Efficacy and safety of integrated traditional Chinese and Western medicine against <scp>COVID</scp>‐19: A systematic review and meta‐analysis

Abstract Although plenty of clinical trials have confirmed the efficacy and safety of integrated traditional Chinese and Western medicine (ITCWM) against COVID‐19, the role of ITCWM remains controversial. So we conducted a systematic review and meta‐analysis of published studies in eight major databases that report the outcomes of interest in COVID‐19 patients receiving ITCWM. RevMan5.4 software was used for meta‐analysis, while the quality of RCTs was assessed by the Cochrane risk of bias tool and the retrospective studies were assessed by Newcastle–Ottawa Scale. Eventually, a total of 53 studies with 5425 COVID‐19 patients was identified. The meta‐analysis results showed that ITCWM was significantly better than western medicine treatment (WMT) alone in the percentage of cases changing to severe/critical [ RR = 0.40, 95%CI (0.33, 0.49), p &lt; .00001, I 2 = 10%], overall clinical effectiveness [ RR = 1.26, 95% CI (1.18, 1.35), p &lt; .00001, I 2 = 50%], time to defervescencer [ MD = −1.45, 95% CI (−1.82, −1.07), p &lt; .00001, I 2 = 83%], disappearing time of cough [ MD = −2.11, 95% CI (−2.98, −1.25), p &lt; .00001, I 2 = 93%], time of RT‐PCR negativity [MD = −3.35, 95% CI (−4.74, −1.95), p &lt; .00001, I 2 = 92%], length of hospital stay [ MD = −4.05, 95% CI (−5.24, −2.85), p &lt; .00001, I 2 = 91%], improvement in CT scan [ RR = 1.22, 95% CI (1.17, 1.28), p &lt; .00001, I 2 = 46%], TCM syndrome score [ MD = −3.95, 95% CI (−5.07, −2.82), p &lt; .00001, I 2 = 92%], disappearance rate of fever [ RR = 1.23, 95% CI (1.10, 1.38), p &lt; .00001, I 2 = 85%], disappearance rate of cough [ RR = 1.43, 95% CI (1.25, 1.63), p &lt; .00001, I 2 = 60%], level of CRP [ MD = −9.23, 95% CI (−10.94, −7.52), p &lt; .00001, I 2 = 97%], and WBC [ MD = −9.23, 95% CI (−10.94, −7.52), p &lt; .00001, I 2 = 97%]. There is no significant difference between ITCWM and WMT in the adverse reaction rate [ RR = 0.85, 95% CI(0.71, 1.03), p = .10, I 2 = 25%]. Our results showed evidence of clinical efficacy and safety benefit in COVID‐19 patients treated with ITCWM. In spite of some limitations, the rapidly developing global pandemic warrants further high‐quality and multicenter clinical studies to confirm the contribution of ITCWM.

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