Background: China’s vigorous anti-COVID-19 campaign has been going on for three months since January 20, which has contained the spread of the virus across China. Objectives: Epidemiological investigations found that COVID-19 fatality rates in Wuhan, rest parts of Hubei province except Wuhan (Rest of Hubei) and rest parts of Mainland China except Hubei province (Rest of China) were different. An ecological study was conducted to analyze the reasons and provide the world with China’s anti-COVID-19 epidemic experiences. Methods: Infected cases from Mainland China were divided into three populations: Wuhan, Rest of Hubei and Rest of China. Methods were based on The Novel Coronavirus Infected Pneumonia Diagnosis and Treatment Standards. Total confirmed cases, daily severe cases, total deaths from February 12 to April 20 were collected for statistical analysis. Results: 50,333 total confirmed cases in Wuhan made up the most substantial part by comparison with 17,795 in Rest of Hubei and 14,630 in Rest of China, respectively. In the early stage of the COVID-19 epidemic, daily severe cases in Wuhan accounted for the majority, and as the epidemic controlled, severe cases in all three populations decreased. Total deaths in Wuhan constituted the most significant proportion, with the highest 3869 in contrast to 643 in Rest of Hubei and 120 in Rest of China. The fatality rates in Wuhan ranged from 2.82% to 7.69%, much higher than 1.80–3.61% in Rest of Hubei, and 0.49–0.88% in Rest of China. Pearson chi-square test for fatality rates in the three populations demonstrated significant differences ( p < 0.01). Conclusion: The ecological comparison study among the three populations have proved that social distancing, quarantine, lockdown, cutting off sources of infection and transmission routes, early detection, early isolation, early treatment are all vital to control the epidemic by reducing COVID-19 confirmed cases, severe cases and the fatality rate.
Context: COVID-19 has turned into a pandemic, threatening the lives of millions of people worldwide. Research has found that some COVID-19 patients will suddenly aggravate, resulting in a cytokine storm, respiratory distress syndrome, and death. It is necessary to articulate the mechanism of cytokine storm and propose a Chinese medicine treatment strategy for COVID-19. Evidence Acquisition: A literature search was conducted using five databases on April 30, 2020, including PubMed, Google Scholar, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data with the keywords of “cytokine storm AND Chinese medicine AND COVID-19 “, “cytokine storm AND Chinese medicine AND SARS-CoV-2”. The outcome of interest was the concept and mechanism of cytokine storm, the characteristics, and the Chinese medicine treatment of COVID-19 cytokine storm, etc. A total of 43 articles were retrieved after removing duplicate articles. Results: The cytokine storm is also called cytokine cascade. The body overreacts with positive feedback without negative feedback, making a variety of abnormal cytokines accumulations, triggering a cytokine storm. COVID-19 cytokine storm does not occur in the early stages, but only after a period of development, it attacks not only the lungs but also the heart, kidneys, and other organs. The key pathogenesis is “toxins and blood stasis, lung failure” in Chinese medicine. The treatment is detoxification, removing blood stasis, and nourishing the lung. Chinese medicine should comprehensively regulate multiple targets and multiple pathways to intervene in the immune regulation of the body to intercept the progress of inflammation and focus on the integration of Chinese medicine with Western medicine to combine anti-virus and anti-inflammatory therapy. Conclusions: The immune response caused by cytokine storm is a complex signal network with multiple targets and pathways and various cytokines acting together. Immunomodulation can balance the excessive inflammatory response and effectively control the replication and spread of SARS-CoV-2. Returning the immune response to a balanced state is an ideal method for treating COVID-19 cytokine storm. Chinese medicine can achieve overall coordination and balance. Nevertheless, the pharmacology of Chinese medicine must be further studied, and the mechanism of cytokine storm treatment should be thoroughly clarified.
From this study, treating EH with wuling powder and modified tianma gouteng decoction as an open add-on therapy seems to be effective and safe. Further randomized trials are needed to test the positive findings.
Objective: To evaluate the efficacy and safety of Wuling Powder and Modified Shengmai Powder on treating chronic cardiac insufficiency. Methods: 42 cases of chronic cardiac insufficiency patients with heart function ranging from NYHA class II to IV took Wuling Powder and Modified Shengmai Powder for 2 weeks to treat chronic cardiac insufficiency without changing former medication. NYHA heart function, systolic pressure, diastolic pressure, heart rate, and 6-minute walk test were evaluated before and after treatment. Results: Wuling Powder and Modified Shengmai Powder decreased systolic pressure, diastolic pressure, heart rate, and increased the 6-minute walk distance significantly(P<0.01). Total effective rate was 92.9%. There was no serious side effect. Conclusion: Using samples from outpatients, this study shows Wuling Powder and Modified Shengmai Powder is effective and safe to treat chronic cardiac insufficiency.
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