The effects of Chinese herbal injections on patients with COVID-19: a systematic review

Abstract

Abstract Background COVID-19, caused by SARS-CoV-2, led to a a worldwide pandemic of acute respiratory illness resulting in more than 760 million infections and 6.9 million deaths. Recent clinical research has demonstrated the beneficial effects of Chinese herbal injections (CHIs), a novel kind of traditional Chinese medicine preparation, in the treatment of COVID-19. This systematic review aimed to investigate the efficacy and safety of CHIs in treatment of COVID-19 and to evaluate the quality of evidence. Methods A systematic search for both human RCTs and non-randomized trials evaluating the efficacy and safety of CHIs in treatment of COVID-19 was performed on PubMed, Cochrane Library, and Ovid, where the language was restricted to English. Quality assessment included the risk of bias (via the Cochrane risk of bias tool) and quality of evidence (via the GRADE system). Results Of 3403 articles identified, 6 studies published between 2020 and 2021 with 382 participants met our selection criteria and were included for analysis. The treatment group was defined as the CHI (XBJ, RDN, or XYP injection) combined with routine treatment, to compare with routine treatment alone in the control group. The included studies overall had moderate risk of bias and low quality of evidence, mainly due to being open-label and confounding. The evidence showed that the clinical efficacy of treatment groups was better for the treatment of COVID-19, in terms of clinical symptom resolution, length of hospital stay, time taken for a negative nucleic acid test, and mortality. There was no significant difference in incidence of adverse events between the study groups (P > 0.05). Conclusions CHIs can play an effective role in the treatment of COVID-19 and can be safely administered under rational operation. More double-blinded RCTs with larger sample sizes are warranted, and the effects on longer-term symptom resolution or the effects of other different CHIs need to be explored in the future.