Clinical effects of traditional Chinese herbal medicine management in patients with COVID-19 sequelae: A hospital-based retrospective cohort study in Taiwan

Abstract

Introduction: An estimated 43% of COVID-19 patients showed sequelae, including fatigue, neurocognitive impairment, respiratory symptoms, and smell or taste disorders. These sequelae significantly affect an individual's health, work capacity, healthcare systems, and socioeconomic aspects. Traditional Chinese herbal medicine (TCHM) management showed clinical benefits in treating patients with COVID-19 sequelae. This study aimed to analyze the effects of personalized TCHM management in patients with COVID-19 sequelae. Methods: After the COVID-19 outbreak in Taiwan, we recorded Chronic Obstructive Pulmonary Disease Assessment Tool (CAT), Chalder Fatigue Questionnaire (CFQ-11), and Brief Symptom Rating Scale (BSRS-5) to assess post-COVID respiratory, fatigue, and emotional distress symptoms, respectively. In this study, we retrospectively reviewed the medical records between July 2022 and March 2023. We analyzed the effects of TCHM administration after 14- and 28-days of treatment. Results: 47 patients were included in this study. The results demonstrated that personalized TCHM treatment significantly improved the CAT, CFQ-11, and BSRS-5 scores after 14 and 28 days. TCHM alleviated physical and psychological fatigue. In logistic regression analysis, there was no statistically significant differences in the severity of the baseline symptoms and TCHM administration effects concerning the duration since the initial confirmation of COVID-19, sex, age, or dietary preference (non-vegetarian or vegetarian). Conclusions: Our study suggested that personalized TCHM treatment notably reduced fatigue, respiratory and emotional distress symptoms after 14- and 28-days of treatment in patients with COVID-19 sequelae. We propose that TCHM should be considered as an effective intervention for patients with COVID-19 sequelae.

Keywords: BSRS-5; CAT; CFQ-11; COVID-19 sequelae; traditional Chinese herbal medicine.

Figure 1

Study flow diagram. COVID-19, coronavirus disease-2019; ICD-10, International Classification of Diseases, Tenth Revision; TCM, Traditional Chinese Medicine.

Figure 2

Effects of TCHM administration on post-COVID respiratory, fatigue, and emotional distress symptoms. TCHM, Traditional Chinese herbal medicine; COVID-19, coronavirus disease-2019; CAT, Chronic obstructive pulmonary disease Assessment Tool; CFQ-11, Chalder Fatigue Questionnaire; BSRS, Brief Symptom Rating Scale; D0, day of the initial visit to the TCM OPD; D14, day of follow-up visits to the TCM OPD 14 days after D0; D28, day of follow-up visits to the TCM OPD 28 days after D0. * P value < 0.05, ** P value < 0.01, *** P value < 0.001, **** P value < 0.0001

Figure 3

Effects of TCHM administration on post-COVID fatigue symptoms. TCHM, Traditional Chinese herbal medicine; COVID-19, coronavirus disease-2019; CFQ-11, Chalder Fatigue Questionnaire, D0: day of the initial visit to the TCM OPD; D14, day of follow-up visits to the TCM OPD 14 days after D0, D28, day of follow-up visits to the TCM OPD 28 days after D0. ** P value < 0.01, **** P value < 0.0001

Figure 4

Shift of the proportions following TCHM administration. TCHM, Traditional Chinese herbal medicine; CAT, Chronic obstructive pulmonary disease Assessment Tool; CFQ-11, Chalder Fatigue Questionnaire; BSRS, Brief Symptom Rating Scale; D0, day of the initial visit to the TCM OPD; D14, day of follow-up visits to the TCM OPD 14 days after D0; D28, day of follow-up visits to the TCM OPD 28 days after D0.