Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide outbreak of respiratory illness. This review aims to evaluate the effectiveness and adverse events of herbal medicines for the treatment of COVID-19. Methods: Twelve databases were searched through 12 May 2020. Randomized controlled trials (RCTs) and quasi-RCTs assessing the effects of herbal medicines for the treatment of COVID-19 were eligible. The study selection and data extraction were performed by two independent reviewers. The Cochrane risk of bias tool was used for the assessment of the risk of bias in all included RCTs. Mean differences (MDs), risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and the effect sizes of the studies were pooled. Results: Seven RCTs with a total of 855 patients were included. All included trials compared the combined therapy of herbal medicine with Western medicine to Western medicine alone. The combined therapy significantly improved the total effective rate (RR 1.23, 95% CI 1.13 to 1.34, p < 0.001), cough symptom disappearance rate (RR 1.45, 95% CI 1.12 to 1.89, p = 0.005), and sputum production symptom disappearance rate (RR 1.73, 95% CI 1.19 to 2.50, p = 0.004). Beneficial effects of the combined therapy were also seen in TCM syndrome score of cough (MD −1.18, 95% CI −1.34 to −1.03, p < 0.001), fever (MD −0.62, 95% CI −0.79 to −0.45, p < 0.001), dry and sore throat (MD −0.83, 95% CI −1.45 to −0.20, p = 0.009), and fatigue (MD −0.60, 95% CI −1.04 to −0.17, p = 0.007). The overall risk of bias of the included studies was unclear. No serious adverse events were reported. Conclusion: Significant effects of the combined therapy of herbal medicine with Western medicine were found, and revealed the potential role of herbal medicine in treating COVID-19. More high-quality RCTs are needed to further validate the effectiveness and adverse events of herbal medicine in the treatment of COVID-19.
Highlights
Beginning in December 2019, a novel coronavirus disease, COVID-19, referred to as SARS-CoV-2, has caused an international outbreak of acute respiratory illness
Based on our predefined inclusion and exclusion criteria, four Randomized controlled trials (RCTs) were further excluded, where one RCT [15] included herbal medicine as a comparator intervention, one RCT studied on suspected cases of COVID-19 [16], and two RCTs focused on the preventive effect [17,18]
The results showed that the combined therapy of herbal medicine with Western medicine had a significant effect on relieving anxiety in patients (n = 123, Mean differences (MDs) 0.34, 95% confidence intervals (CIs) −1.14 to 1.82, p < 0.01)
Summary
Beginning in December 2019, a novel coronavirus disease, COVID-19, referred to as SARS-CoV-2, has caused an international outbreak of acute respiratory illness. Clinical evidence from a range of studies of herbal medicine in the treatment of SARS coronavirus (SARS-CoV) has shown significant results, and supported the idea that herbal medicine has a beneficial effect in the treatment and prevention of epidemic diseases [3]. A Cochrane systematic review reported that herbal medicine combined with Western medicine may improve symptoms and quality of life in SARS-CoV patients [4]. This review aims to evaluate the effectiveness and adverse events of herbal medicines for the treatment of COVID-19. Randomized controlled trials (RCTs) and quasi-RCTs assessing the effects of herbal medicines for the treatment of COVID-19 were eligible. More high-quality RCTs are needed to further validate the effectiveness and adverse events of herbal medicine in the treatment of COVID-19
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