Oral traditional Chinese medicine for mild to moderate cases of COVID-19: a network meta-analysis based on RCTs

Abstract

Introduction: This systemic review examines the effectiveness and safety of combining traditional Chinese medicine with standard therapy in the treatment of mild to moderate cases of coronavirus disease 2019 (COVID-19).

Methodology: We retrieved articles from PubMed, Web of Science, Cochrane, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, Weipi (VIP), and China Biology Medicine disc (CBM). The deadline for retrieval was 20 August 2022, and it was updated on 1 July 2023. Two researchers worked independently on literature screening, data extraction, and evaluation of the quality of the literature.

Results: A total of 21 randomized controlled trials were included in this review; consisting of 9 articles in English and 12 articles in Chinese. According to the fixed-effects model, the results of the traditional meta-analysis indicated a significantly superior efficacy of oral traditional Chinese medicine combined with standard therapy in treating mild to moderate cases of COVID-19, compared to standard treatment (OR = 1.81, 95% CI: 1.59–2.06), with no increased adverse effects (OR = 1.28, 95% CI: 0.95–1.73). The network meta-analysis results revealed Lianhua Qingke, Toujie Quwen, and Jinhua Qinggan granules as the three best Chinese medicines with the most effective treatment outcomes; while Lianhua Qingwen capsule/granules, Reyanning, and Shufeng Jiedu capsules were the top three Chinese medicines with the fewest side effects.

Conclusions: The efficacy of oral traditional Chinese medicine combined with standard therapy in treating mild to moderate COVID-19 was significantly superior to standard therapy alone. However, the limited quality of evidence reduces the reliability of the meta-analysis.