Add-On Chinese Medicine for Coronavirus Disease 2019 (ACCORD): A Retrospective Cohort Study of Hospital Registries

Zixin Shu, Kai Chang, Yana Zhou, Chaoan Peng, Xugui Li, Wei Cai, Li Wei, Qiguang Zheng, Haoyu Tian, Jianan Xia, Kuo Yang, Ning Wang, Jifen Liu, Xiaojun Min, Dengying Yan, Jing Sun, Huan Wu, Xiaomeng Li, Yi Zheng, Zecong YuXi Lu, Yuxia Yang, Ting Jia, Jinghui Ji, Qunzheng Zou, Yinyan Wang, Minzhong Xiao, Qing Zhang, Yajuan Xiong, Feng Sun, Qiang Zhu, Xingxing Jiang, Guodong Wang, Sydney Chi Wai Tang, Junhua Zhang, Xiuyang Li, Nevin Zhang, Boli Zhang*, Xiaolin Tong*, Baoyan Liu*, Xuezhong Zhou*, Kam Wa Chan*, Xiaodong Li*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

19 Citations (Scopus)


Chinese medicine (CM) was extensively used to treat COVID-19 in China. We aimed to evaluate the real-world effectiveness of add-on semi-individualized CM during the outbreak. A retrospective cohort of 1788 adult confirmed COVID-19 patients were recruited from 2235 consecutive linked records retrieved from five hospitals in Wuhan during 15 January to 13 March 2020. The mortality of add-on semi-individualized CM users and non-users was compared by inverse probability weighted hazard ratio (HR) and by propensity score matching. Change of biomarkers was compared between groups, and the frequency of CMs used was analyzed. Subgroup analysis was performed to stratify disease severity and dose of CM exposure. The crude mortality was 3.8% in the semi-individualized CM user group and 17.0% among the non-users. Add-on CM was associated with a mortality reduction of 58% (HR = 0.42, 95% CI: 0.23 to 0.77, p = 0.005) among all COVID-19 cases and 66% (HR = 0.34, 95% CI: 0.15 to 0.76, p = 0.009) among severe/critical COVID-19 cases demonstrating dose-dependent response, after inversely weighted with propensity score. The result was robust in various stratified, weighted, matched, adjusted and sensitivity analyses. Severe/critical patients that received add-on CM had a trend of stabilized D-dimer level after 3-7 days of admission when compared to baseline. Immunomodulating and anti-asthmatic CMs were most used. Add-on semi-individualized CM was associated with significantly reduced mortality, especially among severe/critical cases. Chinese medicine could be considered as an add-on regimen for trial use.

Original languageEnglish
Pages (from-to)543-575
Number of pages33
JournalAmerican Journal of Chinese Medicine
Issue number3
Publication statusPublished - 5 Mar 2021

Scopus Subject Areas

  • Medicine(all)
  • Complementary and alternative medicine
  • Infectious Diseases
  • Epidemiology
  • Public Health, Environmental and Occupational Health

User-Defined Keywords

  • Chinese Medicine
  • Cohort
  • Coronavirus Disease 2019
  • COVID-19
  • Effectiveness
  • Integrative Medicine
  • Mortality


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