Long Ge1,2,3,4, Hongfei Zhu1,2, Qi Wang1,2, Mengting Li1,2, Jianxiong Cai5,6,7, Yang Chen8, Yaolong Chen3,4,9,10, Banghan Ding5, Bangjiang Fang11, Yutong Fei12, Jihong Feng13, Xinfeng Guo5,6,7, Rongmeng Jiang14, Yuyong Jiang14, Guiwei Li15, Xiuhui Li16, Xucheng Li17, Qun Liang18, Jian Liu19, Jianping Liu12, Qingquan Liu20, Shaonan Liu5,6,7, Yun Lu21, Qing Miao22, Wensheng Qi23, Hongcai Shang24, Liqing Shi25, XingHua Tan26, Xudong Tang27, Xianbo Wang14, Xiaojun Wang16, Wenguang Xia28, Kehu Yang2,3,4,9, Lihong Yang5,6,7, Yongan Ye24, Qi Zhou10, Hongchun Zhang29, Junhua Zhang30, Zhiming Zhang31, Zhongde Zhang5, Xu Zou5, Jun Li5, Darong Wu5,6,7. 1. Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China. 2. Evidence-Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China. 3. WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China. 4. Chinese GRADE Centre, Lanzhou University, Lanzhou, China. 5. Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. 6. The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China. 7. Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China. 8. First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China. 9. Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China. 10. Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China. 11. Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China. 12. Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China. 13. Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China. 14. Beijing Ditan Hospital Capital Medical University, Beijing, China. 15. First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China. 16. Beijing Youan Hospital, Capital Medical University, Beijing, China. 17. Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China. 18. First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China. 19. The First Hospital of Lanzhou University, Lanzhou, China. 20. Beijing Traditional Chinese Medicine Hospital, Capital Medical University, Beijing, China. 21. Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China. 22. Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China. 23. Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China. 24. Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. 25. Department of Respiratory Medicine, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China. 26. Guangzhou Eighth People's Hospital, Guangzhou, China. 27. China Academy of Chinese Medical Sciences, Beijing, China. 28. Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China. 29. China-Japan Friendship Hospital, Beijing, China. 30. Evidence-Based Medicine Center of Tianjin University of Traditional Chinese Medicine, Tianjin, China. 31. Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou, China.
Abstract
BACKGROUND: The coronavirus disease 2019 (COVID-19) has turned into a pandemic and resulted in huge death tolls and burdens. Integrating Chinese and western medicine has played an important role in the fight against the COVID-19 pandemic. PURPOSE: We aimed to develop a living evidence-based guideline of integrating Chinese and western medicine for COVID-19. STUDY DESIGN: Living evidence-based guideline. METHODS: This living guideline was developed using internationally recognized and accepted guideline standards, dynamically monitoring the release of new clinical evidence, and quickly updating the linked living systematic review, evidence summary tables, and recommendations. Modified Delphi method was used to reach consensus for all recommendations. The certainty of the evidence, resources, and other factors were fully considered, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence and the strength of recommendations. RESULTS: The first version of this living guidance focuses on patients who are mild or moderate COVID-19. A multidisciplinary guideline development panel was established. Ten clinical questions were identified based on the status of evidence and a face-to-face experts' consensus. Finally, nine recommendations were reached consensus, and were formulated from systematic reviews of the benefits and harms, certainty of evidence, public accessibility, policy supports, feedback on proposed recommendations from multidisciplinary experts, and consensus meetings. CONCLUSION: This guideline panel made nine recommendations, which covered five traditional Chinese medicine (TCM) prescription granules/decoction (MXXFJD, QFPD, XFBD, TJQW, and JWDY), three Chinese patent medicines (LHQW granules/capsule, JHQG granules, and LHQK granules), and one Chinese herbal injection (XBJ injection). Of them, two were strongly recommended (LHQW granules/capsule and QFPD decoction), and five were weakly recommended (MXXFJD decoction, XFBD decoction, JHQG granules, TJQW granules, and JWDY decoction) for the treatment of mild and moderate COVID-19; two were weakly recommended against (XBJ injection and LHQK granules) the treatment of mild and moderate COVID-19. The users of this living guideline are most likely to be clinicians, patients, governments, ministries, and health administrators.
BACKGROUND: The coronavirus disease 2019 (COVID-19) has turned into a pandemic and resulted in huge death tolls and burdens. Integrating Chinese and western medicine has played an important role in the fight against the COVID-19 pandemic. PURPOSE: We aimed to develop a living evidence-based guideline of integrating Chinese and western medicine for COVID-19. STUDY DESIGN: Living evidence-based guideline. METHODS: This living guideline was developed using internationally recognized and accepted guideline standards, dynamically monitoring the release of new clinical evidence, and quickly updating the linked living systematic review, evidence summary tables, and recommendations. Modified Delphi method was used to reach consensus for all recommendations. The certainty of the evidence, resources, and other factors were fully considered, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence and the strength of recommendations. RESULTS: The first version of this living guidance focuses on patients who are mild or moderate COVID-19. A multidisciplinary guideline development panel was established. Ten clinical questions were identified based on the status of evidence and a face-to-face experts' consensus. Finally, nine recommendations were reached consensus, and were formulated from systematic reviews of the benefits and harms, certainty of evidence, public accessibility, policy supports, feedback on proposed recommendations from multidisciplinary experts, and consensus meetings. CONCLUSION: This guideline panel made nine recommendations, which covered five traditional Chinese medicine (TCM) prescription granules/decoction (MXXFJD, QFPD, XFBD, TJQW, and JWDY), three Chinese patent medicines (LHQW granules/capsule, JHQG granules, and LHQK granules), and one Chinese herbal injection (XBJ injection). Of them, two were strongly recommended (LHQW granules/capsule and QFPD decoction), and five were weakly recommended (MXXFJD decoction, XFBD decoction, JHQG granules, TJQW granules, and JWDY decoction) for the treatment of mild and moderate COVID-19; two were weakly recommended against (XBJ injection and LHQK granules) the treatment of mild and moderate COVID-19. The users of this living guideline are most likely to be clinicians, patients, governments, ministries, and health administrators.