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      Efficacy and Safety of Huashi Baidu Granules in Treating Patients with SARS-CoV-2 Omicron Variant: A Single-Center Retrospective Cohort Study

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          Abstract

          Objective

          To evaluate the efficacy and safety of Huashi Baidu Granules (HSBD) in treating patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant.

          Methods

          A single-center retrospective cohort study was conducted during COVID-19 Omicron epidemic in the Mobile Cabin Hospital of Shanghai New International Expo Center from April 1st to May 23rd, 2022. All COVID-19 patients with asymptomatic or mild infection were assigned to the treatment group (HSBD users) and the control group (non-HSBD users). After propensity score matching in a 1:1 ratio, 496 HSBD users of treatment group were matched by propensity score to 496 non-HSBD users. Patients in the treatment group were administrated HSBD (5 g/bag) orally for 1 bag twice a day for 7 consecutive days. Patients in the control group received standard care and routine treatment. The primary outcomes were the negative conversion time of nucleic acid and negative conversion rate at day 7. Secondary outcomes included the hospitalized days, the time of the first nucleic acid negative conversion, and new-onset symptoms in asymptomatic patients. Adverse events (AEs) that occurred during the study were recorded. Further subgroup analysis was conducted in vaccinated (378 HSBD users and 390 non-HSBD users) and unvaccinated patients (118 HSBD users and 106 non-HSBD users).

          Results

          The median negative conversion time of nucleic acid in the treatment group was significantly shortened than the control group [3 days (IQR: 2–5 days) vs. 5 days (IQR: 4–6 days); P<0.01]. The negative conversion rate of nucleic acid in the treatment group were significantly higher than those in the control group at day 7 (91.73% vs. 86.90%, P=0.014). Compared with the control group, the hospitalized days in the treatment group were significantly reduced [10 days (IQR: 8–11 days) vs. 11 days (IQR: 10.25–12 days); P<0.01]. The time of the first nucleic acid negative conversion had significant differences between the treatment and control groups [3 days (IQR: 2–4 days) vs. 5 days (IQR: 4–6 days); P<0.01]. The incidence of new-onset symptoms including cough, pharyngalgia, expectoration and fever in the treatment group were lower than the control group ( P<0.05 or P<0.01). In the vaccinated patients, the median negative conversion time and hospitalized days were significantly shorter than the control group after HSDB treatment [3 days (IQR: 2–5 days) vs. 5 days (IQR: 4–6 days), P<0.01; 10 days (IQR: 8–11 days) vs. 11 days (IQR: 10–12 days), P<0.01]. In the unvaccinated patients, HSBD treatment efficiently shorten the median negative conversion time and hospitalized days [4 days (IQR: 2–6 days) vs. 5 days (IQR: 4–7 days), P<0.01; 10.5 days (IQR: 8.75–11 days) vs. 11.0 days (IQR: 10.75–13 days); P<0.01]. No serious AEs were reported during the study.

          Conclusion

          HSBD treatment significantly shortened the negative conversion time of nuclear acid, the length of hospitalization, and the time of the first nucleic acid negative conversion in patients infected with SARS-COV-2 Omicron variant (Trial registry No. ChiCTR2200060472).

          Electronic Supplementary Material

          Supplementary material (Appendixes 1 and 2) are available in the online version of this article at 10.1007/s11655-023-3549-8.

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          Most cited references31

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          Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa

          The SARS-CoV-2 epidemic in southern Africa has been characterized by three distinct waves. The first was associated with a mix of SARS-CoV-2 lineages, while the second and third waves were driven by the Beta (B.1.351) and Delta (B.1.617.2) variants, respectively 1–3 . In November 2021, genomic surveillance teams in South Africa and Botswana detected a new SARS-CoV-2 variant associated with a rapid resurgence of infections in Gauteng province, South Africa. Within three days of the first genome being uploaded, it was designated a variant of concern (Omicron, B.1.1.529) by the World Health Organization and, within three weeks, had been identified in 87 countries. The Omicron variant is exceptional for carrying over 30 mutations in the spike glycoprotein, which are predicted to influence antibody neutralization and spike function 4 . Here we describe the genomic profile and early transmission dynamics of Omicron, highlighting the rapid spread in regions with high levels of population immunity.
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            Network pharmacology and molecular docking analysis on molecular targets and mechanisms of Huashi Baidu formula in the treatment of COVID-19

            Abstract Purpose Huashi Baidu formula (HSBDF) was developed to treat the patients with severe COVID-19 in China. The purpose of this study was to explore its active compounds and demonstrate its mechanisms against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through network pharmacology and molecular docking. Methods All the components of HSBDF were retrieved from the pharmacology database of TCM system. The genes corresponding to the targets were retrieved using UniProt and GeneCards database. The herb–compound–target network was constructed by Cytoscape. The target protein–protein interaction network was built using STRING database. The core targets of HSBDF were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). The main active compounds of HSBDF were docked with SARS-CoV-2 and angiotensin converting enzyme II (ACE2). Results Compound–target network mainly contained 178 compounds and 272 corresponding targets. Key targets contained MAPK3, MAPK8, TP53, CASP3, IL6, TNF, MAPK1, CCL2, PTGS2, etc. There were 522 GO items in GO enrichment analysis (p < .05) and 168 signaling pathways (p < .05) in KEGG, mainly including TNF signaling pathway, PI3K–Akt signaling pathway, NOD-like receptor signaling pathway, MAPK signaling pathway, and HIF-1 signaling pathway. The results of molecular docking showed that baicalein and quercetin were the top two compounds of HSBDF, which had high affinity with ACE2. Conclusion Baicalein and quercetin in HSBDF may regulate multiple signaling pathways through ACE2, which might play a therapeutic role on COVID-19.
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              Challenges in Inferring Intrinsic Severity of the SARS-CoV-2 Omicron Variant

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                Author and article information

                Contributors
                fangbji@163.com
                Journal
                Chin J Integr Med
                Chin J Integr Med
                Chinese Journal of Integrative Medicine
                Springer Nature Singapore (Singapore )
                1672-0415
                1993-0402
                24 May 2023
                : 1-8
                Affiliations
                [1 ]GRID grid.412540.6, ISNI 0000 0001 2372 7462, Department of Emergency, Longhua Hospital, , Shanghai University of Traditional Chinese Medicine, ; Shanghai, 200032 China
                [2 ]Department of Classical Traditional Chinese Medicine, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, 400021 China
                [3 ]GRID grid.412540.6, ISNI 0000 0001 2372 7462, Acupuncture and Massage College, , Shanghai University of Traditional Chinese Medicine, ; Shanghai, 201203 China
                [4 ]GRID grid.412540.6, ISNI 0000 0001 2372 7462, Institute of Emergency and Critical Care Medicine, , Shanghai University of Traditional Chinese Medicine, ; Shanghai, 200032 China
                Article
                3549
                10.1007/s11655-023-3549-8
                10206345
                37222827
                39d57ce5-fb7d-43da-a7db-dc99a6af48b4
                © The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature 2023

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 4 February 2023
                Categories
                Original Article

                huashi baidu granule,severe acute respiratory syndrome coronavirus 2,omicron variant,retrospective cohort trial,chinese medicine

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