Institute of Medical Intelligence, School of Computer and Information Technology, Beijing Jiaotong University, Beijing, 100044, China.
Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, China.
Front Med. 2020 Dec;14(6):760-775. doi: 10.1007/s11684-020-0803-8. Epub 2020 Sep 14.
Coronavirus disease 2019 (COVID-19) is now pandemic worldwide and has heavily overloaded hospitals in Wuhan City, China during the time between late January and February. We reported the clinical features and therapeutic characteristics of moderate COVID-19 cases in Wuhan that were treated via the integration of traditional Chinese medicine (TCM) and Western medicine. We collected electronic medical record (EMR) data, which included the full clinical profiles of patients, from a designated TCM hospital in Wuhan. The structured data of symptoms and drugs from admission notes were obtained through an information extraction process. Other key clinical entities were also confirmed and normalized to obtain information on the diagnosis, clinical treatments, laboratory tests, and outcomes of the patients. A total of 293 COVID-19 inpatient cases, including 207 moderate and 86 (29.3%) severe cases, were included in our research. Among these cases, 238 were discharged, 31 were transferred, and 24 (all severe cases) died in the hospital. Our COVID-19 cases involved elderly patients with advanced ages (57 years on average) and high comorbidity rates (61%). Our results reconfirmed several well-recognized risk factors, such as age, gender (male), and comorbidities, as well as provided novel laboratory indications (e.g., cholesterol) and TCM-specific phenotype markers (e.g., dull tongue) that were relevant to COVID-19 infections and prognosis. In addition to antiviral/antibiotics and standard supportive therapies, TCM herbal prescriptions incorporating 290 distinct herbs were used in 273 (93%) cases. The cases that received TCM treatment had lower death rates than those that did not receive TCM treatment (17/273 = 6.2% vs. 7/20= 35%, P = 0.0004 for all cases; 17/77= 22% vs. 7/9= 77.7%, P = 0.002 for severe cases). The TCM herbal prescriptions used for the treatment of COVID-19 infections mainly consisted of Pericarpium Citri Reticulatae, Radix Scutellariae, Rhizoma Pinellia, and their combinations, which reflected the practical TCM principles (e.g., clearing heat and dampening phlegm). Lastly, 59% of the patients received treatment, including antiviral, antibiotics, and Chinese patent medicine, before admission. This situation might have some effects on symptoms, such as fever and dry cough. By using EMR data, we described the clinical features and therapeutic characteristics of 293 COVID-19 cases treated via the integration of TCM herbal prescriptions and Western medicine. Clinical manifestations and treatments before admission and in the hospital were investigated. Our results preliminarily showed the potential effectiveness of TCM herbal prescriptions and their regularities in COVID-19 treatment.
新型冠状病毒肺炎（COVID-19）目前已在全球范围内流行，并在 1 月底至 2 月期间使中国武汉市的医院不堪重负。我们报告了在武汉市接受中西医结合治疗的中度 COVID-19 病例的临床特征和治疗特点。我们从武汉市一家指定的中医院收集了电子病历（EMR）数据，其中包括患者的完整临床资料。通过信息提取过程，从入院记录中获取症状和药物的结构化数据。其他关键临床实体也得到了确认和规范化，以获取患者的诊断、临床治疗、实验室检查和结果信息。共有 293 例 COVID-19 住院患者，包括 207 例中度和 86 例（29.3%）严重病例，纳入我们的研究。在这些病例中，238 例出院，31 例转院，24 例（均为严重病例）在医院死亡。我们的 COVID-19 病例涉及年龄较大（平均 57 岁）和合并症发生率较高（61%）的老年患者。我们的结果再次证实了一些公认的危险因素，如年龄、性别（男性）和合并症，并提供了新的实验室指标（如胆固醇）和与 COVID-19 感染和预后相关的中医特定表型标志物（如舌暗）。除了抗病毒/抗生素和标准支持治疗外，还在 273 例（93%）病例中使用了含有 290 种不同草药的中药方剂。接受中医治疗的病例死亡率低于未接受中医治疗的病例（所有病例 17/273=6.2% vs. 7/20=35%，P=0.0004；严重病例 17/77=22% vs. 7/9=77.7%，P=0.002）。用于治疗 COVID-19 感染的中药方剂主要由陈皮、黄芩、半夏及其组合组成，反映了实用的中医原则（如清热化痰）。最后，59%的患者在入院前接受了治疗，包括抗病毒、抗生素和中药专利药。这种情况可能对症状（如发热和干咳）有一定影响。通过使用电子病历数据，我们描述了 293 例接受中西医结合治疗的 COVID-19 病例的临床特征和治疗特点。调查了入院前和住院期间的临床表现和治疗情况。我们的结果初步显示了中药方剂在 COVID-19 治疗中的潜在有效性及其规律。
