Traditional Chinese medicine for COVID-19 pandemic and emerging challenges: An online cross-sectional survey in China

다국어 초록 (Multilingual Abstract)

Background We aimed to investigate use of infection control behaviours, preventative and therapeutic interventions, and outcomes among respondents to an online survey during the COVID-19 pandemic in China.




Methods The survey was designed by an international team, translated and adapted to simplified Chinese, including 132 kinds of traditional Chinese medicine (TCM) preparation recommended by guidelines. It was distributed and collected from February to May 2021, with data analysed by WPS spreadsheet and wjx.cn. Descriptive statistics were used to describe demographics and clinical characteristics, diagnosis, treatments, preventative behaviours and interventions, and their associated outcomes.




Results The survey was accessed 503 times with 341 (67.8%) completions covering 23 provinces and four municipalities in China. Most (282/341, 82.7%) respondents reported no symptoms during the pandemic and the majority (290/341, 85.0%) reported having a SARS-CoV-2 PCR test at some point. Forty-five (13.2%) reported having a respiratory infection, among which 19 (42.2%) took one or more categories of modern medicine, e.g. painkillers, antibiotics; 16 (35.6%) used TCM interventions(s); while seven respondents combined TCM with modern medicine. All respondents reported using at least one behavioural or medical approach to prevention, with 22.3% taking TCM and 5.3% taking modern medicines. No respondents reported having a critical condition related to COVID-19.




Conclusion We found evidence of widespread use of infection control behaviours, modern medicines and TCM for treatment and prevention of COVID-19 and other respiratory symptoms. Larger scale studies are warranted, including a more representative sample exploring TCM preparations recommended in clinical guidelines.

다국어 초록 (Multilingual Abstract)

Background We aimed to investigate use of infection control behaviours, preventative and therapeutic interventions, and outcomes among respondents to an online survey during the COVID-19 pandemic in China.


Methods The survey was designed by an international team, translated and adapted to simplified Chinese, including 132 kinds of traditional Chinese medicine (TCM) preparation recommended by guidelines. It was distributed and collected from February to May 2021, with data analysed by WPS spreadsheet and wjx.cn. Descriptive statistics were used to describe demographics and clinical characteristics, diagnosis, treatments, preventative behaviours and interventions, and their associated outcomes.


Results The survey was accessed 503 times with 341 (67.8%) completions covering 23 provinces and four municipalities in China. Most (282/341, 82.7%) respondents reported no symptoms during the pandemic and the majority (290/341, 85.0%) reported having a SARS-CoV-2 PCR test at some point. Forty-five (13.2%) reported having a respiratory infection, among which 19 (42.2%) took one or more categories of modern medicine, e.g. painkillers, antibiotics; 16 (35.6%) used TCM interventions(s); while seven respondents combined TCM with modern medicine. All respondents reported using at least one behavioural or medical approach to prevention, with 22.3% taking TCM and 5.3% taking modern medicines. No respondents reported having a critical condition related to COVID-19.


Conclusion We found evidence of widespread use of infection control behaviours, modern medicines and TCM for treatment and prevention of COVID-19 and other respiratory symptoms. Larger scale studies are warranted, including a more representative sample exploring TCM preparations recommended in clinical guidelines.

참고문헌 (Reference)

1 Ren JL, "Traditional Chinese medicine for COVID-19 treatment" 155 : 2020

2 Shanxi Municipal Health Commission, "Traditional Chinese Medicine Treatment Plan for COVID-19 of Shanxi (Trial Version 2)"

3 Traditional Chinese Medicine Bureau of Guangdong Province, "Traditional Chinese Medicine Treatment Plan for COVID-19 of Guangdong (Trial Version 2)"

4 Traditional Chinese Medicine Bureau of Guangdong Province, "Traditional Chinese Medicine Treatment Plan for COVID-19 of Guangdong (Trial Version 1)"

5 Jiangxi Municipal Health Commission, "Traditional Chinese Medicine Prevention and Treatment Plan for COVID-19 of Jiangxi (Trial Version 2)"

6 Guizhou Administration of Traditional Chinese Medicine, "Traditional Chinese Medicine Prevention and Treatment Plan for COVID-19 of Guizhou (Version 2)"

7 Gansu Municipal Health Commission, "Traditional Chinese Medicine Prevention and Treatment Plan for COVID-19 of Gansu (Trial)"

8 Shanghai Municipal Health Commission, "Traditional Chinese Medicine Diagnosis and Treatment Plan for COVID-19 of Shanghai (Trial Version 2)"

