Abstract
Background: Qingfei Paidu decoction (QFPD) has been widely used in treating COVID-19 in China. However, there is still a lack of comprehensive and systematic evidence to demonstrate the effectiveness and safety of QFPD. This study aims to evaluate the efficacy and safety of QFPD in patients with COVID-19.Methods: We searched seven databases up to 5 March 2021. Two reviewers independently screened studies, extracted data of interest, and assessed risk of bias. The Cochrane risk of bias tool was used to assess the risk of bias of randomized controlled trials. The Newcastle–Ottawa scale was used to assess the risk of bias of cohort and non-randomized trials. The “Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group” was adopted for controlled pre–post studies. We used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) to assess the certainty of evidence. We carried out a random effect meta-analysis using RevMan 5.3. For outcomes that could not be meta-analyzed, we performed a descriptive analysis.Results: We identified 16 studies with 11,237 patients, including one RCT, six non-randomized trials, two cohort studies, and seven pre–post studies. The certainty of evidence was low to very low because of the observational study design. QFPD combined with conventional treatment might decrease the time for nucleic acid conversion (MD = −4.78 days, 95% CI: −5.79 to −3.77), shorten the length of hospital stay (MD = −7.95 days, 95% CI: −14.66 to −1.24), shorten the duration of symptoms recovery of fever (MD = −1.51 days, 95% CI: −1.92 to −1.09), cough (MD = −1.64 days, 95% CI: −1.91 to −1.36) and chest CT (MD = −2.23 days, 95% CI: −2.46 to −2.00), improve the overall traditional Chinese medicine symptom scores (MD = 41.58 scores, 95% CI: 32.67 to 50.49), and change the laboratory indexes, such as WBC, AST, and CRP.Conclusion: QFPD combined with conventional treatment might be effective for patients with COVID-19. No serious adverse reactions related to QFPD were observed. Further high-quality studies are still needed in the future.
Highlights
Coronavirus disease 2019 (COVID-19) outbreak suddenly and quickly became a public health emergency of international concern (PHEIC) (World Health Organization, 2020), which has caused a pandemic and posed significant threats to international health
We searched the WHO COVID-19 database, which included 26 databases published in different languages and gray literature evidence sources around the world (World Health Organization, 2021a), the Living Overview of the Evidence (L-OVE) COVID-19 Repository (Epistemonikos Foundation, 2021), PubMed, the China National Knowledge Infrastructure (CNKI), WanFang, the Chinese Biomedical Database (CBM), and the Chinese Medical Journal Network (Chinese Medical Journal Network, 2021)
Combined with the core outcome sets of COVID-19 Chinese medicine clinical research (Jin et al, 2020), the outcomes we focused on included the time for nucleic acid conversion, the length of hospital stay, the traditional Chinese medicine (TCM) syndrome scores, the duration of symptom recovery, the effective rate, the rate of recovery of chest CT manifestations, the laboratory indexes, others, and the incidence of adverse reactions
Summary
Coronavirus disease 2019 (COVID-19) outbreak suddenly and quickly became a public health emergency of international concern (PHEIC) (World Health Organization, 2020), which has caused a pandemic and posed significant threats to international health. As of June 10, 2021, there have been 173.6 million confirmed cases of COVID-19, and 3.74 million deaths globally (World Health Organization, 2021b). As a newly discovered disease, the naming of this disease in traditional Chinese medicine (TCM) and Western medicine of COVID19 is unified. It belongs to the category of “phytophthora blight” in TCM, which is a kind of disease caused by the epidemic pathogenic toxin with strong infectivity. Among the confirmed COVID-19 cases in China, 91.5% were treated with the combination of TCM and Western medicine, and the observation on clinical efficacy showed that the effective rate of TCM exceeded 90% (National Administration of Traditional Chinese Medicine, 2020). This study aims to evaluate the efficacy and safety of QFPD in patients with COVID-19
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