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COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease.
Am J Chin Med. 2020; 48(3):737-762.AJ

Abstract

As of 22 February 2020, more than 77662 cases of confirmed COVID-19 have been documented globally with over 2360 deaths. Common presentations of confirmed cases include fever, fatigue, dry cough, upper airway congestion, sputum production, shortness of breath, myalgia/arthralgia with lymphopenia, prolonged prothrombin time, elevated C-reactive protein, and elevated lactate dehydrogenase. The reported severe/critical case ratio is approximately 7-10% and median time to intensive care admission is 9.5-10.5 days with mortality of around 1-2% varied geographically. Similar to outbreaks of other newly identified virus, there is no proven regimen from conventional medicine and most reports managed the patients with lopinavir/ritonavir, ribavirin, beta-interferon, glucocorticoid and supportive treatment with remdesivir undergoing clinical trial. In China, Chinese medicine is proposed as a treatment option by national and provincial guidelines with substantial utilization. We reviewed the latest national and provincial clinical guidelines, retrospective cohort studies, and case series regarding the treatment of COVID-19 by add-on Chinese medicine. We have also reviewed the clinical evidence generated from SARS and H1N1 management with hypothesized mechanisms and latest in silico findings to identify candidate Chinese medicines for the consideration of possible trials and management. Given the paucity of strongly evidence-based regimens, the available data suggest that Chinese medicine could be considered as an adjunctive therapeutic option in the management of COVID-19.

Authors+Show Affiliations

Department of Medicine, The University of Hong Kong, Hong Kong.School of Chinese Medicine, The University of Hong Kong, Hong Kong.Department of Medicine, The University of Hong Kong, Hong Kong.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32164424

Citation

Chan, Kam Wa, et al. "COVID-19: an Update On the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease." The American Journal of Chinese Medicine, vol. 48, no. 3, 2020, pp. 737-762.
Chan KW, Wong VT, Tang SCW. COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease. Am J Chin Med. 2020;48(3):737-762.
Chan, K. W., Wong, V. T., & Tang, S. C. W. (2020). COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease. The American Journal of Chinese Medicine, 48(3), 737-762. https://doi.org/10.1142/S0192415X20500378
Chan KW, Wong VT, Tang SCW. COVID-19: an Update On the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease. Am J Chin Med. 2020;48(3):737-762. PubMed PMID: 32164424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - COVID-19: An Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease. AU - Chan,Kam Wa, AU - Wong,Vivian Taam, AU - Tang,Sydney Chi Wai, Y1 - 2020/03/13/ PY - 2020/3/14/pubmed PY - 2020/5/13/medline PY - 2020/3/14/entrez KW - 2019-nCoV KW - COVID-19 KW - Chinese Medicine KW - Guideline KW - Integrative Medicine KW - Review SP - 737 EP - 762 JF - The American journal of Chinese medicine JO - Am J Chin Med VL - 48 IS - 3 N2 - As of 22 February 2020, more than 77662 cases of confirmed COVID-19 have been documented globally with over 2360 deaths. Common presentations of confirmed cases include fever, fatigue, dry cough, upper airway congestion, sputum production, shortness of breath, myalgia/arthralgia with lymphopenia, prolonged prothrombin time, elevated C-reactive protein, and elevated lactate dehydrogenase. The reported severe/critical case ratio is approximately 7-10% and median time to intensive care admission is 9.5-10.5 days with mortality of around 1-2% varied geographically. Similar to outbreaks of other newly identified virus, there is no proven regimen from conventional medicine and most reports managed the patients with lopinavir/ritonavir, ribavirin, beta-interferon, glucocorticoid and supportive treatment with remdesivir undergoing clinical trial. In China, Chinese medicine is proposed as a treatment option by national and provincial guidelines with substantial utilization. We reviewed the latest national and provincial clinical guidelines, retrospective cohort studies, and case series regarding the treatment of COVID-19 by add-on Chinese medicine. We have also reviewed the clinical evidence generated from SARS and H1N1 management with hypothesized mechanisms and latest in silico findings to identify candidate Chinese medicines for the consideration of possible trials and management. Given the paucity of strongly evidence-based regimens, the available data suggest that Chinese medicine could be considered as an adjunctive therapeutic option in the management of COVID-19. SN - 1793-6853 UR - https://www.unboundmedicine.com/medline/citation/32164424/COVID-19:_An_Update_on_the_Epidemiological,_Clinical,_Preventive_and_Therapeutic_Evidence_and_Guidelines_of_Integrative_Chinese-Western_Medicine_for_the_Management_of_2019_Novel_Coronavirus_Disease L2 - https://www.worldscientific.com/doi/10.1142/S0192415X20500378?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -