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Hu S, Luo D, Zhu Q, Pan J, Chen B, Furian M, Harkare HV, Sun S, Fansa A, Wu X, Yu B, Ma T, Wang F, Shi S. An updated meta-analysis of Chinese herbal medicine for the prevention of COVID-19 based on Western-Eastern medicine. Front Pharmacol 2023; 14:1257345. [PMID: 38044944 PMCID: PMC10693348 DOI: 10.3389/fphar.2023.1257345] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/13/2023] [Indexed: 12/05/2023] Open
Abstract
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.
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Affiliation(s)
- Siying Hu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dan Luo
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qikui Zhu
- Department of Biomedical Engineering and Computer and Data Science, Case Western Reserve University, Cleveland, OH, United States
| | - Jie Pan
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Bonan Chen
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Michael Furian
- Research Department, Swiss University of Traditional Chinese Medicine, Bad Zurzach, Switzerland
| | - Harsh Vivek Harkare
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
| | - Shoukai Sun
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Faculty of Science, University of Basel, Basel, Switzerland
| | - Adel Fansa
- Charité Universitätsmedizin Berlin, Berlin, Germany
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Xiaoping Wu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Baili Yu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianhong Ma
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fei Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shihua Shi
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Grinevich VB, Lazebnik LB, Kravchuk YA, Radchenko VG, Tkachenko EI, Pershko AM, Seliverstov PV, Salikova CP, Zhdanov KV, Kozlov KV, Makienko VV, Potapova IV, Ivanyuk ES, Egorov DV, Sas EI, Korzheva MD, Kozlova NM, Ratnikova AK, Ratnikov VA, Sitkin SI, Bolieva LZ, Turkina CV, Abdulganieva DI, Ermolova TV, Kozhevnikova SA, Tarasova LV, Myazin RG, Khomeriki NM, Pilat TL, Kuzmina LP, Khanferyan RA, Novikova VP, Polunina AV, Khavkin AI. Gastrointestinal disorders in post-COVID syndrome. Clinical guidelines. EXPERIMENTAL AND CLINICAL GASTROENTEROLOGY 2023:4-68. [DOI: 10.31146/1682-8658-ecg-208-12-4-68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Summary Post- COVID syndrome refers to the long-term consequences of a new coronavirus infection COVID-19, which includes a set of symptoms that develop or persist after COVID-19. Symptoms of gastrointestinal disorders in post- COVID syndrome, due to chronic infl ammation, the consequences of organ damage, prolonged hospitalization, social isolation, and other causes, can be persistent and require a multidisciplinary approach. The presented clinical practice guidelines consider the main preventive and therapeutic and diagnostic approaches to the management of patients with gastroenterological manifestations of postCOVID syndrome. The Guidelines were approved by the 17th National Congress of Internal Medicine and the 25th Congress of Gastroenterological Scientifi c Society of Russia.
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Affiliation(s)
| | - L. B. Lazebnik
- A. I. Yevdokimov Moscow State University of Medicine and Dentistry
| | | | | | | | | | | | | | | | - K. V. Kozlov
- Military Medical Academy named after S. M. Kirov
| | | | | | | | - D. V. Egorov
- Military Medical Academy named after S. M. Kirov
| | - E. I. Sas
- Military Medical Academy named after S. M. Kirov
| | | | | | - A. K. Ratnikova
- North-West District Scientifi c and Clinical Center named after L. G. Sokolov Federal Medical and Biological Agency
| | - V. A. Ratnikov
- North-West District Scientifi c and Clinical Center named after L. G. Sokolov Federal Medical and Biological Agency
| | - S. I. Sitkin
- North-Western state medical University named after I. I. Mechnikov;
Almazov National Medical Research Centre
| | | | | | | | - T. V. Ermolova
- North-Western state medical University named after I. I. Mechnikov
