The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
권호 표지
DOI QR코드

DOI QR Code

Management of asymptomatic to mild COVID-19 patients with Cheongpebaedok-tang on the telemedical basis: A retrospective observational case series

  • Sung-Woo Kang (Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Kwan-Il Kim (Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Mideok Song (Kyunghee Korean Medicine clinic) ;
  • Jinhwan Roh (Seoul Kyunghee Clinic) ;
  • Namhun Cho (Wondang Kyunghee Korean medical clinic) ;
  • Heung Ko (Department Korean Internal Medicine, College of Korean Medicine, Semyung University ) ;
  • Sung-Se Son (Department of Acupuncture & Moxibustion, CHA Bundang Medical Center, CHA University ) ;
  • Minjeong Jeong (Department of Pediatrics, College of Korean Medicine, Woosuk University ) ;
  • Jun-Yong Choi (Department of Korean Internal Medicine, School of Korean Medicine & Korean Medicine Hospital of Pusan National University) ;
  • Ojin Kwon (KM Science Research Division, Korea Institute of Oriental Medicine) ;
  • Seojung Ha (Department of Internal Medicine (Pulmonary & Allergy System), Kyung Hee University Medical Center) ;
  • Hee-Jae Jung (Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University) ;
  • Beom-Joon Lee (Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University)
  • Received : 2023.10.05
  • Accepted : 2023.11.15
  • Published : 2023.12.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This retrospective observational study aimed to investigate the efficacy and safety of Cheongpebaedok-tang, a traditional Korean herbal medicine, provided via telemedicine to patients with asymptomatic to mild COVID-19 in Korea. Methods: From February to April 2020, a retrospective analysis investigated COVID-19 patients treated via Korean telemedicine. The study involved asymptomatic to mild cases receiving Cheongpebaedok-tang more than three times, along with continuous Korean medicine care in convalescence. Diagnoses and treatment adhered to the telemedicine guidelines of the Association of Korean Medicine, with varied Cheongpebaedok-tang prescriptions based on symptom severity. Symptom evaluation involved a detailed assessment using a 15-item tool at initial and final sessions. Results: The study included 27 patients, with a mean age of 48.7 ± 2.3 years (mean ± standard error). Patients began self-administering oral Cheongpebaedok-tang for an average of 19.4 ± 1.8 days after the date of COVID-19 diagnosis confirmation and continued the medication for 15.8 ± 1.2 days. The reported side effects of the Cheongpebaedok-tang included palpitations (11.1%), insomnia (7.4%), dizziness (3.7%), and diarrhea (3.7%). All side effects disappeared after adjusting the prescription according to standard treatment guidelines. The occurrence of all COVID-19-related adverse symptoms, except fatigue and myalgia, decreased. Fatigue was the most common chronic symptom persisting after 6 months (51.9%), followed by ocular symptoms (37.0%) and sore throat (22.2%). Conclusions: This study implies Cheongpebaedok-tang may offer a potentially safe, symptom-alleviating approach for managing mild COVID-19 cases via telemedicine, although further comprehensive research is warranted.

Keywords

Acknowledgement

We are grateful for the support and cooperation of the COVID-19 telemedicine center of Korean medicine and the Association of Korean Medicine.

