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

TitleAdd-On Chinese Medicine for Coronavirus Disease 2019 (ACCORD): A Retrospective Cohort Study of Hospital Registries
Authors
KeywordsCoronavirus Disease 2019
COVID-19
Integrative Medicine
Chinese Medicine
Cohort
Issue Date2021
PublisherWorld Scientific Publishing Co Pte Ltd. The Journal's web site is located at http://www.worldscinet.com/ajcm/ajcm.shtml
Citation
The American Journal of Chinese Medicine, 2021, v. 49 n. 3, p. 543-575 How to Cite?
AbstractChinese 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.
Persistent Identifierhttp://hdl.handle.net/10722/304701
ISSN
2020 Impact Factor: 4.667
2020 SCImago Journal Rankings: 1.025
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorShu, Z-
dc.contributor.authorChang, K-
dc.contributor.authorZhou, Y-
dc.contributor.authorPeng, C-
dc.contributor.authorLi, X-
dc.contributor.authorCai, W-
dc.contributor.authorWei, L-
dc.contributor.authorZheng, Q-
dc.contributor.authorTian, H-
dc.contributor.authorXia, J-
dc.contributor.authorYang, K-
dc.contributor.authorWang, N-
dc.contributor.authorLiu, J-
dc.contributor.authorMin, X-
dc.contributor.authorYan, D-
dc.contributor.authorSun, J-
dc.contributor.authorWu, H-
dc.contributor.authorLi, X-
dc.contributor.authorZheng, Y-
dc.contributor.authorYu, Z-
dc.contributor.authorLu, X-
dc.contributor.authorYang, Y-
dc.contributor.authorJia, T-
dc.contributor.authorJi, J-
dc.contributor.authorZou, Q-
dc.contributor.authorWang, Y-
dc.contributor.authorXiao, M-
dc.contributor.authorZhang, Q-
dc.contributor.authorXiong, Y-
dc.contributor.authorSun, F-
dc.contributor.authorZhu, Q-
dc.contributor.authorJiang, X-
dc.contributor.authorWang, G-
dc.contributor.authorTang, SCW-
dc.contributor.authorZhang, J-
dc.contributor.authorLi, X-
dc.contributor.authorZhang, N-
dc.contributor.authorZhang, B-
dc.contributor.authorTong, X-
dc.contributor.authorLiu, B-
dc.contributor.authorZhou, X-
dc.contributor.authorChan, KW-
dc.contributor.authorLi, X-
dc.date.accessioned2021-10-05T02:33:54Z-
dc.date.available2021-10-05T02:33:54Z-
dc.date.issued2021-
dc.identifier.citationThe American Journal of Chinese Medicine, 2021, v. 49 n. 3, p. 543-575-
dc.identifier.issn0192-415X-
dc.identifier.urihttp://hdl.handle.net/10722/304701-
dc.description.abstractChinese 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.-
dc.languageeng-
dc.publisherWorld Scientific Publishing Co Pte Ltd. The Journal's web site is located at http://www.worldscinet.com/ajcm/ajcm.shtml-
dc.relation.ispartofThe American Journal of Chinese Medicine-
dc.rightsFor preprints : Preprint of an article published in [Journal, Volume, Issue, Year, Pages] [Article DOI] © [copyright World Scientific Publishing Company] [Journal URL] For postprints : Electronic version of an article published as [Journal, Volume, Issue, Year, Pages] [Article DOI] © [copyright World Scientific Publishing Company] [Journal URL]-
dc.subjectCoronavirus Disease 2019-
dc.subjectCOVID-19-
dc.subjectIntegrative Medicine-
dc.subjectChinese Medicine-
dc.subjectCohort-
dc.titleAdd-On Chinese Medicine for Coronavirus Disease 2019 (ACCORD): A Retrospective Cohort Study of Hospital Registries-
dc.typeArticle-
dc.identifier.emailTang, SCW: scwtang@hku.hk-
dc.identifier.emailChan, KW: chriskwc@hku.hk-
dc.identifier.authorityTang, SCW=rp00480-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1142/S0192415X21500257-
dc.identifier.pmid33683189-
dc.identifier.scopuseid_2-s2.0-85102308069-
dc.identifier.hkuros326402-
dc.identifier.volume49-
dc.identifier.issue3-
dc.identifier.spage543-
dc.identifier.epage575-
dc.identifier.isiWOS:000634398100001-
dc.publisher.placeSingapore-

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