The Role of Traditional Chinese Medicine in COVID-19: Theory, Initial Clinical Evidence, Potential Mechanisms, and Implications.

Traditional Chinese Medicine (TCM) has played a significant role in combating coronavirus disease 2019 (COVID-19) in China. However, our understanding of the efficacy and mechanisms of TCM in treating COVID-19 remains limited. Thus, it is important to stimulate further discussion based on early empirical evidence.This review aims to summarize initial clinical evidence for the role of TCM in COVID-19 treatment, discuss potential TCM and biological mechanisms, and suggest implications for practice and research.A literature search was conducted on PubMed, PsycInfo, and Google Scholar between December 2019 and January 2021. Observational studies, retrospective studies, case studies, cohort studies, and randomized controlled trials with at least a published English abstract were inspected and included in the final review.In general, herbal medicine has been shown to improve clinical symptoms, patient prognosis and mortality, and inflammatory markers, especially when paired with Western medicine. Potential mechanisms of action involve bioactive compounds preventing the virus from binding to the angiotensin-converting enzyme 2 of the host cell, inhibiting viral replication after its penetration into the host cell, as well as counteracting the proinflammatory overreaction of the immune system. Other TCM modalities, including acupuncture and moxibustion, qigong, and tuina and acupressure for COVID-19 treatment have not been well investigated.While there is initial support for the use of Traditional Chinese Medicine for COVID-19, conclusions cannot be drawn to support its use as a replacement for conventional COVID-19 treatment, given the lack of high-quality evidence from strictly-designed randomized controlled trials. However, there is initial evidence suggesting that TCM may serve as an effective adjunct to conventional treatments in alleviating COVID-19 symptoms. More research is needed to confirm the efficacy and safety of TCM in treating COVID-19.