Mixed Chinese herbs and Western medicine for novel coronavirus disease 2019 (COVID-19): a mixed method review

  1. Zhang Yong Tai
  2. Louisa Tay
  3. Robby Miguel Goh
  4. Rui Shu Zhou
  5. Lin Ho Wong
  6. Pang Ong Wong

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Abstract

Background: Coronavirus disease 2019 (COVID-19) is a pandemic affecting millions around the world. There is no existing pharmaceutical treatment that is known to be effective. Preliminary data shows that San Yao San Fang (SYSF) has clinical benefits in patients with COVID-19. The aim of this paper is to review existing data regarding the use of formulas within San Yao San Fang in the treatment of COVID-19 Search Strategy: We searched through 5 databases for studies on SYSF and patients with COVID-19 through April 2020. Eligibility Criteria: We included studies that included formulas within San Yao San Fang with or without Western interventions against Western interventions. Main results: We included 7 studies involving 532 patients. SYSF combined with Western interventions improved the recovery rate of symptoms such as fever (Risk Ratio (RR) 0.40 (95% CI 0.24 to 0.66, P < 0.01)), cough (RR 0.56 (95% CI 0.38 to 0.82, P < 0.01)) and fatigue (RR 0.61 (95% CI 0.47 to 0.78, P < 0.01)) and other symptoms such as headache, gastrointestinal symptoms, myalgia, dyspnoea and chest tightness (RR 0.63 (95% CI 0.47 to 0.83, P < 0.01)) as compared to the control group. SYSF combined with Western interventions reduced the duration of fever as compared to the control group. (Mean difference (MD) -1.18 (95% CI -1.45 to -0.91, P < 0.01)) In regards to adverse events, there is no statistical difference between the treatment group and the control group. (RR 1.62 (95% CI 0.83 to 3.17, P = 0.16)). SYSF combined with Western interventions did not show to significantly reduce duration of hospitalisation as compared to the control group. (MD -0.73 (95% CI -5.19 to 3.73, P = 0.75)) Conclusion: SYSF appears to be clinically effective and safe. Further research is required to ensure the efficacy of SYSF.

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    SciScore for 10.1101/2020.05.11.20098111: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Criteria for considering studies for this review: Search methods for identification of studies: EMBASE, Pubmed And Cochrane: CNKI (overseas CNKI) And Wanfang (based on the translations of the keywords used in English medium): Data collection and analysis: Assessment of risk of bias in included studies: We assessed risk of bias following the recommendations in the Cochrane Handbook for Systematic Reviews of Interventions.
    EMBASE
    suggested: (EMBASE, RRID:SCR_001650)
    Pubmed
    suggested: (PubMed, RRID:SCR_004846)
    Cochrane Handbook
    suggested: None
    Unit of analysis issues: We analysed the data using Review Manager (RevMan 2011) software.
    RevMan
    suggested: (RevMan, RRID:SCR_003581)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.05.11.20098111v1 on medRxiv