High-quality randomized controlled trials conducted over the long-term from multiple countries are warranted to further validate the efficacy and safety of LHQW. Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease. Niu Q.Q., Chen Y., Liu Y., Mao S.Z., Wang H., Zheng W.K., Zhang J.H. Lianhua Qingwen (LHQW) is a classical Chinese medical preparation, while one of its prescription compositions Maxingshigan Decoction has a history of more than thousand years to treat plague, and exhibits antiviral and lung protection actions [15,16]. Analysis of the molecular mechanism of Pudilan (PDL) treatment for COVID-19 by network pharmacology tools. Data analysis were done by CH and DZ. It has approved by China Food and Drug Administration (CFDA). J. Eval. Received 2020 Jul 3; Revised 2020 Aug 9; Accepted 2020 Aug 16. Chinese supplement Lianhua Qingwen: What you need to know Effects of Four Types of Integrated Chinese and Western Medicines for the Treatment of Covid-19 in china: a Network Meta-Analysis. Inclusion in an NLM database does not imply endorsement of, or agreement with, Both Lian-Hua-Qing-Wen Capsule (LHQWC) and Jin-Hua-Qing . Received: 27 August 2021; Accepted: 06 January 2022;Published: 27 January 2022. (2020). Several limitations of our meta-analysis should be taken into consideration. Study on the network pharmacology and evidences of Lianhua Qingwen in the treatment of Novel Coronavirus (2019 nCoV) Pneumonia. However, the efficacy and safety of which shall be confirmed by more high-quality clinical trials. Kunming: Kunming University of technology. Formulae. Literature analysis of Chinese patent medicine treatment in the observation period of Clinical Management of Corona Virus Disease 2019 (trial 6th edition). These results were different from our findings, which may be attributed to the limited number of adverse reactions reported in the previous study. Other related clinical studies also revealed that LHQW significantly improved the symptoms in COVID-19 patients and reduced the duration of fever, fatigue and cough and so forth, which provide preliminary research evidence for clinical treatment of COVID-19 [45,46]. COVID-19 pandemic has caused a serious threat to public health and become the greatest challenge facing the world. 'medicine using forsythia suspensa and lonicera japonica to clear illness',[1] LHQW) is a traditional Chinese medicine (TCM) formulation used for the treatment of influenza. Data were considered statistically significant at p values <0.05. [3], Lianhua Qingwen was developed by Shijiazhuang Yiling Pharmaceutical in 2003 as a treatment for severe acute respiratory syndrome (SARS) following the outbreak of the disease in 2002 and was listed by the National Health Commission of China in 2004 as a treatment for influenza and other respiratory disease. To protect the interests of patients, the risk-benefit ratio of the drug needs to be considered in clinical applications. Chakraborty C., Sharma A.R., Sharma G., Bhattacharya M., Lee S.S. SARS-CoV-2 causing pneumonia-associated respiratory disorder (COVID-19): diagnostic and proposed therapeutic options. Further clinical trial showed that LHQW was superior to oseltamivir in improving the symptoms of influenza A virus infection by a meta-analysis of randomized, controlled trials [37]. [citation needed]. A multi-center, randomized, double-blind, and placebo-controlled phase II clinical study, sponsored by Yiling Pharmaceutical Inc., was conducted to investigate the safety and efficacy of two doses of LHQW capsule compared to placebo in subjects with acute uncomplicated influenza in the U.S.A (https://www.clinicaltrials.gov/ct2/show/study/{"type":"clinical-trial","attrs":{"text":"NCT02867358","term_id":"NCT02867358"}}NCT02867358). [9], During the COVID-19 pandemic, the government of the People's Republic of China (PRC) approved the use of Lianhua Qingwen for mild to moderate COVID-19 cases in January 2020, and promotes the use of the medicine abroad. Lianhua Qingwen (simplified Chinese: ; traditional Chinese: ; lit. Further investigation confirmed that the combination treatment of LHQW capsules (200mg/kg/day) with oseltamivir (2mg/kg/day) markedly reduced IBV infection over the individual administration of either alone in vivo, proving that LHQW capsules could be used as an assistant drug to enhance the effect of oseltamivir against IBV infection [26]. Traditional Chinese medicine Lianhua Qingwen capsule has been proven effective for the treatment of COVID-19, China's top respiratory expert Zhong Nanshan said in a webinar with overseas Chinese students on Monday. