Efficacy and Safety of Lianhua Qingwen for Patients with COVID-19: A Systematic Review and Meta-Analysis

Background: Corona virus disease 2019(COVID-19) has spread around the world since its outbreak, and there is no ascertained effective drug up to now. Lianhua Qingwen(LHQW) has been widely used in China and overseas Chinese, which had some advantages in the treatment of COVID-19. Objective: To evaluate the efficacy and safety of LHQW for COVID-19 by conducting a systematic review with meta-analysis. Methods: A comprehensive literature search was conducted in 12 electronic databases from their establishment to October 30, 2021. Note Express 3.2.0 was used for screening of trials, and the data was independently extracted in duplicate by 2 researchers. The risk of bias of randomized controlled trials(RCTs) and retrospective studies were assessed by using the Cochrane collaboration tool and Newcastle Ottawa Scale, respectively, followed by data analysis using RevMan 5.3. The RCTs or retrospective studies to treat COVID-19 using LHQW were included. The intervention measures in the experimental group were LHQW alone or combined with chemical drugs(LCWC), and that in the control group were chemical drugs(CDs). Outcome measures included computed tomography(CT) recovery rate, disappearance rates of primary(fever, cough, fatigue), respiratory, gastrointestinal and other symptoms, exacerbation rate and adverse reaction. Subgroup analysis was conducted according to whether LHQW was combined with CDs and the different treatment methods in the control group. Results: Nine trials with 1,152 participants with COVID-19 were included. The CT recovery rates of LHQW and LCWC were 1.36 and 1.32 times of CDs, respectively(P<0.05). Compared with CDs, LCWC remarkably increased the disappearance rates of fever, cough, fatigue, expectoration, shortness of breath, and muscle soreness(P<0.05). LHQW also obviously decreased the exacerbation rate, which was 0.45 times of CDs alone(P<0.05). There was no obvious difference between LCWC and CDs in adverse reaction(P>0.05). Conclusions: LHQW was more suitable for treating COVID-19 patients with obvious expectoration, shortness of breath and muscle soreness. LHQW had advantages in treating COVID-19 with no obvious exacerbation.(PROSPERO No. CRD42021235937)