TY - JOUR
T1 - Add-On Chinese Medicine for Coronavirus Disease 2019 (ACCORD)
T2 - A Retrospective Cohort Study of Hospital Registries
AU - Shu, Zixin
AU - Chang, Kai
AU - Zhou, Yana
AU - Peng, Chaoan
AU - Li, Xugui
AU - Cai, Wei
AU - Wei, Li
AU - Zheng, Qiguang
AU - Tian, Haoyu
AU - Xia, Jianan
AU - Yang, Kuo
AU - Wang, Ning
AU - Liu, Jifen
AU - Min, Xiaojun
AU - Yan, Dengying
AU - Sun, Jing
AU - Wu, Huan
AU - Li, Xiaomeng
AU - Zheng, Yi
AU - Yu, Zecong
AU - Lu, Xi
AU - Yang, Yuxia
AU - Jia, Ting
AU - Ji, Jinghui
AU - Zou, Qunzheng
AU - Wang, Yinyan
AU - Xiao, Minzhong
AU - Zhang, Qing
AU - Xiong, Yajuan
AU - Sun, Feng
AU - Zhu, Qiang
AU - Jiang, Xingxing
AU - Wang, Guodong
AU - Tang, Sydney Chi Wai
AU - Zhang, Junhua
AU - Li, Xiuyang
AU - Zhang, Nevin
AU - Zhang, Boli
AU - Tong, Xiaolin
AU - Liu, Baoyan
AU - Zhou, Xuezhong
AU - Chan, Kam Wa
AU - Li, Xiaodong
N1 - This work is partially supported by the National Key Research and DevelopmentProgram (2017YFC1703506 and 2020YFC0841600) and Beijing Natural Science Foun-dation Project (M21012).
Publisher Copyright:
© 2021 World Scientific Publishing Company.
PY - 2021/3/5
Y1 - 2021/3/5
N2 - 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.
AB - 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.
KW - Chinese Medicine
KW - Cohort
KW - Coronavirus Disease 2019
KW - COVID-19
KW - Effectiveness
KW - Integrative Medicine
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=85102308069&partnerID=8YFLogxK
U2 - 10.1142/S0192415X21500257
DO - 10.1142/S0192415X21500257
M3 - Journal article
C2 - 33683189
AN - SCOPUS:85102308069
SN - 0192-415X
VL - 49
SP - 543
EP - 575
JO - American Journal of Chinese Medicine
JF - American Journal of Chinese Medicine
IS - 3
ER -