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement. During the study, no serious adverse events were reported. Shi, M., Peng, B., Li, A., Li, Z., Song, P., Li, J., et al. [16][17] A Filipino TCM physician interviewed by ABS-CBN clarified that although the medicine can be used for symptomatic treatment of flu-like symptoms in COVID-19 patients, it is not an antibiotic nor anti-viral, and cannot cure the disease itself. The sensitivity results are shown in Table 2. Systematic review of traditional Chinese medicine Lianhua Qingwen in Studies were classified as low risk of bias, high risk of bias or unclear risk of bias based on individual items. Effect of Lianhua Qingwen capsule on immunity of mice infected with flu virus. Ma Y., Zhang Z., Wei L., He S., Deng X., Ji A., Zhou B., Jiang D., Li M., Wang Y. Efficacy and safety of Reduqing granules in the treatment of common cold with wind-heat syndrome: a randomized, double-blind, double-dummy, positive-controlled trial. Meanwhile, the network pharmacology analysis confirmed that its effects were mainly focused on the biological processes such as the response to LPS, the molecular response to bacterial origin, the response to metal ions and cell biological stimulation [41]. There was no statistically significant difference in the incidence of adverse reactions during treatment of common pneumonia between the LHQW group and the conventional drug group (RR = 0.99, 95% CI = 0.791.24, p = 0.927). Further long-term high-quality studies are essential to validate our conclusions. Fig. Wu, L., Chen, Y., Ma, Y., Yang, Z., Yang, N., Deng, W., et al. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Accessibility Lianhua Qingwen is a commonly used Chinese patent medicine to treat viral infection. Future related studies will provide accumulated evidence to clarify it. 04:26. However, while the potential clinical efficacy of LHQW has been demonstrated in several studies (Hu et al., 2020; Wu et al., 2020; Xiao et al., 2020; Wang et al., 2021), no consensus has been reached regarding the adverse reactions associated with LHQW therapy to date. Lu Z.J., Wu L.Y., Mou Y.Y., Duan H.M., Chen R.C., Xiao Y., Zheng W.J. Upon full text filtering of the remaining 715 citations, 498 were excluded due to a number of reasons (shown in Figure 1). Meanwhile, the median effective concentrations (EC50) in above-mentioned effects were 0.042, 0.031, 0.051 and 0.050mg/mL, respectively, while the prevention effect on virus adsorption was the strongest [25]. Efficacy and safety of Lianhua Qingwen combined with : Medicine It includes Forsythia suspensa (Thunb.) Herald. the contents by NLM or the National Institutes of Health. 161, 105126. doi:10.1016/j.phrs.2020.105126, Yang, C., Wang, Y., He, J., Yan, W., Jiang, H., Chen, Q., et al. Introduction As the global epidemic continues to spread, countries have tapped effective drugs to treat new coronavirus pneumonia. Pharmacol. Ping F., Li Z., Zhang F., Li D., Han S. Effects of Lianhua Qingwen on pulmonary oxidative lesions induced by fine particulates (PM2.5) in rats. From SARS to COVID-19: pathogens, receptor, pathogenesis and principles of the treatment. LHQW has a reduced incidence of other adverse reactions compared to the conventional drug group (RR = 0.60, 95% CI = 0.430.84, p = 0.003). Bras (1992). Due to the inclusion of Ephedra people with high blood pressure, anxiety, history of seizures, irregular heart beats, or other heart heart conditions, should avoid taking Linhua Quingwen. Clinical effectiveness and case analysis in 54 NCP patients treated with Lanhuaqingwen granules. 13 (08), 676681. Currently, the drug has been approved for marketing in 23 countries and regions, including Canada, Russia, Cambodia and Indonesia. (2020). There was no statistically significant difference in the incidence of adverse reactions during treatment of rheum between the LHQW group and the conventional drug group (RR = 0.46, 95% CI = 0.121.83, p = 0.270). A network analysis of the Chinese medicine Lianhua-Qingwen formula to identify its main effective components. Lianhua-qingwen Displays Antiviral and Anti-inflammatory Activity and Synergistic Effects with Oseltamivir against Influenza B Virus Infection in the Mouse Model. Exploring material basis and mechanism of Lianhua Qingwen prescription against coronavirus based on network pharmacology. Frontiers | Broad Anti-Viral Capacities of Lian-Hua-Qing-Wen Capsule (2020) identified 38 randomized controlled trials (RCTs) comparing LHQW with antivirals or other Chinese medicines for treating influenza and reported a lower risk of adverse reactions in the LHQW group compared to oseltamivir (RR = 0.29, 95%CI = 0.110.80), and ribavirin groups (RR = 0.29, 95%CI = 0.110.80). Significant heterogeneity was detected for COVID-19 pneumonia (I2 = 76.0), hand-foot-mouth disease (I2 = 62.1), rheum (I2 = 88.2), and drowsiness of nervous system damage (I2 = 91.8). Since the outbreak of COVID-19, Lianhua Qingwen Capsules have been recommended by the official Chinese "Diagnosis and Treatment Protocol for COVID-19" and widely used in designated admission hospitals for COVID-19. Subgroup analysis showed the incidence of dizziness or headache was significantly reduced with LHQW group (RR = 0.54, 95% CI = 0.340.84, p = 0.006), no statistical difference was detected for drowsiness and legacy neuralgia. The .gov means its official. Hence, the researches on specific active components of LHQW are still important and the reduction of irrelevant ingredients may be related to less adverse reactions. Traditional Chinese medicine, such as Lianhua Qingwen, has achieved some curative effect in many countries, but its effect is not clear. (2010). Chin. doi:10.1097/MD.0000000000026059, Gallelli, L., Ferreri, G., Colosimo, M., Pirritano, D., Guadagnino, L., Pelaia, G., et al. The following aspects were assessed for each study: random sequence generation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other sources of bias. There was no statistically significant difference in the incidence of adverse reactions during treatment of herpes zoster between the LHQW group and the conventional drug group (RR = 0.80, 95% CI = 0.521.23, p = 0.302). Natural herbal medicine Lianhuaqingwen capsule anti-influenza A (H1N1) trial: a randomized, double blind, positive controlled clinical trial. FDA Advisory No.2021-0723 - Food and Drug Administration [Saururaceae; Houttuyniae Botanical drug] (255g), Pogostemon cablin (Blanco) Benth. In mice after infected with the flu virus FM1, LHQW capsule obviously increased IFN- content in lung homogenate and significantly reduced the levels of TNF-, IL-1 and IL-6 in lung tissues, and had inhibiting effect on the marked decrease of CD4+ and CD4+/CD8+ [31,32]. J. Pharmacovigilance. Guo H., Zhang Q.H., Yang J., Gong J.N., Zhao Y.S., Zhou X.P. Finally, all adverse reactions were described solely based on grouping of patients into treatment and control categories and no data were obtained according to gender stratification, which limited further analysis. Nervous system damage was described as an adverse event in 34 studies. Chinese drug Lianhua Qingwen not to be taken without doctor's OK [Caprifoliaceae; Lonicerae Japonicae Flos] (255g), Ephedra sinica Stapf [Ephedraceae; Ephedrae Botanical drug] (85g), Prunus armeniaca L. [Rosaceae; Armeniacae Semen Amarum] (85g), Gypsum Fibrosum (255g), Isatis indigotica Fort. ChemRxiv. conducted another single center clinical trial which was showed that seven days after treatment with LHQW granules (6g, tid) in conjunction with conventional treatment for COVID-19 patients had a total effective rate of 92.73 % accompanied by significantly reduced major symptoms including fever, cough, fatigue and chest tightness [41]. Vahl [Oleaceae; Forsythiae Fructus] (255g), Lonicera japonica Thunb. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Our findings support the adverse reactions recorded by Yiling Pharmaceutical, and compare the incidence risk of gastrointestinal system damage and rash with the control group. Although the data were far from adequate, the latest advances had shown the benefits of LHQW in COVID-19, especially in combination with other antiviral drugs. HHS Vulnerability Disclosure, Help Lianhuaqingwencaps.com - 608667 - 07/06/2020 | FDA Due to the low quality of the clinical research, the accuracy of this conclusion needs to be conducted to verify. Academician Yiling Wu systematically constructs the theory of collateral disease, provides theoretical guidance for the formulation of Lianhua Qingwen, and gives . The collected evidence demonstrated that LHQW exhibited benefits against COVID-19. Liu Y., Liu L., Cao M.M., Wen J., Zhou S., Jiang H., Zhang Y., Zhao R.S., Yang Y.H. Efficacy of Lianhua Qingwen Compared with Conventional Drugs - Hindawi Ren Y., Yao M.C., Huo X.Q., Gu Y., Zhu W.X., Qiao Y.J., Zhang Y.L. doi:10.13422/j.cnki.syfjx.20201099, Ye, C., Gao, M., Lin, W., Yu, K., Li, P., and