References

  1. World Health Organization. (2020). WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Retrieved October 20, 2023 from https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 
  2. Kim, J.-H., An, J. A.-R., Min, P.-K., Bitton, A., & Gawande, A. A. (2020). How South Korea Responded to the Covid-19 Outbreak in Daegu. NEJM Catalyst, 1(4). https://doi.org/10.1056/cat.20.0159 
  3. The Association of Korean medicine. (2020). Guidance on COVID-19 Telemedicine of Korean Medicine (2nd ed.). Retrieved October 20, 2023 from https://www.akom.org/Home/AkomArticleNews/1098627?NewsType=7 
  4. The Association of Korean medicine. (2020). COVID-19 Korean medicine clinical guidance (2nd ed.). Retrieved October 20, 2023 from https://www.akom.org/Home/AkomArticleNews/1098499?NewsType=7 
  5. The Korean Medicine Professor Council of Internal Medicine of the Respiratory System. (2020). Clinical Guidelines on COVID-19 Korean Medicine (2.1 ed.). Retrieved October 20, 2023 from https://www.akom.org/Home/AkomArticleNews/1098498?NewsType=7 
  6. National Health Commission of the People's Republic of China. (2020). Diagnosis and Treatment Protocol for COVID-19 (Trial Version 7). Retrieved October 20, 2023 from http://en.nhc.gov.cn/2020-03/29/c_78469.htm 
  7. Kim, D. S., Chu, H., Min, B. K., Moon, Y., Park, S., Kim, K., et al. (2020). Telemedicine Center of Korean Medicine for treating patients with COVID-19: a retrospective analysis. Integr Med Res, 9(3), 100492. https://doi.org/10.1016/j.imr.2020.100492 
  8. National Health Commission of the People's Republic of China. (2020). Diagnosis and Treatment Protocol for COVID-19 Patients (Tentative 8th Edition). Retrieved October 20, 2023 from http://en.nhc.gov.cn/2020-09/07/c_81565.htm 
  9. Ren, W., Ma, Y., Wang, R., Liang, P., Sun, Q., Pu, Q., et al. (2021). Research Advance on Qingfei Paidu Decoction in Prescription Principle, Mechanism Analysis and Clinical Application [Review]. Frontiers in pharmacology, 11(2046). https://doi.org/10.3389/fphar.2020.589714 
  10. Chen, J., Wang, Y. K., Gao, Y., Hu, L. S., Yang, J. W., Wang, J. R., et al. (2020). Protection against COVID-19 injury by qingfei paidu decoction via anti-viral, anti-inflammatory activity and metabolic programming. Biomed Pharmacother, 129, 110281. https://doi.org/10.1016/j.biopha.2020.110281 
  11. Yang, R., Liu, H., Bai, C., Wang, Y., Zhang, X., Guo, R., et al. (2020). Chemical composition and pharmacological mechanism of Qingfei Paidu Decoction and Ma Xing Shi Gan Decoction against Coronavirus Disease 2019 (COVID-19): In silico and experimental study. Pharmacological Research, 157, 104820. https://doi.org/10.1016/j.phrs.2020.104820 
  12. Wang, Q., Zhu, H., Li, M., Liu, Y., Lai, H., Yang, Q., et al. (2021). Efficacy and Safety of Qingfei Paidu Decoction for Treating COVID-19: A Systematic Review and Meta-Analysis. Frontiers in pharmacology, 12, 688857-688857. https://doi.org/10.3389/fphar.2021.688857 
  13. Jang, S., Kim, D., Yi, E., Choi, G., Song, M., & Lee, E.-K. (2021). Telemedicine and the Use of Korean Medicine for Patients With COVID-19 in South Korea: Observational Study. JMIR Public Health and Surveillance, 7(1), e20236. https://doi.org/10.2196/20236 
  14. Kim, S.-W., Kim, S.-M., Kim, Y. K., Kim, J.-Y., Lee, Y.-M., Kim, B.-O., et al. (2021). Clinical Characteristics and Outcomes of COVID-19 Cohort Patients in Daegu Metropolitan City Outbreak in 2020. Journal of Korean Medical Science, 36(1). https://doi.org/10.3346/jkms.2021.36.e12 
  15. Stokes, E. K., Zambrano, L. D., Anderson, K. N., Marder, E. P., Raz, K. M., El Burai Felix, S., et al. (2020). Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR. Morbidity and Mortality Weekly Report, 69(24), 759-765. https://doi.org/10.15585/mmwr.mm6924e2 
  16. Wiersinga, W. J., Rhodes, A., Cheng, A. C., Peacock, S. J., & Prescott, H. C. (2020). Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19). JAMA, 324(8), 782. https://doi.org/10.1001/jama.2020.12839 
  17. Carfi, A., Bernabei, R., & Landi, F. (2020). Persistent Symptoms in Patients After Acute COVID-19. JAMA, 324(6), 603. https://doi.org/10.1001/jama.2020.12603 
  18. Halpin, S. J., McIvor, C., Whyatt, G., Adams, A., Harvey, O., McLean, L., et al. (2021). Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. Journal of Medical Virology, 93(2), 1013-1022. https://doi.org/10.1002/jmv.26368 
  19. Xiong, Q., Xu, M., Li, J., Liu, Y., Zhang, J., Xu, Y., et al. (2021). Clinical sequelae of COVID-19 survivors in Wuhan, China: a single-centre longitudinal study. Clinical Microbiology and Infection, 27(1), 89-95. https://doi.org/10.1016/j.cmi.2020.09.023 
