Effectiveness of Traditional Chinese Medicine in Reducing the Positive Rate of COVID-19 Close Contacts: A Large Population Cohort Study
doi: 10.14148/j.issn.1672-0482.2022.1086
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摘要:
目的 观察中医药对新型冠状病毒肺炎(COVID-19)密切接触者的核酸检测转阳率的影响，为中医药预防新型冠状病毒肺炎的应用提供依据。 方法 将扬州隔离点中使用和未使用中药(清肺排毒汤、扶正益清方)的COVID-19密接者纳入本研究，通过倾向性评分匹配和logistic回归分析对核酸扩增试验(NAATs)的阳性率、核酸阳性者的病毒载量、阳性者的病情等级进行分析，以评估中医药预防新型冠状病毒肺炎的作用。 结果 共收集了30 000余例观察对象，基于数据筛选、核对，以1 286例密接者作为研究对象，包括中医组1 016例(79.00%)和对照组270例(21.00%)，共有转阳患者55例。在倾向性评分匹配分析前后，结果均显示在男性和大于60岁的老年人群中，中药组的转阳率低于对照组，差异具有统计学意义(P＜0.05)。多因素logistic回归(不纳入N值和O值)结果显示中药组转阳的风险与对照组相比降低了0.547倍。另外，密接者转阳后，中药组的总体和女性的病毒CT值高于对照组，差异具有统计学意义(P＜0.05)。 结论 中医药有利于降低COVID-19密接者的转阳率和病毒载量。 Abstract:OBJECTIVE Corona-virus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2 virus. The variant of corona-virus first identified in India, known as Delta, has become the dominant strain in China. Unfortunately, more contagious and unknown variants are coming, leading to a number of close contacts under quarantine. Chinese medicine (TCM) has been recommended to prevention and treatment due to the satisfactory therapeutic effects. However, the effect of TCM to decrease positive rate in close contacts remains unknown. METHODS We conducted an retrospective cohort study in Yangzhou, China to assess the effect of Chinese medicine on decreasing positive rate in close contacts under quarantine. The primary observation outcome was positive rate of Nucleic Acid Amplification Tests (NAATs). The secondary observation outcome was a composite of viral load of positive NAATs, severity levels of confirmed cases (asymptomatic, mild, moderate, or severe), daily body temperature, and levels of close contact (primary or secondary). RESULTS A total of 1 286 subjects were collected, of which 1 016 (79.00%) in TCM group and 270 (21.00%) in control group with 55 participants tested positive. The incidence of the primary outcome, positive rate of NAATs was significantly lower in the Chinese medicine group than in the control group, occurring in male and age≥60 years subjects. Multi-variable logistic regression (excluding NO viral load) indicated that the risk of testing positive was reduced by 0.547 times in TCM group compared to control group. CT value of TCM group was higher than that of control group in all subjects and female subjects, and the result showed statistically significant difference. CONCLUSIONS In our study involving close contacts under quarantine, Chinese medicine resulted in lower positive rate of NAATs and viral load than control. -
Key words:
- COVID-19 /
- close contacts /
- traditional Chinese medicine /
- prevent /
- positive rate
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Table 1. Comparison of characteristics between TCM group and control group
Characteristics Control Group TCM Group W/χ2/t P value Age, Median (IQR) 35.0 (25.0, 50.0) 41.0 (30.0, 53.0) -5.278 < 0.001 Gender, n (%) Male 135 (50.00) 471 (46.77) 0.889 0.346 Female 135 (50.00) 536 (53.22) Underlying diseases, n (%) No 230 (85.19) 917 (90.26) 5.689 0.017 Yes 40 (14.81) 99 (9.74) N value, x±s 24.91±7.47 23.00±7.67 3.295 0.001 O value, x±s 27.31±6.79 25.73±7.07 3.001 0.003 
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Table 2. The detail of underlying diseases of close contacts
Underlying disease Frequency/n Percentage/% Hypertension 45 32.37 Diabetes 14 10.07 Chronic bronchitis 9 6.47 Chronic nephrosis 7 5.04 Other 85 61.15 Note: Some close contacts have multiple underlying disease.
