, and suffering in isolation profoundly impacted mental health. Clinical and public health interventions are needed to manage the psychological consequences arising from this pandemic.

7.
Front Pharmacol ; 11: 614024, 2020.
Article in English | MEDLINE | ID: covidwho-1542362

ABSTRACT

Sepsis-induced myocardial dysfunction is a major contributor to the poor outcomes of septic shock. As an add-on with conventional sepsis management for over 15 years, the effect of Xuebijing injection (XBJ) on the sepsis-induced myocardial dysfunction was not well understood. The material basis of Xuebijing injection (XBJ) in managing infections and infection-related complications remains to be defined. A murine cecal ligation and puncture (CLP) model and cardiomyocytes in vitro culture were adopted to study the influence of XBJ on infection-induced cardiac dysfunction. XBJ significantly improved the survival of septic-mice and rescued cardiac dysfunction in vivo. RNA-seq revealed XBJ attenuated the expression of proinflammatory cytokines and related signalings in the heart which was further confirmed on the mRNA and protein levels. Xuebijing also protected cardiomyocytes from LPS-induced mitochondrial calcium ion overload and reduced the LPS-induced ROS production in cardiomyocytes. The therapeutic effect of XBJ was mediated by the combination of paeoniflorin and hydroxysafflor yellow A (HSYA) (C0127-2). C0127-2 improved the survival of septic mice, protected their cardiac function and cardiomyocytes while balancing gene expression in cytokine-storm-related signalings, such as TNF-α and NF-κB. In summary, Paeoniflorin and HSYA are key active compounds in XBJ for managing sepsis, protecting cardiac function, and controlling inflammation in the cardiac tissue partially by limiting the production of IL-6, IL-1ß, and CXCL2.

8.
Acta Pharm Sin B ; 11(11): 3337-3363, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1499623

ABSTRACT

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.

9.
Engineering (Beijing) ; 2021 Oct 28.
Article in English | MEDLINE | ID: covidwho-1487711

ABSTRACT

Traditional Chinese medicine (TCM) has been successfully applied worldwide in the treatment of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the pharmacological mechanisms underlying this success remain unclear. Hence, the aim of this review is to combine pharmacological assays based on the theory of TCM in order to elucidate the potential signaling pathways, targets, active compounds, and formulas of herbs that are involved in the TCM treatment of COVID-19, which exhibits combatting viral infections, immune regulation, and amelioration of lung injury and fibrosis. Extensive reports on target screening are elucidated using virtual prediction via docking analysis or network pharmacology based on existing data. The results of these reports indicate that an intricate regulatory mechanism is involved in the pathogenesis of COVID-19. Therefore, more pharmacological research on the natural herbs used in TCM should be conducted in order to determine the association between TCM and COVID-19 and account for the observed therapeutic effects of TCM against COVID-19.

10.
J Evid Based Med ; 14(4): 313-332, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1462829

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has turned into a pandemic and resulted in huge death tolls and burdens. Integrating Chinese and western medicine has played an important role in the fight against the COVID-19 pandemic. PURPOSE: We aimed to develop a living evidence-based guideline of integrating Chinese and western medicine for COVID-19. STUDY DESIGN: Living evidence-based guideline. METHODS: This living guideline was developed using internationally recognized and accepted guideline standards, dynamically monitoring the release of new clinical evidence, and quickly updating the linked living systematic review, evidence summary tables, and recommendations. Modified Delphi method was used to reach consensus for all recommendations. The certainty of the evidence, resources, and other factors were fully considered, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence and the strength of recommendations. RESULTS: The first version of this living guidance focuses on patients who are mild or moderate COVID-19. A multidisciplinary guideline development panel was established. Ten clinical questions were identified based on the status of evidence and a face-to-face experts' consensus. Finally, nine recommendations were reached consensus, and were formulated from systematic reviews of the benefits and harms, certainty of evidence, public accessibility, policy supports, feedback on proposed recommendations from multidisciplinary experts, and consensus meetings. CONCLUSION: This guideline panel made nine recommendations, which covered five traditional Chinese medicine (TCM) prescription granules/decoction (MXXFJD, QFPD, XFBD, TJQW, and JWDY), three Chinese patent medicines (LHQW granules/capsule, JHQG granules, and LHQK granules), and one Chinese herbal injection (XBJ injection). Of them, two were strongly recommended (LHQW granules/capsule and QFPD decoction), and five were weakly recommended (MXXFJD decoction, XFBD decoction, JHQG granules, TJQW granules, and JWDY decoction) for the treatment of mild and moderate COVID-19; two were weakly recommended against (XBJ injection and LHQK granules) the treatment of mild and moderate COVID-19. The users of this living guideline are most likely to be clinicians, patients, governments, ministries, and health administrators.