9 Liaoning Municipal Health Commission, "Traditional Chinese Medicine Diagnosis and Treatment Plan for COVID-19 of Liaoning (Trial Version 2)"

10 Hunan Municipal Health Commission, "Traditional Chinese Medicine Diagnosis and Treatment Plan for COVID-19 of Hunan (Trial Version 3)"

11 Hunan Municipal Health Commission, "Traditional Chinese Medicine Diagnosis and Treatment Plan for COVID-19 of Hunan (Trial Version 2)"

12 Hunan Municipal Health Commission, "Traditional Chinese Medicine Diagnosis and Treatment Plan for COVID-19 Rehabilitation Stage of Hunan (Trial)"

13 Huang K, "Traditional Chinese Medicine (TCM) in the treatment of COVID-19 and other viral infections:Efficacies and mechanisms" 225 : 2021

14 Takemoto MLS, "The tragedy of COVID-19 in Brazil : 124maternal deaths and counting" 151 (151): 154-156, 2020

15 Von Elm E, "The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement : guidelines for reporting observational studies" 370 (370): 1453-1457, 2007

16 Sichuan Municipal Health Commission, "Suggested prescriptions for Traditional Chinese Medicine intervention for COVID-19 of Sichuan (Trial Version 1)"

17 Wu Z, "Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine(CoronaVac)in healthy adults aged 60 years and older : a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial" 21 (21): 803-812, 2021

18 Zhang Y, "Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18-59 years : A randomised, double-blind, placebo-controlled, phase 1/2 clinical trial" 21 (21): 181-192, 2021

19 Zhu FC, "Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine : A dose-escalation, open-label, non-randomised, first-in-human trial" 395 (395): 1845-1854, 2020

20 Xia S, "Safety and immunogenicity of an inactivated SARS-CoV-2 vaccine, BBIBP-CorV : A randomised, double-blind, placebo-controlled, phase 1/2 trial" 21 (21): 39-51, 2021

21 Yang S, "Safety and immunogenicity of a recombinant tandemrepeat dimeric RBD protein vaccine against COVID-19 in adults: Pooled analysis of two randomized, double-blind, placebo-controlled, phase 1 and 2 trials"

22 Mehra MR, "Retraction-Hydroxychloroquine or Chloroquine with or without a macrolide for treatment of COVID-19 : A multinational registry analysis" 395 (395): 1820-, 2020

23 Rolstad S, "Response burden and questionnaire length : is shorter better? A review and meta-analysis" 14 (14): 1101-1108, 2011

24 WHO Solidarity Trial Consortium, "Repurposed antiviral drugs for COVID-19 - Interim WHO solidarity trial results" 384 (384): 497-511, 2021

25 World Health Organization, "R&D Blue Print. The COVID-19 Vaccine Tracker and Landscape Compiles Detailed Information of each COVID-19 Vaccine Candidate in Development by Closely Monitoring their Progress Through the Pipeline"

26 Nussbaumer-Streit B, "Quarantine alone or in combination with other public health measures to control COVID-19: A rapid review" 9 (9): 2020

27 World Health Organization, "Preventing and mitigating COVID-19 at Work: Policy Brief 19 May 2021"

28 Li T, "Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China" 74 (74): 871-875, 2020

29 Wenling Y, "Pregnancy and COVID-19 : Management and challenges" 62 : e62-, 2020

30 National Health Commission of the People’s Republic of China, "Novel Coronavirus Vaccine Technical Guide (First edition)"

31 The State Council of the People’s Republic of China, "Notice on doing a good job in guaranteeing service for the people who staying in local region during Chinese New Year"

32 "National Health Commission of the People’s Republic of ChinaDiagnosis and Treatment Plan for COVID-19 (Trial Version 8)" 10 (10): 321-328, 2020

33 "National Health Commission of the People’s Republic of ChinaDiagnosis and Treatment Plan for COVID-19 (Trial Version 7)" 18 (18): 100-105, 2020

34 "National Health Commission of the People’s Republic of ChinaDiagnosis and Treatment Plan for COVID-19 (Trial Version 3)" 37 (37): 1-3, 2020

35 National Health Commission of the People’s Republic of China, "Medical correspondence [2020]No. 77: Diagnosis and Treatment Practice Guidelines for COVID-19(4th version)"

36 National Health Commission of the People’s Republic of China, "Medical correspondence [2020]No. 680: Diagnosis and Treatment Practice Guidelines for COVID-19 (8th version)"

37 National Health Commission of the People’s Republic of China, "Medical correspondence [2020]No. 66: Diagnosis and Treatment Practice Guidelines for COVID-19(3rd version)"

