Traditional Chinese medicine for long COVID-19: the potential roles of immunity remodeling

Given that the immunity imbalance in patients with Long COVID-19 (LC) may pose a significant global health and economic post-pandemic burden, there is an emergent need to identify therapeutic targets and treatment options. Traditional Chinese medicine (TCM), as an evidence-based therapeutic approach, can effectively improve the sequelae of LC patients by eliminating pathogenic factors. The purpose of this paper is to discuss how immune remodeling contributes to the pathogenesis of LC, the clinical evidence supporting TCM’s treatment of LC, and the mechanism of TCM modulating immune remodeling and relieving chronic inflammation to develop new ideas for the treatment of LC as well as the development of drugs. Data were retrieved using appropriate keywords from a variety of internet databases, including PubMed and Web of Science. Current evidence shows that LC can affect multiple organ systems, and its prominent manifestations include respiratory complications, neurological symptoms and cardiovascular dysfunction. Immunoassay showed a characteristic increase in interleukin 6 (IL-6), interferon gamma (IFN-γ), and T helper (Th)17/regulatory T (Treg) imbalance. TCM interventions have shown great therapeutic potential, with active compounds such as baicalin reducing lung inflammation and ginsenosides improving heart function. Clinical research reports that Qingfei Paidu decoction (QFPD) can effectively alleviate respiratory symptoms, and Sini powder (SNP) has antidepressant effects. TCM interventions can be tailored based on the specific clinical symptoms of individual patients. This article elucidates the crucial role of inflammation and immune dysfunction in alleviating multiple organ symptoms of LC. TCM used in LC treatment is an important source of new molecules. These new molecules may act synergistically to combat adverse effects such as COVID-19 infection-induced inflammation and oxidative stress.