Comparative efficacy of Lianhua Qingwen capsules combined with standard care versus standard care alone in patients with mild to moderate COVID-19

INTRODUCTION: The COVID-19 pandemic has prompted a search for effective treatments. This study evaluated the efficacy and safety of Lianhua Qingwen capsules combined with standard care for treating patients with mild to moderate COVID-19. METHODOLOGY: A retrospective cohort study was conducted in a tertiary hospital in China between 1 March 2023 and 31 December 2023. The medical records of 284 patients with mild to moderate COVID-19 were analyzed; 142 patients who received Lianhua Qingwen capsules plus standard care were compared with 142 matched controls who received standard care alone. Propensity score matching was used to minimize selection bias. The primary outcomes included time to symptom improvement, time to viral clearance, 14-day clinical recovery rate, improvement in chest computed tomography (CT) findings, and quality of life scores. Secondary outcomes included changes in inflammatory markers, immune function improvement, and adverse event rates. RESULTS: The Lianhua Qingwen group showed a significantly shorter time to symptom improvement (hazard ratio [HR] 1.43, 95% confidence interval [CI] 1.21-1.69, p < 0.001), faster viral clearance (HR 1.52, 95% CI: 1.28-1.80, p < 0.001), higher 14-day clinical recovery rate (91.5% vs 82.4%, p = 0.024) and more pronounced chest CT improvements (78.9% vs 64.8%, p = 0.009). Quality of life scores, inflammatory markers, and immune function improved more in the treatment group. Adverse event rates were similar (12.7% vs 13.4%, p = 0.856). CONCLUSIONS: Lianhua Qingwen capsules, when combined with standard care, demonstrated superior efficacy compared with standard care alone in treating mild to moderate COVID-19, with a favorable safety profile. These findings suggest that Lianhua Qingwen capsules could be a valuable adjunct therapy for COVID-19 management.