38 National Health Commission of the People’s Republic of China, "Medical correspondence [2020]No. 45: Diagnosis and Treatment Practice Guidelines for COVID-19(6th version)"

39 National Health Commission of the People’s Republic of China, "Medical correspondence [2020]No. 184: Diagnosis and Treatment Practice Guidelines for COVID-19 (7th version)"

40 National Health Commission of the People’s Republic of China, "Medical correspondence [2020]No. 103: Diagnosis and Treatment Practice Guidelines for COVID-19 (5th version)"

41 Eysenbach G, "Improving the quality of Web surveys : the Checklist for Reporting Results of Internet E-Surveys(CHERRIES)" 6 (6): e34-, 2004

42 Jiang CY, "Impact of COVID-19 control measures on the spread of influenza" 1-7, 2021

43 Lin Ang, "Herbal medicine and pattern identification for treating COVID-19: a rapid review of guidelines" 한국한의학연구원 9 (9): 1-14, 2020

44 Ahmed I, "First COVID-19 maternal mortality in the UK associated with thrombotic complications" 190 (190): e37-e38, 2020

45 Hur K, "Factors associated with intubation and prolonged intubation in hospitalized patients with COVID-19" 163 (163): 170-178, 2020

46 Wu Q, "Evaluation of the safety profile of COVID-19vaccines : A rapid review" 19 (19): 173-, 2021

47 Ali K, "Evaluation of mRNA-1273 SARS-CoV-2 vaccine in adolescents [published online ahead of print, 2021 Aug 11]" 2021

48 Wang H, "Efficacy and safety of traditional Chinese medicine in Coronavirus Disease 2019 (COVID-19): A systematic review and meta-analysis" 12 : 2021

49 Singh S, "Efficacy and safety of Remdesivir in COVID-19 caused by SARS-CoV-2: A systematic review and meta-analysis" 11 (11): 2021

50 Xia S, "Effect of an inactivated vaccine against SARS-CoV2 on safety and immunogenicity outcomes : Interim analysis of 2 randomized clinical trials" 324 (324): 951-960, 2020

51 Li Q, "Early transmission dynamics in Wuhan, China, of novel Coronavirus-infected Pneumonia" 26 (26): 1199-1207, 2020

52 Hebei Municipal Health Commission, "Diagnosis and Treatment Plan for COVID19 of Hebei (Trial Version 2)"

53 Hayakawa S, "Covid-19 pandemic and pregnancy" 46 (46): 1958-1966, 2020

54 Li YD, "Coronavirus vaccine development : from SARS and MERS to COVID-19" 27 (27): 104-, 2020

55 Krause PR, "Considerations in boosting COVID-19 vaccine immune responses [published online ahead of print, 2021 Sep 14]" S0140-6736 (S0140-6736): 02046-02048, 2021

56 World Health Organization, "Clinical management of COVID-19: living guidance 25January 2021"

57 Guan WJ, "Clinical characteristics of Coronavirus Disease 2019 in China" 382 (382): 1708-1720, 2020

58 Chen H, "Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women : a retrospective review of medical records" 395 (395): 809-815, 2020

59 Zhu H, "Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia" 9 (9): 51-60, 2020

60 Wang D, "Clinical Characteristics of 138 hospitalized patients with 2019 novel Coronavirus-infected Pneumonia in Wuhan" 17 (17): 1061-1069, 2020

61 Singh B, "Chloroquine or Hydroxychloroquine for prevention and treatment of COVID-19" 2 (2): 2021

62 Luo H, "Can Chinese medicine be used for prevention of Corona Virus Disease 2019 (COVID-19)? A review of historical classics, research evidence and current prevention programs" 26 (26): 243-250, 2019

63 Dhabaan G, "COVID-19 pandemic in Yemen : A questionnaire based survey, what do we know" 14 (14): 1374-1379, 2020

64 Rajkumar RP, "COVID-19 and mental health: A review of the existing literature" 52 : 2020

65 World Health Organization, "COVID-19 Dashboard" World Health Organization

66 "Beijing Administration of Traditional Chinese MedicineTraditional Chinese medicine prevention and treatment plan for COVID-19 of Beijing (Trial Version 5)" 39 (39): 655-656, 2020

67 Hao F, "A quantitative and qualitative study on the neuropsychiatric sequelae of acutely ill COVID-19 inpatients in isolation facilities" 10 (10): 355-, 2020

68 Dong F, "A living systematic review of the psychological problems in people suffering from COVID-19" 292 : 172-188, 2021