AUTHOR=Hu Siying , Luo Dan , Zhu Qikui , Pan Jie , Chen Bonan , Furian Michael , Harkare Harsh Vivek , Sun Shoukai , Fansa Adel , Wu Xiaoping , Yu Baili , Ma Tianhong , Wang Fei , Shi Shihua 

TITLE=An updated meta-analysis of Chinese herbal medicine for the prevention of COVID-19 based on Western-Eastern medicine

JOURNAL=Frontiers in Pharmacology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1257345

DOI=10.3389/fphar.2023.1257345

ISSN=1663-9812

ABSTRACT=<p><bold>Background and aims:</bold> Chinese herbal medicine (CHM) was used to prevent and treat coronavirus disease 2019 (COVID-19) in clinical practices. Many studies have demonstrated that the combination of CHM and Western medicine can be more effective in treating COVID-19 compared to Western medicine alone. However, evidence-based studies on the prevention in undiagnosed or suspected cases remain scarce. This systematic review and meta-analysis aimed to investigate the effectiveness of CHM in preventing recurrent, new, or suspected COVID-19 diseases.</p><p><bold>Methods:</bold> We conducted a comprehensive search using ten databases including articles published between December 2019 and September 2023. This search aimed to identify studies investigating the use of CHM to prevent COVID-19. Heterogeneity was assessed by a random-effects model. The relative risk (RR) and mean differences were calculated using 95% confidence intervals (CI). The modified Jadad Scale and the Newcastle-Ottawa Scale (NOS) were employed to evaluate the quality of randomized controlled trials and cohort studies, respectively.</p><p><bold>Results:</bold> Seventeen studies with a total of 47,351 patients were included. Results revealed that CHM significantly reduced the incidence of COVID-19 (RR = 0.24, 95% CI = 0.11–0.53, <italic>p</italic> = 0.0004), influenza (RR = 0.37, 95% CI = 0.18–0.76, <italic>p</italic> = 0.007), and severe pneumonia exacerbation rate (RR = 0.17, 95% CI = 0.05–0.64, <italic>p</italic> = 0.009) compared to non-treatment or conventional control group. Evidence evaluation indicated moderate quality evidence for COVID-19 incidence and serum complement components C3 and C4 in randomized controlled trials. For the incidence of influenza and severe pneumonia in RCTs as well as the ratio of CD4<sup>+</sup>/CD8<sup>+</sup> lymphocytes, the evidence quality was low. The remaining outcomes including the disappearance rate of symptoms and adverse reactions were deemed to be of very low quality.</p><p><bold>Conclusion:</bold> CHM presents a promising therapeutic option for the prevention of COVID-19. However, additional high-quality clinical trials are needed to further strengthen evidential integrity.</p>