Abstract
There has been a large global outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), representing a major public health issue. In China, combination therapy, including traditional Chinese medicine (TCM) as a treatment for COVID-19 has been used widely. “Fei Yan No. 1” (QFDYG) is a formula recommended by the Hubei Government to treat COVID-19. A retrospective study of 84 COVID-19 patients from Hubei Provincial Hospital of TCM and Renmin Hospital of Hanchuan was conducted to explore the clinical efficacy of QFDYG combination therapy. TCMSP and YaTCM databases were used to determine the components of all Chinese herbs in QFDYG. Oral bioavailability (OB) ≥ 30% and drug-like (DL) quality ≥ 0.18 were selected as criteria for screening the active compounds identified within the TCMSP database. The targets of active components in QFDYG were determined using the Swiss TargetPrediction (SIB) and Targetnet databases. The STRING database and the Network Analyzer plugin in Cytoscape were used to obtain protein-protein interaction (PPI) network topology parameters and to identify hub targets. Gene Ontology (GO) enrichment was conducted using FunRich version 3.1.3, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment using ClueGO version 2.5.6 software. PPI and compound-pathway (C-T) networks were constructed using Cytoscape 3.6.0. Compared with the control group, combined treatment with QFDYG resulted in a significantly higher rate of patients recovering from symptoms and shorter the time. After 14 days of treatment, QFDYG combined treatment increased the proportion of patients testing negative for SARS-CoV-2 nucleic acid by RT-PCR. Compared with the control group, promoting focal absorption and inflammation as viewed on CT images. GO and KEGG pathway enrichment indicated that QFDYG principally regulated biological processes, such as inflammation, an immune response, and apoptosis. The present study revealed that QFDYG combination therapy offered particular therapeutic advantages, indicating that the theoretical basis for the treatment of COVID-19 by QFDYG may play an antiviral and immune response regulation through multiple components, targets, and pathways, providing reference for the clinical treatment of COVID-19.
Highlights
Since December 2019, coronavirus disease 2019 (COVID-19), caused by infection with the SARS-CoV-2 virus, has spread to most countries and regions around the world (Zhu et al, 2020)
Of the 103 patients assessed for eligibility, 19 were excluded, including 3 that were asymptomatic infection who stopped taking the medication by themselves, 5 cases did not undergo computed tomography (CT) image scanning at discharge, 6 where nucleic acid assay time were inaccurate (2 of patients did not cooperate with RT-PCR test for SARS-CoV-2 testing. 4 cases were due to insufficient nucleic acid detection capabilities at that time), and 5 that had transferred to other hospitals
QFDYG combination therapy confers a therapeutic effect on COVID-19 by both increasing the proportion of patients that recovered and accelerating the recovery from symptoms
Summary
Since December 2019, coronavirus disease 2019 (COVID-19), caused by infection with the SARS-CoV-2 virus, has spread to most countries and regions around the world (Zhu et al, 2020). In common with two other highly pathogenic coronaviruses, SARS-CoV and MERS-CoV, SARS-CoV-2 is a bcoronavirus (Xu et al, 2020), principally transmitted by close contact and through the respiratory tract, resulting in severe respiratory illness and even death. A small number of patients display symptoms that include sore throat, stuffy or runny nose, muscle pain, and diarrhea. A number of patients rapidly progress to acute respiratory failure or acute respiratory distress syndrome (ARDS) (Chen N. et al, 2020). According to the recent data from the WHO, the number of global infections has passed 27 million, with a death toll greater than 880,000, threatening 214 countries. There is a pressing need to establish a specific and effective therapeutic schedule for the treatment of COVID-19
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