Subject(s)
COVID-19 , Drugs, Chinese Herbal , China , Humans , Medicine, Chinese Traditional , Pandemics , Practice Guidelines as Topic , SARS-CoV-2
11.
Integr Med Res ; 10: 100774, 2021.
Article in English | MEDLINE | ID: covidwho-1406276

ABSTRACT

BACKGROUND: A large number of protocols for Systematic Reviews (SR) of Traditional Chinese Medicine (TCM) for coronavirus disease 2019 (COVID-19) have been registered in the International Prospective Register of Systematic Reviews (PROSPERO). This study aimed to analyze the innovativeness and rigorousness of the SR protocols and make recommendations for the design and implementation of future SRs on TCM for COVID-19. This effort is likely to enhance the value of the produced information and prevent the futility of the research. METHODS: PROSPERO was searched comprehensively for identifying SRs of TCM for COVID-19 from the inception of the database to August 2020. Two researchers independently screened the literature, extracted the data, and cross-checked the retrieved information for consistency. The following details were recorded: database, registration time, organizations, types of research included, participants, interventions, and outcome measures. All extracted data were analyzed by an overview. The "P - participants, I - interventions, C - controls, and O - outcomes (PICO)" included in the protocols were compared for similarity. The outcomes of the included SR protocols were compared with the newly published Core Outcome Sets (COSs). RESULTS: A total of 80 protocols of SR related to TCM for COVID-19 were obtained after a primary search, and finally 71 protocols were included. The majority of the protocols were from China. Thirty-two organizations participated in the protocol registrations, including 11 hospitals and 21 universities/colleges. However, some protocols were not innovative or rigorous enough, as the PICO of some protocols were similar and non-specific, and the searched literature was incomprehensive. In addition, COS is not commonly adopted. CONCLUSIONS: Registering a protocol of SR is an effective way to ensure the usefulness of the produced information, and to avoid the duplication of research and the wastage of resources. In future SR protocols, it is important to focus on and solve the methodological problems such as non-specific PICO, incomprehensive literature retrieval, and improper outcome measures.

12.
Vox Sang ; 116(6): 682-691, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1319367

ABSTRACT

BACKGROUND AND OBJECTIVES: Thousands of healthcare workers (HCWs) have been infected with 2019 novel coronavirus pneumonia (COVID-19) during the COVID-19 pandemic. Laboratory personnel in blood transfusion departments may be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) if laboratory biosafety protection is insufficient. Therefore, we investigated the current situation of laboratory biosafety protection in blood transfusion departments to determine how to improve the safety of laboratory processes. MATERIALS AND METHODS: An online survey was conducted in blood transfusion departments from 1st to 6th May 2020 in China. A total of 653 individuals completed the questionnaire. The questionnaire was designed with reference to COVID-19 laboratory biosafety summarized in Annex II. All responses were summarized using only descriptive statistics and expressed as frequencies and ratios [n (%)]. RESULTS: Most participants were concerned about COVID-19. Some participants had inadequate knowledge of COVID-19. Two participants stated that there were laboratory personnel infected with SARS-CoV-2 in their departments. A total of 31 (4.7%) participants did not receive any safety and security training. In terms of laboratory biosafety protection practices, the major challenges were suboptimal laboratory safety practices and insufficient laboratory conditions. CONCLUSION: The major deficiencies were insufficient security and safety training, and a lack of personal protective equipment, automatic cap removal centrifuges and biosafety cabinets. Consequently, we should enhance the security and safety training of laboratory personnel to improve their laboratory biosafety protection practices and ensure that laboratory conditions are sufficient to improve the safety of laboratory processes.