| | | | | | | | - N. M. Khomeriki
- Moscow Regional Research Clinical Institute n. a. M. F. Vladimirsky”
| | - T. L. Pilat
- Scientifi c Research Institute of labour medicine named after academician N. F. Izmerov
| | - L. P. Kuzmina
- Scientifi c Research Institute of labour medicine named after academician N. F. Izmerov;
I. M. Sechenov First Moscow State Medical University (Sechenov University)
| | | | | | | | - A. I. Khavkin
- Russian National Research Medical University named after N. I. Pirogov
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Milano A, Efthymakis K, D’Ardes D, Tana M, Mazzotta E, De Febis G, Laterza F, Tarquini P, Marini E, Porreca E, Cipollone F, Neri M. Gastrointestinal manifestations of SARS-CoV-2 infection in an Italian population of hospitalized patients. Therap Adv Gastroenterol 2022; 15:17562848221104610. [PMID: 35757382 PMCID: PMC9218448 DOI: 10.1177/17562848221104610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus enters the cells via angiotensin-converting enzyme 2 receptor; therefore, tissues expressing this receptor are potential targets for infection. Although many studies have observed gastrointestinal (GI) symptoms in coronavirus disease 2019 (COVID-19) patients, prevalence and clinical impact are still uncertain due to the heterogeneity of reports and obstacles to generalization. METHODS In this cross-sectional study, we included symptomatic patients requiring hospital admission, with a confirmed diagnosis of COVID-19 by nasopharyngeal polymerase chain reaction test, between 18 March and 30 May 2020. Demographic data, symptoms at onset, vital signs, and laboratory tests at admission were recorded. RESULTS In all, 300 patients were included (57%M, 43%F). GI symptoms were mainly diarrhea (13%), anorexia (4.3%), vomiting (3%), and abdominal pain (2.3%). Overall, males were younger (68 years versus 76 years; p = 0.01); patients with GI manifestations at disease onset required significantly faster hospital admission and showed larger GI complication rates. GI symptoms were associated with abnormal high aspartate aminotransferase and alanine aminotransferase serum titers, especially in male patients. CONCLUSION Our study on an Italian population during the outbreak of the COVID-19 pandemic shows that GI symptoms are part of the spectrum of the SARS-CoV-2 infection and could be the only manifestations at disease onset. Although patients with GI symptoms were associated with faster hospital admission and liver involvement, prognosis was not affected.
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Affiliation(s)
- Angelo Milano
- UOSD Endoscopia Digestiva e Gastroenterologia, Ospedale Clinicizzato ‘SS Annunziata’, ASL2 Abruzzo, Chieti, Italy
| | - Konstantinos Efthymakis
- UOSD Endoscopia Digestiva e Gastroenterologia, Ospedale Clinicizzato ‘SS Annunziata’, ASL2 Abruzzo, Chieti, Italy
| | - Damiano D’Ardes
- Medicina Generale 1, Ospedale Clinicizzato ‘SS Annunziata’, ASL2 Abruzzo, Chieti, Italy
| | - Marco Tana
- Medicina Generale 2, Ospedale Clinicizzato ‘SS Annunziata’, ASL2 Abruzzo, Chieti, Italy
| | - Elena Mazzotta
- Malattie Infettive, Ospedale Civile ‘Giuseppe Mazzini’, ASL Teramo, Teramo, Italy
| | - Giulia De Febis
- Medicina Interna, Ospedale ‘San Liberatore’, ASL Teramo, Atri, Italy
| | - Francesco Laterza
- UOSD Endoscopia Digestiva e Gastroenterologia, Ospedale Clinicizzato ‘SS Annunziata’, ASL2 Abruzzo, Chieti, Italy
| | - Pierluigi Tarquini
- Malattie Infettive, Ospedale Civile ‘Giuseppe Mazzini’, ASL Teramo, Teramo, Italy
| | - Enrico Marini
- Medicina Interna, Ospedale ‘San Liberatore’, ASL Teramo, Atri, Italy
| | - Ettore Porreca
- Medicina Generale 2, Ospedale Clinicizzato ‘SS Annunziata’, ASL2 Abruzzo, Chieti, Italy,Department of Innovative Technologies in Medicine and Dentistry, University ‘G. D’Annunzio’, Chieti-Pescara, Chieti, Italy
| | - Francesco Cipollone
- Medicina Generale 1, Ospedale Clinicizzato ‘SS Annunziata’, ASL2 Abruzzo, Chieti, Italy,Department of Medicine and Ageing Sciences, University ‘G. D’Annunzio’, Chieti-Pescara, Chieti, Italy
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