ABSTRACT
Background: Chronic fatigue is a predominant symptom of post COVID-19 condition, or long COVID. We aimed to evaluate the efficacy and safety of Traditional, Complementary and Integrative Medicine (TCIM) for fatigue post COVID-19 infection. Methods: Ten English and Chinese language databases and grey literature were searched up to 12 April 2023 for randomized controlled trials (RCTs). Cochrane "Risk of bias" (RoB) tool was applied. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Effect estimates were presented as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI). Results: Thirteen RCTs with 1632 participants were included. One RCT showed that Bufei Huoxue herbal capsules reduced fatigue (n=129, MD -14.90, 95%CI -24.53 to -5.27), one RCT reported that Ludangshen herbal liquid lowered fatigue (n=184, MD -1.90, 95%CI -2.38 to -1.42), and the other one RCT shown that fatigue disappearance rate was higher with Ludangshen herbal liquid (n=184, RR 4.19, 95%CI 2.06 to 8.53). Compared to traditional Chinese medicine rehabilitation (TCM-rahab) alone, one RCT showed that fatigue symptoms were lower following Qingjin Yiqi granules plus TCM-rehab (n=388, MD -0.48, 95%CI -0.50 to -0.46). Due to concerns with RoB and/or imprecision, the certainty in this evidence was low to very low. No serious adverse events was reported. Conclusions: Limited evidence suggests that various TCIM interventions might reduce post COVID-19 fatigue. Larger, high quality RCTs of longer duration are required to confirm these preliminary findings. Study Registration: The protocol of this review has been registered at PROSPERO: CRD42022384136.
ABSTRACT
Cascade reactions catalyzed by two or more enzymes have been widely used in industrial production and exhibited many advantages over the single-enzyme catalytic system. In this study, two components of hydroxylase monooxygenase (HpaBC) were first co-immobilized by Ni2+-nitrilotriacetic acid (Ni-NTA) functionalized magnetic silica nanoparticles (Ni-NTA/H2N-SiO2@Fe3O4) for enhancing the stability and activity of biocatalysts with multi-components. These two components, HpaB and HpaC, were modified with histidine-tag and employed to construct a bi-enzyme catalytic system. After co-immobilization, the activity of the bi-enzyme system was 2.6 times of free enzymes. Meanwhile, the co-immobilized system was more stable against high temperature and alkaline condition, and maintained 76.6% of the initial activity for storage 12 days. Moreover, the co-immobilized HpaBC remained more than 60% catalytic activity after 7 cycles. These results showed that co-immobilized multi-component enzymes based on functionalized magnetic nanoparticles without purification would play a great potential role in the field of industrial biocatalysis.
