Traditional Chinese Medicine holds key to unlocking lasting solutions for Covid-19

Chris Mahove

More effective and appropriate application of Traditional Chinese Medicine (TCM) for treatment of COVID-19 could potentially benefit human health globally, according to findings by World Health Organisation Expert Meeting on Traditional Chinese Medicine in the Treatment of COVID-19.

A culmination of a high-level policy dialogue between the Director-General of WHO and China’s National Administration of Traditional Chinese Medicine (NATCM) in Geneva on 17 January, the meeting was held virtually from February 28, 2022 to March 2, 2022.

The meeting was held to evaluate the role of Traditional Chinese Medicine (TCM) in the treatment of COVID-19.

Twenty-one international experts from the six WHO regions, including five members of the WHO Expert Advisory Panel, representatives of eight WHO collaborating centres, three members of the WHO International Regulatory Cooperation for Herbal Medicines (IRCH), and members of the China Academy of Chinese Medical Sciences and technical staff from WHO headquarters, regional and country offices attended the meeting.

“The experts acknowledged that the included trials involved heterogeneous settings and various types of patients and outcome measures. In addition to routine treatment, the results from the studied TCMs suggest that, on the basis of clinically relevant outcome measures, the studied TCMs are beneficial in the treatment of COVID-19, particularly in mild-to-moderate cases,’ read the report.

The experts recommended members states to consider the potential use of CTM in the management of COVID-19 in the context of their health-care systems and health regulations.

Part of the key findings of the Expert Meeting was that the evidence evaluation reports presented at the meeting applied appropriate and rigorous methodology to determine the current level of clinical evidence and safety of the studied TCM interventions used in the trials.

The experts said there was promising data to suggest that TCM was beneficial in reducing the risk of progression from mild-to-moderate cases to severe COVID-19 although evidence on the benefit of

“For mild-to-moderate cases, there is encouraging evidence that the studied TCMs, when administered as add-on interventions to conventional treatment, may shorten the time for viral clearance, resolution of clinical symptoms and length of hospital stay when compared to conventional treatment alone,”.

It was noted that  results of the TCM trials did not substantiate the use of any specific plant species outside the general TCM framework in the context of COVID-19 and that the studied TCM interventions given in addition to conventional treatment were well tolerated and had a safety profile comparable to that of conventional treatment alone.

“There is encouraging evidence that early application of TCM may result in better clinical outcomes for patients with mild-to-moderate COVID-19. Despite inherent limitations, the results from the selected RCTs justify further investments in clinical trials to evaluate the potential benefits of selected TCMs in the management of COVID-19,” the experts noted

The experts urged member states to share experiences and lessons, particularly those actively acquired through this organized research programme in TCM and clinical experience from China; to collaborate actively in clinical and mechanistic research to further evaluate and elucidate the clinical benefits and safety of TCM in the management of COVID-19.

According to minutes of the meeting, the experts further encouraged member states to collaborate in developing consistent approaches, where practicable, and to improve health-care systems for the management of the current pandemic and prepare for future pandemics.

“The participants in the Expert Meeting commended the experts from China for sharing research data and clinical experience in using TCM in conjunction with conventional medicine in the management of COVID 19; (and) expressed their appreciation for the significant investment and effort made by the Chinese government and its researchers to advance knowledge and to develop therapeutics for the management of COVID-19 from the outset of the current pandemic,” reads part of the minutes.

The experts, however, recommended that further research be done on TCM for the treatment of COVID-19 since the progress to date laid a strong foundation for international collaboration and cooperation.

There were suggestions for the optimization of the analysis of the current database and to conduct pooled analyses based on subcategories (e.g. shared herbal combinations, single herb if available, individual symptom resolution, rate/proportion of symptom resolution, length of stay in hospital, days in intensive care unit, conversion rates, viral clearance).

The experts also called for retrospective treatment outcome (RTO) studies regarding Long COVID, the use of artificial intelligence (AI) to scrutinize the data for meaningful correlation and the exploration of the potential of AI for data/sample/cohort analysis were also suggested.

Calls have also been made for the facilitation and improvement of new trials.

The meeting considered three reports on traditional Chinese medicine and COVID-19 –including on clinical service, research and evidence-based evaluation provided by national expert groups in China.

The evidence-based evaluation report focused on outcomes from the reports as well from 12 randomized controlled trials (RCTs) which had been registered and published.

The objectives of the meeting were to understand the methodology applied in producing the reports; to review and analyse the reports and randomized controlled trials of TCM in various phases of the progression of COVID-19 disease;  to evaluate the contribution of a TCM integrated approach in the treatment of COVID19; and to discuss how to effectively enhance the contribution of traditional medicine in global pandemics.

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