  20. Nehme, M., Braillard, O., Alcoba, G., Aebischer Perone, S., Courvoisier, D., Chappuis, F., et al. (2021). COVID-19 Symptoms: Longitudinal Evolution and Persistence in Outpatient Settings. Annals of internal medicine, 174(5), 723-725. https://doi.org/10.7326/M20-5926 
  21. Morin, L., Savale, L., Pham, T., Colle, R., Figueiredo, S., Harrois, A., et al. (2021). Four-Month Clinical Status of a Cohort of Patients After Hospitalization for COVID-19. JAMA, 325(15), 1525. https://doi.org/10.1001/jama.2021.3331 
  22. Rudroff, T., Fietsam, A. C., Deters, J. R., Bryant, A. D., & Kamholz, J. (2020). Post-COVID-19 Fatigue: Potential Contributing Factors. Brain Sciences, 10(12), 1012. https://doi.org/10.3390/brainsci10121012 
  23. Chen, L., Deng, C., Chen, X., Zhang, X., Chen, B., Yu, H., et al. (2020). Ocular manifestations and clinical characteristics of 535 cases of COVID-19 in Wuhan, China: a cross-sectional study. Acta Ophthalmologica, 98(8). https://doi.org/10.1111/aos.14472 
  24. Gambini, G., Savastano, M. C., Savastano, A., De Vico, U., Crincoli, E., Cozzupoli, G. M., et al. (2021). Ocular Surface Impairment After Coronavirus Disease 2019: A Cohort Study. Cornea, 40(4), 477-483. https://doi.org/10.1097/ico.0000000000002643 
  25. Li, L., Gou, C.-Y., Li, X.-M., Song, W.-Y., Wang, X.-J., Li, H.-Y., et al. (2021). Effects of Chinese Medicine on Symptoms, Syndrome Evolution, and Lung Inflammation Absorption in COVID-19 Convalescent Patients during 84-Day Follow-up after Hospital Discharge: A Prospective Cohort and Nested Case-Control Study. Chinese Journal of Integrative Medicine, 27(4), 245-251. https://doi.org/10.1007/s11655-021-3328-3 
  26. Shi, S., Fang, Z., Xiong, K., Ye, D., Wang, W., Wu, H., et al. (2021). Clinical Studies of Comprehensive TCM Treatment to 30 Cases of Qi Yin Deficiency Type of COVID-19 in its Recovery Period. Jiangsu Journal of Traditional Chinese Medicine, 53(01), 25-28. 
  27. Jegal, K. H., Yoon, J., Kim, S., Jang, S., Jin, Y. H., Lee, J. H., Choi, S. M., Kim, T. H., & Kwon, S. (2022). Herbal Medicines for Post-Acute Sequelae (Fatigue or Cognitive Dysfunction) of SARS-CoV-2 Infection: A Phase 2 Pilot Clinical Study Protocol. Healthcare (Basel, Switzerland), 10(10), 1839. https://doi.org/10.3390/healthcare10101839 
  28. Gao, Y., Zhong, L. L. D., Quach, B., Davies, B., Ash, G. I., Lin, Z.-X., et al. (2021). COVID-19 Rehabilitation With Herbal Medicine and Cardiorespiratory Exercise: Protocol for a Clinical Study. JMIR Research Protocols, 10(5), e25556. https://doi.org/10.2196/25556 
  29. Lee, Y.-H., Hong, C. M., Kim, D. H., Lee, T. H., & Lee, J. (2020). Clinical Course of Asymptomatic and Mildly Symptomatic Patients with Coronavirus Disease Admitted to Community Treatment Centers, South Korea. Emerging Infectious Diseases, 26(10), 2346-2352. https://doi.org/10.3201/eid2610.201620 
  30. Shaw, D. (2010). Toxicological Risks of Chinese Herbs. Planta Med, 76(17), 2012-2018. https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0030-1250533.pdf 
  31. Boullata, J. I., & Nace, A. M. (2000). Safety Issues with Herbal Medicine. Pharmacotherapy, 20(3), 257-269. https://doi.org/10.1592/phco.20.4.257.34886 
  32. Ghavam, M., & Soleimaninejad, Z. (2020). An Overview of the Various Uses of Ephedra distachya L. from the Past to the Present. Avicenna J Pharm Res, 1(2), 82-86. https://doi.org/10.34172/ajpr.2020.15 
  33. Portnoy, J., Waller, M., & Elliott, T. (2020). Telemedicine in the Era of COVID-19. The Journal of Allergy and Clinical Immunology: In Practice, 8(5), 1489-1491. https://doi.org/10.1016/j.jaip.2020.03.008 
  34. Hollander, J. E., & Carr, B. G. (2020). Virtually Perfect? Telemedicine for Covid-19. New England Journal of Medicine, 382(18), 1679-1681. https://doi.org/10.1056/nejmp2003539 
  35. Monaghesh, E., & Hajizadeh, A. (2020). The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09301-4 
  36. Lo, L.-C., Chen, Y.-F., Chen, W.-J., Cheng, T.-L., & Chiang, J. Y. (2012). The Study on the Agreement between Automatic Tongue Diagnosis System and Traditional Chinese Medicine Practitioners. Evidence-Based Complementary and Alternative Medicine, 2012, 1-9. https://doi.org/10.1155/2012/505063 
  37. Tania, M. H., Lwin, K., & Hossain, M. A. (2019). Advances in automated tongue diagnosis techniques. Integrative Medicine Research, 8(1), 42-56. https://doi.org/https://doi.org/10.1016/j.imr.2018.03.001 
  38. Chen, H. S., Chen, S. M., Jiang, C. Y., Zhang, Y. C., Lin, C. Y., Lin, C. E., et al. (2021). Computational tongue color simulation in tongue diagnosis. Color Research & Application. https://doi.org/10.1002/col.22717 
  39. Liu, X., Kesebir, D., & Kazachkov, M. (2021). Approach to patient with cough by American and Chinese respiratory specialist. Complementary Therapies in Medicine, 60, 102733. https://doi.org/https://doi.org/10.1016/j.ctim.2021.102733