A Retrospective Cohort Study on the Improvement of Prognosis of Hospitalized COVID-19 Patients Using Traditional Chinese Medicine Preparations

OBJECTIVE The emergence of evolving variants of Coronavirus disease 2019 (COVID-19) has fostered the need for change of newer and adaptive treatments for these infections. During the COVID-19 pandemic and persists, traditional Chinese medicine (TCM) herbs exhibit significant bioactivity and therapeutic effect. This study is aimed to evaluate the efficacy of four TCM preparations on 28-day mortality risk of patients and changes of the laboratory indicators.

METHODS The retrospective cohort study included patients with COVID-19 who were admitted to the Jiangsu Province Hospital of Chinese Medicine from December 15, 2022 to January 15, 2023, and those died within 48 hours of admission or cannot be tracked for outcomes were excluded. The primary outcome was survival status in 28 days (death or survival) starting from the day of admission. The second outcomes were laboratory indicators, including absolute lymphocyte count, lactate dehydrogenase, creatinine, and blood urea nitrogen. Binary logistic regressions were used to estimate the effect of TCM preparations on the primary and secondary outcomes in main analysis. Meanwhile, heterogeneity and robustness of results from main analysis were assessed by subgroup analyses and multiple sensitivity analyses.

RESULTS 1 816 eligible patients were included in analysis dataset, including 573 patients received standard care (control group) and 1 243 patients received TCM preparations (hospital preparation group). The 28-day mortality rate of hospital preparation group was lower than that of control group (4.75% vs. 14.83%), and the difference was statistically significant (χ²=54.666, P < 0.001). The risk of 28-day mortality was 0.535 times lower in the hospital preparation group as compared with the control group (OR=0.46, 95%CI: 0.305-0.708, P < 0.001) showed by multivariable binary logistic regressions. Subgroup analyses showed that taking TCM preparations reduced the 28-day mortality risk. Sensitivity analyses demonstrated that the results of the main analysis for primary outcomes were robust. For secondary outcomes, the risk of abnormal absolute lymphocyte counts at discharge in the hospital preparation group decreased by 0.284 times (OR=0.703, 95%CI: 0.515-0.961, P=0.027).

CONCLUSION Compared with standard of care, taking four hospital preparations including Kanggan Heji, Feining Heji, Qishen Gubiao Keli, and Qianghuo Qushi Qingwen Heji decreased risk of 28-day mortality among hospitalized COVID-19 patients. TCM therapy achieves adequate therapeutic effects in COVID-19.