Chen, G. (2020). (2020). COPD is characterized by a chronic inflammatory response and can be worsened by acute exacerbations. Results of publication bias and sensitivity analysis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Lianhua Qingwen capsule and Lianhua Qingwen granules were approved to add "functional indications" to the originally approved indications: "In the conventional treatment of novel. doi:10.1111/j.0006-341x.2000.00455.x, Fan, Z., Guo, G., Che, X., Yang, Y., Liu, Y., Li, L., et al. In addition, LHQW had antagonist effects on the pulmonary oxidative lesions that induced by fine particulates PM2.5 in rats [34]. Few reports of adverse reactions in the course of treating COVID-19 pneumonia with LHQW are available. 160, 105101. doi:10.1016/j.phrs.2020.105101, Xiao, M., Tian, J., Zhou, Y., Xu, X., Min, X., Lv, Y., et al. Therefore, people have also observed that Lianhua Qingwen capsule (granule) inhibits the over-expression of human common coronavirus (HcV-229E), novel coronavirus (COVID-19) infected cells and. There was no statistically significant difference in the incidence of abnormal white blood cells and reticuloendothelial system between the LHQW group and the conventional drug group (RR = 1.00, 95% CI = 0.382.62, p = 1.000). The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author. For drowsiness of nervous system damage, sample size (p = 0.500), year of publication (p = 0.157), and treatment of the control group (p = 0.599) were not linked with heterogeneity. (2002). Pract. The different incidence of these adverse reactions may be related to the metabolic level, which varies greatly among the different age groups. 2020, 5157089. doi:10.1155/2020/5157089, Huang, N. L., Huang, H. M., Zhang, B. Y., and Xie, J. Cytokine storm is an excessive immune response of the body to external stimuli such as viruses, which will stimulate the secretion of a large number of inflammatory factors and lead to cytokine cascade reaction [4,6]. Second, the herbs in LHQW are mostly grown in specific areas, the varied origin of herbs are usually together with different content of bioactive ingredients, thus the quality standard control of the included crude drugs should be encouraged [12]. Methods: Comprehensive document retrieval was performed from both English and Chinese databases. The quadruple combination therapy including Ribavirin, Lopinavir/ritonavir, Umifenovir, and LHQW, could markedly improve the abnormal coagulation and leukocyte of severe COVID-19 patients with a better prognosis [42]. 382 (21), e68. Chin. 1 Otherwise, the fixed-effects model was used (DerSimonian and Laird, 1986; Higgins et al., 2003). Advances in Pharmacology and Clinical Research of Lianhua Qingwen Capsules. Conclusion: The current study provides potential a reference for the security of LHQW. Recent data also showed that LHQW played a vigorous role in COVID-19 treatment. Kong Q., Wu Y., Gu Y., Lv Q., Qi F., Gong S., Chen X. Lianhua Qingwen Capsules has a better therapeutic effect on viral influenza, but the incidence of adverse reactions is high, and its safety must be taken seriously. Treatment of SARS-Cov-2: How Far Have We Reached? The authors report no declarations of interest. Compared with the conventional drug group, the incidence of disease recurrence was lower in the LHQW group, implied that LHQW might could regulate and enhance the immune function of the body. In recent years, LHQW has been registered to obtain marketing authorization in Canada, Brazil, Singapore, Thailand, the Philippines, Kuwait and other countries under the designation Chinese patent medicine, medicine, physical natural health products, food supplement, modern botanical medicine or natural medicine (Yiling Pharmaceutical, 2020). Chin. Ni L., Zhou L., Zhou M., Zhao J., Wang D.W. Lianhua Qingwen Capsules of Yiling Pharmaceutical Approved in mauritius. Meta-analysis in Clinical Trials. 