Intern Med . Conventional and Kampo Medicine Treatment for Mild-to-moderate COVID-19: A Multicenter, Retrospective, Observational Study by the Integrative Management in Japan for Epidemic Disease (IMJEDI study-Observation)

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Intern Med


. 2022 Nov 2.
doi: 10.2169/internalmedicine.0027-22. Online ahead of print.
Conventional and Kampo Medicine Treatment for Mild-to-moderate COVID-19: A Multicenter, Retrospective, Observational Study by the Integrative Management in Japan for Epidemic Disease (IMJEDI study-Observation)


Shin Takayama ¹ , Tetsuhiro Yoshino ² , Sayaka Koizumi ³ , Yasuhito Irie ⁴ , Tomoko Suzuki ⁵ , Susumu Fujii ⁶ , Rie Katori ⁷ , Mosaburo Kainuma ⁸ , Seiichi Kobayashi ⁹ , Tatsuya Nogami ¹⁰ , Kenichi Yokota ¹¹ , Mayuko Yamazaki ¹² , Satoko Minakawa ¹³ , Shigeki Chiba ¹¹ , Norio Suda ¹⁴ , Yoshinobu Nakada ¹⁵ , Tatsuya Ishige ¹⁶ , Hirofumi Maehara ¹⁷ , Yutaka Tanaka ¹⁸ , Mahiko Nagase ¹⁹ , Akihiko Kashio ²⁰ , Kazuhisa Komatsu ²¹ , Makoto Nojiri ²² , Osamu Shimooki ²³ , Kayo Nakamoto ²⁴ , Ryutaro Arita ¹ , Rie Ono ¹ , Natsumi Saito ¹ , Akiko Kikuchi ¹ , Minoru Ohsawa ¹ , Hajime Nakae ⁴ , Tadamichi Mitsuma ²⁵ , Masaru Mimura ^{2 26} , Tadashi Ishii ¹ , Kotaro Nochioka ²⁷ , Shih-Wei Chiu ²⁸ , Takuhiro Yamaguchi ²⁸ , Takao Namiki ²⁹ , Akito Hisanaga ³⁰ , Kazuo Mitani ³¹ , Takashi Ito ³²



Affiliations

• PMID: 36328579
• DOI: 10.2169/internalmedicine.0027-22

Abstract

Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37 °C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

Keywords: COVID-19; Kampo medicines; SARS-CoV-2; conventional treatment; illness worsening; symptom.