COVID-19: TCM Lianhua Qingwen speeds up recovery but no effect in preventing conversion to severe cases – two-week RCT

By Tingmin Koe contact

- Last updated on GMT

Lianhua Qingwen capsules have been proven to speed up symptoms recovery but no effect in preventing infections from worsening.
Lianhua Qingwen capsules have been proven to speed up symptoms recovery but no effect in preventing infections from worsening.

Related tags: TCM, COVID-19, China

A two-week clinical trial led by renowned Chinese pulmonologist Zhong Nanshan has shown that consuming the botanical TCM product Lianhua Qingwen (LH) capsules and undergoing the standard therapy can speed up recovery in COVID-19 patients.

However, it has not proved to be effective in preventing severe infection from happening or reducing median viral assay conversion time. 

In the trial which took place from Feb 2 to 15, nine in 10 of the subjects (91.5%) in the treatment group had completely recovered from at least one major symptom, such as coughing, fever, and fatigue by the end of the trial.

The recovery rate in the control group was 82.4%. The result was statistically significant with a p-value of less than 0.05 at 0.022.

Published in Phytomedicine, ​the study is said to be the first multicentre, open-labelled RCT that assess the safety and efficacy of LH capsules.

Comprising of more than 10 botanicals, LH capsules is made of ingredients such as Forsythia suspensa, Lonicera japonica (Japanese honeysuckle), Ephedra sinica, ​and Isatis indigotica.

A product of Shijiazhuang Yiling Pharmaceuticals, it was manufactured based on The Pharmacopedia of People’s Republic of China.

A total of 284 COVID-19 patients from 23 hospitals from nine provinces completed the trial.

Those suffering from severe pneumonia requiring mechanical ventilation or other chronic airway diseases, or severe systemic diseases, or pregnant women were excluded from the trial.

The treatment group took four LH capsules thrice daily and underwent the standard treatment consisting of oxygen therapy and anti-viral medications.

The control group only received the standard treatment.

The study was funded by four national organisations, including the Beijing Municipal Science and technology commission NCP Emergency project, the Hebei Provincial Department of Science and Technology NCP prevention and control emergency scientific research project.

Quicker recovery

The trial found that the median time taken for symptom recovery was shorter in the treatment group.

For example, the median time taken to recover from coughing was seven days in the treatment group and 10 days in the control group.

Also, the treatment group took three days to recover from fatigue while the control group took six days.

Citing a 2020 study conducted by Niu et al,​ the researchers suggested that the LH capsules, because of key components such as Lonicera japonica​ and Forsythia suspense, ​could block the binding of SARS-CoV-2 with the angiotensin converting enzyme.

Another ingredient, Pogostemon cablin, ​has shown to ameliorate lung injury via the abrogation of pulmonary inflammation, according to a 2020 study by Yao and Luo.

“In summary, LH capsules confer therapeutic effects on COVID-19 by improving the recovery rate of symptoms, shortening the time to symptom recovery, and improving the recovery of chest radiologic abnormalities.

“In light of the efficacy and safety profiles, LH capsules could be considered for the treatment of COVID-19,” ​said the researchers.

No effect seen

While it could speed up recovery, the LH capsules have not proved to be effective in preventing severe symptoms from developing in the patients.

Three and six subjects from the treatment group and control group respectively developed severe conditions which was not a statistically significant difference.  

Also, there was no significant difference in the median viral assay conversion time between the two groups. This means that LH capsules intake will not significantly shorten the time in reducing the viral load and producing a negative COVID-19 RNA result in patients.

Safety

Both groups experienced the common problem of elevated alanine aminotransferase levels, which signifies abnormal liver functions.

In both groups, 22.5% of the subjects reported abnormal liver function.

Other than that, the treatment group has seen a lower incidence of adverse events such as diarrhoea (5.6%), while that of the control group was 13.4%.

No serious adverse events were reported.

Future studies

Extending the duration of the study was recommended by the researchers to gain a fuller understanding of the LH capsules.

“The duration of treatment was established empirically, and whether a prolonged duration would translate into the greater efficacy warrants further investigation.

“An extended study would be needed to thoroughly explore the effects of LH capsules on the viral shedding and the resolution of all symptoms,”​ said the researchers.

 

Source: Phytomedicine

Efficacy and Safety of Lianhuaqingwen Capsules, a repurposed Chinese Herb, in Patients with Coronavirus disease 2019: A multicenter, prospective, randomised controlled trial

DOI: 10.1016/j.phymed.2020.153242

Authors: Zhong Nanshan, et al

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