| Summary: |
Background
1. COVID-19 symptoms have been reported to persist after hospital discharge. Such symptoms not only included both physical deterioration, but also psychological disturbance such as lung function deterioration, fatigue and sleep disturbance. In order to strengthen the rehabilitation and health management of the discharged COVID-19 patients, CM has been used as one of the treatment options. CM is characterized by the holistic concept, in which treatment is based on syndrome differentiation instead of individual clinical symptom. The main principle of CM is to achieve balance, hence strengthening body resistance to eliminate pathogenic factors could lead to a healthier physique. This study aimed to collect observational data on the effect of CM on the rehabilitation of the post-COVID-19 subjects, as well as to explore the sub-groups of post-COVID-19 of CM Syndromes to guide better health management.
2. It was observed that persistence heterogeneous clinical manifestations were observed in patients recovering from COVID-19.A review would be helpful to summarize those residual symptoms to aid for future research and consolidate the treatment experience.In the practice of Chinese medicine, CM practitioners prescribe treatments through CM Syndromes diagnosis.However, a review would be helpful to consolidate those experience and understand the persistent symptoms to aid for future research.
Objective
1. To evaluate the effects of Chinese Medicine (CM) on the health condition of the post-COVID-19 patients, particularly with the CM Syndrome diagnosis and Body Constitutions (BC), as well as related clinical characteristics.
2. To examine the occurrence of persistent clinical symptoms through CM text-based mining of medical records and elucidate the contributing factors that might be correlated with that and to propose a decision tree based on the events of persistent clinical manifestations.
Results
1. 150 participants who had COVID-19 and discharged from Hong Kong public hospitals were recruited and provided with three to six months of CM treatments. Among these patients, the most common symptoms were fever (59.3%), fatigue (55.3%), and dry cough (46%). A majority of patients (71.3%) were of the two particular post-COVID CM Syndromes (Qi Deficiency of Lung and Spleen, and Qi and Yin Deficiency). Upon CM treatment, there was an observable increase in participants reaching a balanced BC (i.e. healthy body conditions). Furthermore, the lung functions of the participants improved after treatment. Both the performance in 6-minute walk test (6MWT) and scores in the Lung Function Questionnaire (LFQ) improved upon CM treatments (P < 0.05).
2. Three common CM Syndromes (1. Lung and Spleen Deficiency, 2.Qi Deficiency of both Spleen and Lung, 3. Qi and Yin Deficiency) and nine clinical conditions (1. poor sleep, 2. tiredness, 3. sweating, 4. fatigue, 5. coughing phlegm, 6. dry mouth, 7. shortness of breath, 8. cough, 9. headache) were recognized as prevalence in using semi-text-mining strategy of CM clinical records. A logistic model analysis using the package for fitting Generalized Linear Mixed Models using Marko chain Monte Carlo techniques (MCMCglmm) was performed. Result indicated that the events of persisting clinical conditions were significantly correlated with existing chronic conditions (hypertension, high cholesterol, and diabetes mellitus), female gender, and the three persisting CM Syndromes. The present study triangulated with the result of the quantitative analysis that patients with certain post-COVID CM Syndromes had significantly increased the likelihood of having persisting clinical manifestations. The semi-text-mining also revealed the associations and the likelihood of having persistent post-COVID clinical manifestations.
Conclusion
1. This study provided evidence for individualized CM treatment on COVID-19 rehabilitation. CM would further promote rehabilitation and resolution of residual symptoms. Future research would be required to further elucidate treatment of persistent symptoms associated with long-COVID.
2. This study enlightened the application of text-based mining in CM clinical records to identify persistent post-COVID clinical manifestations and their correlates. Future research may investigate on incorporating other treatment regimens in promoting rehabilitation, such as health qigong.
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