“Fei Yan No. 1” as a Combined Treatment for COVID-19: An Efficacy and Potential Mechanistic Study

Abstract

There has been a large global outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), representing a major public health issue. In China, combination therapy, including traditional Chinese medicine (TCM) as a treatment for COVID-19 has been used widely. “Fei Yan No. 1” (QFDYG) is a formula recommended by the Hubei Government to treat COVID-19. A retrospective study of 84 COVID-19 patients from Hubei Provincial Hospital of TCM and Renmin Hospital of Hanchuan was conducted to explore the clinical efficacy of QFDYG combination therapy. TCMSP and YaTCM databases were used to determine the components of all Chinese herbs in QFDYG. Oral bioavailability (OB) ≥ 30% and drug-like (DL) quality ≥ 0.18 were selected as criteria for screening the active compounds identified within the TCMSP database. The targets of active components in QFDYG were determined using the Swiss TargetPrediction (SIB) and Targetnet databases. The STRING database and the Network Analyzer plugin in Cytoscape were used to obtain protein-protein interaction (PPI) network topology parameters and to identify hub targets. Gene Ontology (GO) enrichment was conducted using FunRich version 3.1.3, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment using ClueGO version 2.5.6 software. PPI and compound-pathway (C-T) networks were constructed using Cytoscape 3.6.0. Compared with the control group, combined treatment with QFDYG resulted in a significantly higher rate of patients recovering from symptoms and shorter the time. After 14 days of treatment, QFDYG combined treatment increased the proportion of patients testing negative for SARS-CoV-2 nucleic acid by RT-PCR. Compared with the control group, promoting focal absorption and inflammation as viewed on CT images. GO and KEGG pathway enrichment indicated that QFDYG principally regulated biological processes, such as inflammation, an immune response, and apoptosis. The present study revealed that QFDYG combination therapy offered particular therapeutic advantages, indicating that the theoretical basis for the treatment of COVID-19 by QFDYG may play an antiviral and immune response regulation through multiple components, targets, and pathways, providing reference for the clinical treatment of COVID-19.

In silico analysis of the potential mechanism of a preventive Chinese medicine formula on coronavirus disease 2019

“…TCM treatment combined with symptomatic treatment was the main strategy for patients in China. Studies referring to TCM treatment in combating COVID-19 showed significant therapeutic effects especially in early use ( Ai et al, 2020 ; Shi et al, 2020 ; Wu et al, 2020 ). XG-1is a recommended preventive TCM formula and has been widely used to prevent the epidemic.…”

Traditional Chinese medicine in COVID-19

“…A total of 40 representative clinical trials, including 11 randomized controlled trials (RCTs), 16 retrospective cohort studies (RCSs), 5 multi-center clinical observations, and 8 others were completed and summarized 27 , 28 , 30 , 31 , 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 . According to the available clinical data, integrated TCM and WM exhibited several clinical advantages in COVID-19 treatment, including the outcomes of 1) clinical manifestations, 2) lung features, and 3) laboratory findings as shown in Table 1 27 , 28 , 30 , 31 , 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , <...>…”

“…According to the available clinical data, integrated TCM and WM exhibited several clinical advantages in COVID-19 treatment, including the outcomes of 1) clinical manifestations, 2) lung features, and 3) laboratory findings as shown in Table 1 27 , 28 , 30 , 31 , 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 . Furthermore, based on Table 1 , the clinical evidence of TCM for typical characteristics of COVID-19 were analyzed and summarized in Table 2 27 , 28 , 30 , 31 , 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51...…”

“…1” 64 , Matrine injection 69 Time to symptom recovery Lianhua Qingwen capsule 27 , Xuebijing injection 44 , Qingfei Paidu decoction 47 , 48 , 49 , 50 , Huashi Baidu Decoction 31 , Honeysuckle oral liquid 60 , Yidu‒toxicity blocking lung decoction 62 , “Fei Yan No. 1” 64 , Keguan-1 66 The progression to severe disease Shufeng Jiedu capsule 51 , Hanshiyi formula 55 Multiorgan injury Xuebijing injection 44 , Qingfei Paidu decoction 48 Lung feature Lung inflammatory absorption Jinhua Qinggan granules 36 , Lianhua Qingwen capsule 41 , Xuebijing injection 44 , Qingfei Paidu decoction 45 , Shufeng Jiedu capsule 52 , “Fei Yan No. 1” 64 , Xuanfei Huazhuo decoction 65 , Ganlu Xiaodu decoction 68 , Matrine injection 69 CT imaging Lianhua Qingwen capsule 27 , Qingfei Paidu decoction 46 , 47 , Huashi Baidu formula 30 , Shufeng Jiedu capsule 51 , Toujie Quwen granules 57 , Reyanning mixture 58 , Honeysuckle oral liquid 60 Lung injury Xuebijing injection 42 , Lianhua Qingke granules 56 , Qingfei Dayuan granules 63 , Keguan-1 66 Lung function <...>…”

He-Jie-Shen-Shi Decoction as an Adjuvant Therapy on Severe Coronavirus Disease 2019: A Retrospective Cohort and Potential Mechanistic Study

“…"Fei Yan No. 1" could significantly improve the clinical outcomes and reduce the duration of the negative conversion time of nucleic acid in patients with COVID-19 (Ai et al, 2020). Tanreqing Capsule treatment also reduced the duration of the negative conversion time of nucleic acid and increased CD3 + T cell production in patients with COVID-19 (Zhang et al, 2021).…”