100 (21), e26059. Jie Chen, Qin Chen and Hua-Qian Jin analyzed literatures. Wang L., Yang Z.H., Zhang H.R., Yu H.X., Yang K., Fu B.H., Yang H.T. aDepartment of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, PR China, bShanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200082, PR China, cShanghai TCM-Integrated Institute of Vascular Anomalies, Shanghai, 200082, PR China, dDepartment of Pharmacy, The First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, 310018, PR China, eDepartment of Pharmacy, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, 310018, PR China, fState Key Laboratory of Pharmaceutical Biotechnology, Department of Biotechnology and Pharmaceutical Sciences, School of Life Science, Nanjing University, Nanjing, 210023, PR China. Considerable research to date has focused on the clinical efficacy of LHQW, the safety of LHQW is additionally an important consideration for clinical application that should not be neglected. and transmitted securely. Besides, on April 14, 2020, the National Medical Products Administration of China approved modifying the specification of LHQW (Yiling Pharmaceutical Inc.) by adding a new indication for COVID-19 treatment in mild and normal cases. What Is in a Name? Data from our meta-analysis also failed to compare the security of LHQW with conventional drugs for treatment of COVID-19 pneumonia, which requires further investigation. The Chinese herbal medicine that can help treat COVID, according to BMJ. Notably, the stomach is full after a meal, and LHQW does not directly contact the gastric mucosa, which reduces the risk of irritation of stomach mucous membrane and thus the occurrence of side-effects. doi:10.1126/science.367.6485.1412, Lei, X. There was no statistically significant difference in the incidence of heart rate and arrhythmia between the LHQW group and the conventional drug group (RR = 0.67, 95% CI = 0.231.93, p = 0.454). Based on analysis of 40 cases of RCT, the clinical safety of LHQW was comprehensively examined, 163 adverse reactions were reported from 24 studies (Wang et al., 2013). [Systematic review of efficacy and safety of Lianhua Qingwen - PubMed 81703740), the Zhejiang Provincial Natural Science Foundation of China (No. Front. The site is secure. J. Nanjing Univ. LHQW had been proven to accelerate the improvement of acute exacerbation of COPD (AECOPD) patients, especially for the high-risk subgroup, due to the decreased release of inflammatory mediators including IL-8, TNF- , IL-17, and IL-23 [38]. 132 studies documented gastrointestinal system damage. Zhu S.Y., Li X.Y., Wei Y.L., Yang P.Y., Qin E.D. Progress on the efficacy and clinical application of Lianhua Qingwen capsule (LHQW). Business China. Bethesda, MD 20894, Web Policies The current meta-analysis was performed to evaluate the safety profile of LHQW in relation to conventional drugs (PROSPERO CRD-42020224180). Heterogeneity was evaluated using I2 statistic. Related tags TCM COVID-19 China A two-week clinical trial led by renowned Chinese pulmonologist Zhong Nanshan has shown that consuming the botanical TCM product Lianhua Qingwen (LH) capsules and undergoing the standard . Cheng D.Z., Wang W.J., Li Y., Wu X.D., Zhou B., Song Q.Y. (2011). It warned that sellers who make claims that it can prevent, protect against or treat COVID-19 may face prosecution. The clinical application experience of LHQW has improved over the years, the clinical considers the patients condition, physical quality, and age, controls the amount of LHQW prescribed accordingly and thereby, reduced the likelihood of adverse reactions. Further evaluation revealed that LHQW significantly inhibited SARS-CoV-2 replication in Vero E6 cells, markedly reduced pro-inflammatory cytokines (TNF-, IL-6, CCL-2/MCP-1 and CXCL-10/IP-10) production and resulted in abnormal particle morphology of virion in cells [30]. The trim and fill method was employed in cases where publication bias existed (Duval and Tweedie, 2000). (Guanghuoxiang), Rheum palmatum L. (Dahuang), Rhodiola rosea Linn. Am. In another prospective multicenter randomized controlled trial in confirmed COVID-19 cases, Hu et al. Reports emerged indicating that this process consumed significant logistical capacity, drawing criticism about misuse of resources at a time when people were struggling with shortages of basic needs such as food and medication. (2015). In addition, it can also interact with other compounds and herbs. J. Med. Measuring Inconsistency in Meta-Analyses. LHQW is one of the TCM formulations that have been officially approved to treat COVID-19 patients, which may be due to its antiviral, lung protection, and regulation of inflammation response as well as immune regulation actions (Fig. It cannot be taken as prophylaxis or as a health supplement. Lianhua Qingwen - Wikipedia Pharmacol. Frontiers | The Adverse Reactions of Lianhua Qingwen Capsule/Granule Copyright 2022 Hu, He, Gong, Liang, Zhao and Zhang. These in vivo data further demonstrate the antiviral effects of LHQW as well as its lung protection role. