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
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
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DOI：
10.1142/s0192415x20500378
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发表时间：
2020-01-01
影响因子：
5.7
通讯作者：
Tang, Sydney Chi Wai
中科院分区：
文献类型：
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作者：
Chan, Kam Wa;Wong, Vivian Taam;Tang, Sydney Chi Wai
截至2020年2月22日，全球已记录超过77662例COVID-19确诊病例，超过2360人死亡。确诊病例的常见表现包括发热、疲劳、干咳、上呼吸道充血、咳痰、呼吸短促、肌痛/关节痛伴淋巴细胞减少、凝血酶原时间延长、C反应蛋白升高和乳酸脱氢酶升高。报告的重度/危重病例比率约为7-10%，重症监护入院的中位时间为9.5-10.5天，死亡率约为1-2%，地理位置不同。与其他新发现的病毒爆发类似，传统药物没有经过证实的治疗方案，大多数报告使用洛匹那韦/利托那韦、利巴韦林、β-干扰素、糖皮质激素和正在进行临床试验的Remdesivir支持治疗来管理患者。在中国，国家和省级指南建议将中医药作为一种治疗选择，并得到了大量使用。我们回顾了最新的国家和省级临床指南，回顾性队列研究和病例系列，关于添加中药治疗COVID-19。我们亦已检讨SARS和H1N1治疗的临床证据，包括假设的机制和最新的计算机研究结果，以确定候选中药，供考虑进行可能的试验和治疗。鉴于缺乏强有力的循证治疗方案，现有数据表明，中医药可被视为COVID-19管理的一种有效治疗选择。
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.