Yindan Jiedu Granules, a Traditional Chinese Medicinal Formulation, as a Potential Treatment for Coronavirus Disease 2019

Jingyuan Liu,Zhiyun Yang,Yuyong Jiang,Yuxin Li,Lin Pu,Rui Song,Xianbo Wang,Chunjing Du,Yao Liu,Xiaojing Wang,Jie Ren,Wen Xie,Zhihai Chen,Wei Liu

doi:10.3389/fphar.2020.634266

Abstract

Background: Yindan Jiedu Granules (YDJDG) have been newly prescribed as a Chinese herbal formula. This study aimed to compare the efficacy of YDJDG and lopinavir-ritonavir in the treatment of coronavirus disease 2019 (COVID-19). Methods: Overall, 131 patients with COVID-19 were included in this study. In addition to standard care, 60 of these patients received YDJDG (YDJDG group) and 71 received lopinavir-ritonavir (lopinavir-ritonavir group). Propensity score matching (PSM) was used to match the characteristics of individuals in the two groups, while the Kaplan-Meier method was used to compare the proportion recovery observed. Results: Cox analysis revealed that YDJDG and CD4 ≥ 660 cells/µL were independent predictive factors of proportion recovery. At baseline, disease types differed between the YDJDG and lopinavir-ritonavir treatment groups. Furthermore, no significant adverse effects or toxicities relevant to YDJDG were observed. The median recovery time was 21 days in the YDJDG group and 27 days in the lopinavir-ritonavir group. After PSM (1:1), 50 patient pairs, YDJDG vs. lopinavir-ritonavir, were analyzed. In the YDJDG group, the proportion of recovered patients was remarkably higher than that observed in the lopinavir-ritonavir group (p = 0.0013), especially for those presenting mild/moderate disease type and CD4 < 660 cells/µL. In the YDJDG group, the mean duration of fever and pulmonary exudative lesions was significantly shorter than that observed in the lopinavir-ritonavir group (p = 0.0180 and p = 0.0028, respectively). Conclusion: YDJDG reveals the potential to hasten the recovery period in COVID-19 patients with mild/moderate disease type or CD4 < 660 cells/µL by shortening the mean duration of fever and pulmonary exudative lesions.

Highlights

Coronavirus disease-2019 (COVID-19) is an international public health emergency
Disease types differed between the Yindan Jiedu Granules (YDJDG) and lopinavir-ritonavir treatment groups
In the YDJDG group, the proportion of recovered patients was remarkably higher than that observed in the lopinavirritonavir group (p 0.0013), especially for those presenting mild/moderate disease type and CD4 < 660 cells/μL

Summary

Introduction

Coronavirus disease-2019 (COVID-19) is an international public health emergency. Antivirals investigated for the treatment of COVID-19 in clinical trials or in vitro studies include inhibitors of viral RNA polymerase/RNA synthesis (remdesivir), inhibitors of viral protein synthesis (lopinavirritonavir), viral entry inhibitors (chloroquine), and immunomodulators (Nitazoxanide) Among patients hospitalized for severe COVID-19, 68% of patients treated with remdesivir experience clinical improvement. A randomized, placebo-controlled trial is required to measure the efficacy of remdesivir therapy (Grein et al, 2020). In a controlled, randomized, open-label trial, lopinavir-ritonavir treatment has failed to demonstrate an improvement over standard treatment in adult patients with severe COVID-19 (Cao et al, 2020). This study aimed to compare the efficacy of YDJDG and lopinavir-ritonavir in the treatment of coronavirus disease 2019 (COVID-19)

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