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Tradit. Zhao P., Yang H.Z., Lv H.Y., Wei Z.M. There was no statistically significant difference in the incidence of body as a whole-general disorders between the LHQW group and the conventional drug group (RR = 0.77, 95% CI = 0.193.01, p = 0.708). The Plant List (2021). Wang F.C., Shen B.X., He C.Y., Zhao W.C., Nie S.L. Efficacy of Huoxiang Zhengqi Dropping Pills and Lianhua Qingwen Granules in Treatment of Covid-19: a Randomized Controlled Trial. To explore the material basis and mechanism of Lianhua Qingwen Twelve representative compounds were further quantified as chemical markers, including amygdalin, forsythoside E, salidroside, glycyrrhizic acid, chlorogenic acid, hyperin, rutin, forsythoside A, cryptochlorogenic acid, sweroside, phillyrin, and rhein (Jia et al., 2015). Protection against COVID-19 injury by qingfei paidu decoction via anti-viral, anti-inflammatory activity and metabolic programming. Zhou X.P. Pharmacological Action, Clinical Application and Adverse Reactions of Houttuynia Cordata. Research progress in use of traditional Chinese medicine for treatment of spinal cord injury. [Lamiaceae; Pogostemonis Botanical drug] (85g), Rheum palmatum L. [Polygonaceae; Rhei Radix et Rhizoma] (51g), Rhodiola crenulata (Hook. official website and that any information you provide is encrypted Trials. Pharmacopoeia of Peoples Republic of China. (10), 100. A Trial of Lopinavir-Ritonavir in Covid-19. World Health Organization Adverse Drug Reaction Terminology (2009). As the Financial Times report showed, these appeared to be serious conflicts of interest as the investments benefited from the PRC and HK governments' rapid approval and then widespread national & international promotion of Lianhua Qingwen and other suspect treatments for purportedly helping COVID-19 sufferers. Medicine (Baltimore). Retrospective Clinical Analysis on Treatment of Novel Coronavirus-Infected Pneumonia with Traditional Chinese Medicine Lianhua Qingwen. Qualitative and Quantitative Analysis of the Major Constituents in Chinese Medical Preparation Lianhua-Qingwen Capsule by UPLC-DAD-QTOF-MS. ScientificWorldJournal. 2019ZYC-A85), and the Scientific Research Projects of Hospital Pharmacy of Zhejiang Pharmaceutical Association (No. Pharmacol. Lianhua Qingwen capsules have been proven to speed up symptoms recovery but no effect in preventing infections from worsening. Li Q., Yin J., Ran Q.S., Yang Q., Liu L., Zhao Z., Li Y.J., Chen Y., Sun L.D., Wang Y.J., Weng X.G., Cai W.Y., Zhu X.X. First, the data indicated that LHQW combined with conventional therapies could markedly improve the clinical symptoms, quality of life and absorption of lung infiltration during anti-viral therapy, but the level of evidence is weak due to the included small sample trial and lacking the classification of disease severity. Emerging data have also shown its beneficial effects in treating diverse diseases such as acute respiratory infection, influenza, pneumonia, hand-foot-mouth disease, chronic obstructive pulmonary disease (COPD), as well as COVID-19 [[20], [21], [22], [23]]. Clinical Practice Guideline on Treating Influenza in Adult Patients with Chinese Patent Medicines. The Cochrane Collaboration risk of bias tool comprising seven items was applied to assess the risk of bias of each eligible study (Higgins et al., 2011). Efficacy and Safety of Lianhua Qingwen Granule Combined with Oseltamivir in the Treatment of Influenza Virus Infection in Children. In a lipopolysaccharide (LPS)-induced acute lung injury animal model, LHQW could efficiently decrease the chemotaxis of monocytes toward the pulmonary infection foci, and thus blocked the disease development by down-regulating MCP-1 expression [33]. Lianhua Qingwen can be a complementary strategy for treating COVID-19. There was a reduced risk of skin and its appendage damage in the LHQW group compared to the conventional drug group (RR = 0.63, 95% CI = 0.440.92, p = 0.015). doi:10.26434/chemrxiv.12016236.v1. (Lianqiao), Lonicera japonica Thunb. 43 studies on treatment of respiratory tract infection were examined, with 29 reporting adverse reactions. The outcome measures included the alleviation of fever and other symptoms including nasal congestion, sore throat, cough, aches and pains, fatigue, headache, chills or sweats in subjects with acute uncomplicated influenza. doi:10.1111/j.1365-2796.1990.tb00199.x, Higgins, J. P., Altman, D. G., Gtzsche, P. C., Jni, P., Moher, D., Oxman, A. D., et al. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19.