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Table 3. Comparison of positive rate between TCM and control group before matching
Subgroups NAATs Result, n (%) χ2 P value Negative Positive All Control Group
TCM Group251 (92.96)
980 (96.46)19 (7.04)
36 (3.54)5.535 0.019 Male Control Group
TCM Group126 (93.33)
457 (97.03)9 (6.67)
14 (2.97)3.922 0.048 Female Control Group
TCM Group125 (92.59)
514 (95.90)10 (7.41)
21 (4.10)2.590 0.108 Age < 60 Control Group
TCM Group234 (97.50)
796 (96.72)6 (2.50)
27 (3.28)0.376 0.540 Age ≥60 Control Group
TCM Group13 (52.00)
135 (93.75)12 (48.00)
9 (6.25)30.392 < 0.001
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Table 4. Comparison of positive rate between TCM and control groups after matching
Subgroups NAATs Result, n (%) χ2 P value Negative Positive All Control Group
TCM Group242 (93.44)
254 (98.07)17 (6.56)
5 (1.93)6.836 0.009 Male Control Group
TCM Group121 (94.53)
134 (99.26)7 (5.47)
1 (0.74)- 0.032* Female Control Group
TCM Group121 (92.37)
120 (96.77)10 (7.63)
4 (3.23)2.385 0.123 Age < 60 Control Group
TCM Group229 (97.86)
231 (97.88)5 (2.14)
5 (2.12)< 0.001 >0.999 Age ≥60 Control Group
TCM Group13 (52.00)
23 (100.00)12 (48.00)
0 (0)- < 0.001* Note: *Fisher's exact test.
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Table 5. Multivariable logistic regression of TCM reducing positive rate
Variable β Std.Error P OR 95%CI TCM vs Control -0.793 0.307 0.010 0.453 0.251-0.842 Females vs Males 0.349 0.289 0.227 1.418 0.810-2.530 Age 0.034 0.009 < 0.001 1.034 1.017-1.053 Underlying diseases 0.232 0.383 0.545 1.260 0.571-2.589
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Table 6. Multi-variable logistic regression of TCM reducing positive rate after adjusting N and O value
Variables β Std.Error P OR 95%CI TCM vs Control -0.069 0.416 0.868 0.933 0.131-2.251 Females vs Males 0.109 0.336 0.745 1.116 0.578-2.184 Age 0.007 0.010 0.508 1.007 0.986-1.028 Underlying diseases 0.486 0.489 0.320 1.626 0.571-4.003 N value 0.000 1 0.036 0.998 1.000 1 0.945-1.092 O value -0.019 0.038 0.616 0.981 0.896-1.045
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Table 7. Comparison of N/O values between TCM and control groups
Subgroup Control Group TCM Group t value P N value, x±s All 22.05±7.12 27.00±6.05 -2.252 0.017 Males 24.46±6.76 27.36±7.04 -0.974 0.343 Females 19.89±7.06 26.74±5.42 -2.663 0.018 Age < 60 25.97±9.97 26.92±5.52 -0.223 0.831 Age ≥60 19.92±4.91 27.24±7.80 -2.365 0.038 O value, x±s All 24.99±5.55 28.42±6.01 -2.068 0.045 Males 27.03±5.20 27.77±6.78 -0.289 0.776 Females 23.16±5.44 28.86±5.57 -2.663 0.015 Age < 60 27.48±7.34 28.54±5.97 -0.327 0.753 Age ≥60 23.83±4.56 28.04±6.50 -1.587 0.139
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Table 8. Illness categories of positive cases between TCM and control groups
Taking Chinese medicine Moderate illness Mild illness χ2 P No
Yes15 (83.33)
23 (69.70)3 (16.67)
10 (30.30)0.535 0.464
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Table 9. Multi-variable logistic regression of the effect of TCM on illness severity
Variables β Std.Error P OR 95%CI TCM vs Control 0.566 0.815 0.487 1.761 0.357-8.696 Females vs Males 0.370 0.712 0.603 1.448 0.359-5.846 Age -0.023 0.018 0.199 0.977 0.943-1.012 Underlying diseases 0.306 1.038 0.768 1.358 0.177-10.394
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