Subject(s)
COVID-19/prevention & control , Containment of Biohazards , Laboratories , Pandemics , Transfusion Reaction/prevention & control , Adolescent , Adult , COVID-19/epidemiology , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Young Adult
13.
Pharmacol Res ; 158: 104896, 2020 08.
Article in English | MEDLINE | ID: covidwho-1318933

ABSTRACT

Corona virus disease (COVID-19) has now spread to all parts of the world and almost all countries are battling against it. This study aimed to assess the efficacy and safety of Integrated Traditional Chinese and Western Medicine (Hereinafter referred to as "Integrated Medicine") to COVID-19. We searched six major Chinese and English databases to identify randomized controlled trials (RCTs) and case-control studies (CCSs) of Integrated Medicine on COVID-19. Two reviewers independently screened, identified studies, and extracted data. Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale were used to assess the quality of included RCTs and CCSs, respectively. Stata (version 13.0; StataCorp) was used to perform meta-analyses with the random-effects model. Risk ratio (RR) was used for dichotomous data while the weighted mean difference (WMD) was adopted for continuous variables as effect size, both of which were demonstrated in effect size and 95% confidence intervals (CI). A total of 11 studies were included. Four were RCTs and seven were CCSs. The sample size of including studies ranged from 42 to 200 (total 982). The traditional Chinese medicine included Chinese medicine compound drugs (QingFei TouXie FuZhengFang) and Chinese patent medicine (e.g. Shufeng Jiedu Capsule, Lianhua Qingwen granules). Compared with the control group, the overall response rate [RR = 1.230, 95%CI (1.113, 1.359), P = 0.000], cure rate [RR = 1.604, 95%CI (1.181, 2.177), P = 0.002], severity illness rate [RR = 0.350, 95%CI (0.154, 0.792), P = 0.012], and hospital stay [WMD = -1.991, 95%CI (-3.278, -0.703), P = 0.002] of the intervention group were better. In addition, Integrated Medicine can improve the disappearance rate of fever, cough, expectoration, fatigue, chest tightness and anorexia and reduce patients' fever, and fatigue time (P < 0.05). This review found that Integrated Medicine had better effects and did not increase adverse drug reactions for COVID-19. More high-quality RCTs are needed in the future.


Subject(s)
Betacoronavirus , Clinical Medicine/methods , Combined Modality Therapy/adverse effects , Combined Modality Therapy/methods , Coronavirus Infections/therapy , Medicine, Chinese Traditional/methods , Pneumonia, Viral/therapy , COVID-19 , Humans , Pandemics , SARS-CoV-2
14.
Med Phys ; 48(8): 4334-4349, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1265402

ABSTRACT

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused hundreds of thousands of infections and deaths. Efficient diagnostic methods could help curb its global spread. The purpose of this study was to develop and evaluate a method for accurately diagnosing COVID-19 based on computed tomography (CT) scans in real time. METHODS: We propose an architecture named "concatenated feature pyramid network" ("Concat-FPN") with an attention mechanism, by concatenating feature maps of multiple. The proposed architecture is then used to form two networks, which we call COVID-CT-GAN and COVID-CT-DenseNet, the former for data augmentation and the latter for data classification. RESULTS: The proposed method is evaluated on 3 different numbers of magnitude of COVID-19 CT datasets. Compared with the method without GANs for data augmentation or the original network auxiliary classifier generative adversarial network, COVID-CT-GAN increases the accuracy by 2% to 3%, the recall by 2% to 4%, the precision by 1% to 3%, the F1-score by 1% to 3%, and the area under the curve by 1% to 4%. Compared with the original network DenseNet-201, COVID-CT-DenseNet increases the accuracy by 1% to 3%, the recall by 4% to 9%, the precision by 1%, the F1-score by 1% to 3%, and the area under the curve by 2%. CONCLUSION: The experimental results show that our method improves the efficiency of diagnosing COVID-19 on CT images, and helps overcome the problem of limited training data when using deep learning methods to diagnose COVID-19. SIGNIFICANCE: Our method can help clinicians build deep learning models using their private datasets to achieve automatic diagnosis of COVID-19 with a high precision.


