Effect of Traditional Chinese Medicine in patients with COVID-19: A multi-center retrospective cohort study

Abstract Background Traditional Chinese medicine (TCM) has been applied in the treatment of COVID-19 in China, but its effectiveness and safety need evaluation. Methods A multi-center retrospective cohort study was carried out, with cumulative TCM treatment period of ≥ 3 days during hospitalization as exposure. Data came from consecutive inpatients in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting, and the Cox proportional hazards regression model was used for statistical analysis. Results A total of 2272 COVID-19 patients were included, including 1684 in the TCM group and 588 in the control group. Compared with the control group, the hazard ratio for the deterioration rate in the TCM group was 0.52 [95% CI: (0.41, 0.64), P < 0.001]. The results were consistent across patients of varying severity at admission, and two sensitivity analyses confirmed the robustness of the results. In addition, the hazard ratio for all-cause mortality in the TCM group was 0.29 (95% CI = 0.19–0.44, P < 0.001). For safety, the proportion of patients with abnormal liver function or renal function in the TCM group was smaller. Conclusion This real-world study indicates that the addition of a full course of TCM therapy to basic conventional treatment, may reduce the deterioration rate and all-cause mortality of COVID-19 patients with safety. This result can provide evidence to support the current treatment of COVID-19 and new respiratory infectious diseases in the future. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific TCM interventions. Trial registration: ChiCTR, ChiCTR2200062917. Registered 23 August 2022, http://www.chictr.org.cn/showproj.aspx?proj=171556.