Traditional Chinese medicine application and evidence analysis of 1426 cases of long COVID: A retrospective study

At present, the focus of COVID-19's treatment has shifted from the prevention and treatment of acute viral infection to the treatment and rehabilitation of symptoms in the recovery period of long COVID and the associated diseases. To preliminarily evaluate the clinical efficacy of integrated Chinese and Western medical treatment plans and to describe the characteristics of “long COVID” syndromes. Eligible “long COVID” patients diagnosed between December 2022 and June 2023 at the Third Affiliated Hospital of Zhejiang Chinese Medical University were identified through electronic medical records. Baseline demographic information was collected, and patients were divided into a TCM group and a Western medicine group based on their treatment methods. The primary outcome for efficacy evaluation was TCM syndrome scores and symptom improvement time, with secondary outcomes including symptom improvement rates. Survival curve analysis was used to assess symptom improvement time, and a Cox regression model was employed to identify potential risk factors affecting symptom prognosis. Chi-square tests were used to compare binary data between or among groups. The Jaccard method was applied for systematic clustering of TCM syndromes, and clinical characteristics at the start and end of treatment were reported. Analysis showed that younger patients, those with underweight, and those receiving TCM treatment had shorter recovery times ( P < 0.0001). Systematic clustering of the main symptom elements (33 elements with a frequency ≥ 5%) identified six core combinations. The main symptoms of long COVID included cough, excessive sputum, nasal congestion, chest tightness, sore throat, and fatigue. Notably, symptoms such as fatigue, shortness of breath, and loss of appetite, classified as deficiency syndromes in TCM, had longer recovery times. Elderly, obesity, underlying diseases, and exclusive Western medicine treatment were associated with poorer prognosis. The early recovery period is characterized by a mix of deficiency and excess syndromes, whereas the later period is dominated by deficiency syndromes. TCM treatment can effectively improve clinical symptoms and shorten symptom duration, but further research is needed.