Effect of Chinese Medicine in Patients with COVID-19: A Multi-center Retrospective Cohort Study

Objective: To evaluate the effectiveness and safety of Chinese medicine(CM) in the treatment of coronavirus disease 2019(COVID-19) in China. Methods: A multi-center retrospective cohort study was carried out, with cumulative CM treatment period of 3 days during hospitalization as exposure. Data came from consecutive inpatients from December 19, 2019 to May 16, 2020 in 4 medical centers in Wuhan, China. After data extraction, verification and cleaning, confounding factors were adjusted by inverse probability of treatment weighting(IPTW), and the Cox proportional hazards regression model was used for statistical analysis. Results:A total of 2,272 COVID-19 patients were included. There were 1,684 patients in the CM group and 588 patients in the control group. Compared with the control group, the hazard ratio(HR) for the deterioration rate in the CM group was 0.52 [95% confidence interval(CI): 0.41 to 0.64, P<0.001]. The results were consistent across patients of varying severity at admission, and the robustness of the results were confirmed by 3 sensitivity analyses. In addition, the HR for all-cause mortality in the CM group was 0.29(95% CI: 0.19 to 0.44, P<0.001).Regarding of safety, the proportion of patients with abnormal liver function or renal function in the CM group was smaller. Conclusion: This real-world study indicates that the combination of a full-course CM therapy on the basic conventional treatment, may safely reduce the deterioration rate and all-cause mortality of COVID-19patients. This result can provide the new evidence to support the current treatment of COVID-19. Additional prospective clinical trial is needed to evaluate the efficacy and safety of specific CM interventions.(Registration No. ChiCTR2200062917)