Subject(s)
COVID-19 , COVID-19 Testing , Humans , Radionuclide Imaging , SARS-CoV-2 , Tomography, X-Ray Computed
15.
J Clin Lab Anal ; 35(5): e23767, 2021 May.
Article in English | MEDLINE | ID: covidwho-1216187

ABSTRACT

BACKGROUND: Different disease severities of COVID-19 patients could be reflected on clinical laboratory findings. METHODS: In this single-centered retrospective study, demographic, clinical, and laboratory indicators on and during admission were compared among 74 participants with mild, moderate, critical severe, or severe classification. Risk factors associated with disease severity were analyzed by multivariate analyses. The AUC and 95% CI of the ROC curve were calculated. RESULTS: The most common manifestations of these patients were fever and cough. Critical severe or severe group owned the longest length of stay (23 (19,31), p < 0.001). After multivariate logistic regression, independent influence factors on admission for severity of disease were CK-MB (OR 0.674; 95% CI 0.489-0.928; p = 0.016), LDH (OR 1.111 or 1.107; 95% CI 1.026-1.204 or 1.022-1.199; p = 0.009 or 0.013), normal T-BIL (OR 4.58 × 10-8 ; 95% CI 3.05 × 10-9 -6.88 × 10-7 ; p < 0.001), LYM% (OR 0.008; 95% CI 0-0.602; p = 0.029), and normal ESR (OR 0.016; 95% CI 0-0.498; p = 0.019). Factors during hospitalization were normal T-BIL (OR 8.56 × 10-9 ; 95% CI 8.30 × 10-10 -8.83 × 10-8 ; p < 0.001), LYM (OR 0.068; 95% CI 0.005-0.934; p = 0.044), albumin (OR 0.565; 95% CI 0.327-0.977; p = 0.041), and normal NEU% (OR 0.013; 95% CI 0.000-0.967; p = 0.048). Combined indicators of AUC were 0.860 (LYM, LDH, and normal ESR on admission, p < 0.001) and 0.750 (CK-MB, LDH, and normal T-BIL during hospitalization, p = 0.020) when predicting for severe or critical severe patients. CONCLUSION: To pay close attention to the progression of COVID-19 and take measures promptly, we should be cautious of the laboratory indicators when patients on admission especially CK-MB, LDH, LYM%, T-BIL as well as ESR; and T-BIL, LYM, albumin, NEU% with the process of disease.


Subject(s)
COVID-19/diagnosis , SARS-CoV-2 , Adult , Aged , Bilirubin/blood , Blood Sedimentation , COVID-19/blood , Female , Humans , L-Lactate Dehydrogenase/blood , Laboratories , Male , Middle Aged , Retrospective Studies , Severity of Illness Index
16.
Ann Palliat Med ; 10(5): 5146-5155, 2021 May.
Article in English | MEDLINE | ID: covidwho-1200420

ABSTRACT

BACKGROUND: Reduning injection is a traditional Chinese medicine (TCM) with known efficacy against a variety of viral infections, but there is no data about its efficacy against coronavirus disease 2019 (COVID-19). METHODS: To explore the efficacy and safety of Reduning injection in the treatment of COVID-19, a randomized, open-labeled, multicenter, controlled trial was conducted from 12 general hospitals between 2020.02.06 and 2020.03.23. Patients with COVID-19 who met the diagnostic criteria of the "Diagnosis and Treatment Program for Novel Coronavirus Infection Pneumonia (Trial Fifth Edition)". Patients were randomized to routine treatment with or without Reduning injection (20 mL/day for 14 days) (ChiCTR2000029589). The primary endpoint was the rate of achieving clinical symptom recovery on day 14 of treatment. RESULTS: There were 77 and 80 participants in the Reduning and control groups. The symptom resolution rate at 14 days was higher in the Reduning injection than in controls [full-analysis set (FAS): 84.4% vs. 60.0%, P=0.0004]. Compared with controls, the Reduning group showed shorter median time to resolution of the clinical symptoms (143 vs. 313.5 h, P<0.001), shorter to nucleic acid test turning negative (146.5 vs. 255.5 h, P<0.001), shorter hospital stay (14.1 vs. 18.1 days, P<0.001), and shorter time to defervescence (29 vs. 71 h, P<0.001). There was no difference in AEs (3.9% vs. 8.8%, P=0.383). CONCLUSIONS: This preliminary trial suggests that Reduning injection might be effective and safe in patients with symptomatic COVID-19.


