Cohort study investigates the efficacy of traditional Chinese medicine for post-COVID-19 syndrome

Background and objectives

Due to the lack of specific Western medicine therapies for post-coronavirus disease 2019 (COVID-19) syndrome in clinical practice, this study aimed to investigate the efficacy of traditional Chinese medicine (TCM) for post-COVID-19 syndrome using a cohort study design and to explore its clinical value in alleviating patients' symptoms and improving clinical outcomes.

Methods

In this cohort study, patients were divided into two groups according to clinical treatment. The control group received conventional Western medicine, and the treatment group received additional TCM syndrome differentiation–based treatment. Propensity score matching methods were used to reduce selection bias by equating groups based on observed covariates. Clinical data, including TCM symptom scores, the Short Form 36 Health Survey, clinical efficacy, and adverse events at Day 7, were collected. The primary outcome was the efficacy rate, defined by improvement at Day 7 compared with the Day 0 score. Data were processed and analyzed using SPSS 23.0 and R 4.5.0 software.

Results

A total of 434 patients were enrolled in the cohort, including 306 patients in the control group and 128 in the treatment group. After 1:1 matching, 94 matched pairs were analyzed. For the primary outcome, the effective rate in the treatment group was higher than that in the control group (30.8% vs. 17.2%; odds ratio (OR) = 2.17, 95% confidence interval (CI): 1.09–4.35, P = 0.003). After seven days of treatment, the TCM syndrome score improved more in the treatment group than in the control group (median difference (MD) = 2.00, 95% CI: 0.50–3.50, P = 0.009). Subgroup analyses showed generally favorable efficacy in the treatment group across subgroups, though not all reached statistical significance.

Conclusions

In this single-center cohort study, standardized TCM syndrome differentiation-based treatment from the Diagnostic and Treatment Protocol for Novel Coronavirus Infection, combined with conventional Western medicine symptomatic treatment and lifestyle intervention, effectively relieved TCM symptoms in adult patients aged 18–80 years with post-COVID-19 syndrome after seven days of intervention, with favorable short-term efficacy and good safety. The change in TCM syndrome scores was the only independent influencing factor for clinical efficacy, and the stability of the study results was fully verified by sensitivity analysis. This study provides clinical evidence for the short-term standardized application of TCM syndrome differentiation-based treatment in the clinical management of post-COVID-19 syndrome.