Subject(s)
COVID-19 , Drugs, Chinese Herbal , Drugs, Chinese Herbal/adverse effects , Humans , Medicine, Chinese Traditional , SARS-CoV-2 , Treatment Outcome
17.
Journal of Modern Laboratory Medicine ; 35(5):103-105, 2020.
Article in Chinese | GIM | ID: covidwho-1125328

ABSTRACT

Objective: To investigate the related factors of abnormal liver function in patients with new coronavirus pneumonia (COVID-19).

18.
Am J Chin Med ; 49(3): 543-575, 2021.
Article in English | MEDLINE | ID: covidwho-1119998

ABSTRACT

Chinese medicine (CM) was extensively used to treat COVID-19 in China. We aimed to evaluate the real-world effectiveness of add-on semi-individualized CM during the outbreak. A retrospective cohort of 1788 adult confirmed COVID-19 patients were recruited from 2235 consecutive linked records retrieved from five hospitals in Wuhan during 15 January to 13 March 2020. The mortality of add-on semi-individualized CM users and non-users was compared by inverse probability weighted hazard ratio (HR) and by propensity score matching. Change of biomarkers was compared between groups, and the frequency of CMs used was analyzed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a mortality reduction of 58% (HR = 0.42, 95% CI: 0.23 to 0.77, [Formula: see text] = 0.005) among all COVID-19 cases and 66% (HR = 0.34, 95% CI: 0.15 to 0.76, [Formula: see text] = 0.009) among severe/critical COVID-19 cases demonstrating dose-dependent response, after inversely weighted with propensity score. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients that received add-on CM had a trend of stabilized D-dimer level after 3-7 days of admission when compared to baseline. Immunomodulating and anti-asthmatic CMs were most used. Add-on semi-individualized CM was associated with significantly reduced mortality, especially among severe/critical cases. Chinese medicine could be considered as an add-on regimen for trial use.


Subject(s)
COVID-19/prevention & control , Drugs, Chinese Herbal/therapeutic use , Hospitalization/statistics & numerical data , Medicine, Chinese Traditional/methods , Registries/statistics & numerical data , SARS-CoV-2/drug effects , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/virology , China/epidemiology , Drugs, Chinese Herbal/classification , Epidemics , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology
20.
SciFinder; 2020.
Preprint | SciFinder | ID: ppcovidwho-5399

ABSTRACT

A review. Novel coronavirus pneumonia belongs to the category of Trditional Chinese Medicine epidemics. Since its outbreak, China′s health management official has issued a series of Diagnosis and Treatment Schemes for Preventionand Treatment of Novel Coronavirus Pneumonia (referred to as the National Schemes), which requires for the active role of traditional Chinese medicine and strengthening the integration of traditional Chinese and western medicine. There were 24 provinces, municipalities and autonomous regions have released the Regional Schemes on the basis of the National Schemes, combining local characteristics. This study comprehensively collected and sorted out relevant information and systematically analyzed the different schemes. It is believed that this epidemic has several characteristics, namely dampness, heat, toxin and deficiency. The disease lies in the lungs, hurting righteousness qi, damaging the spleen and lungs and even leading to loss of consciousness. The regional schemes basically adopts different measures according to the three stages of prevention, treatment and recovery. The prevention stage is mainly based on the solidifying surface-qi using Yupingfeng San, and the treatment stage is mainly based on clearing heat, disolving dampness, detoxification and rescuing. The recovery stage is mainly based on nourishing qi and Yin.

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