TCM may improve post-COVID symptoms

A retrospective analysis suggests that traditional Chinese medicine (TCM) may be a suitable treatment alternative for post-COVID symptoms.

After an average of seven consultations, physicians rated patients’ global improvement at 62 percent on average, with 67 percent of patients showing at least 50-percent improvement. Patients who had completed treatment had a global symptom reduction of 71 percent, with 76 percent showing at least 50-percent improvement. Global symptom improvement for those who have ongoing treatments was rated at 52 percent (p<0.001).

Fatigue, the most common post-COVID complaint, was initially reported by 86 percent of patients. By the end of treatment or at the time of assessment, this rate dropped to 45 percent. [Medicine (Baltimore) 2025;104:e42275]

About half of the fatigue cases were classified as moderate at the beginning of TCM therapy. During treatment, a third of these cases improved to mild, and no more severe cases were observed.

In a subgroup of patients who were initially unable to work due to their symptoms, TCM treatment correlated with significant improvements in fatigue (p<0.0001) and cognitive impairment (p=0.003). “This suggests that TCM approaches could help alleviate the socioeconomic burden of sick leave caused by post-COVID syndrome,” the investigators noted.

Other symptoms that markedly improved with TCM were exertional dyspnoea, memory and concentration impairment, headache, depressed mood, sleep difficulties, vertigo, circulatory disturbances, and chest pain.

No specific Tx

There are currently no effective treatments specifically addressing post-COVID syndrome. TCM holds promise not only for alleviating symptoms but also for influencing intricate pathogenic mechanisms. [Front Pharmacol 2022;13:1054312; World J Acupunct Moxibustion 2023;doi:10.1016/j.wjam.2023.05.012; Chinese Medicine 2021;36:113-125]

The study utilized data from 79 patients (mean age 47 years, 65 percent women) provided by nine practicing TCM physicians who completed the survey. Fifty-six percent of patients were from Germany, while the rest were from Austria. All but one patient reported that post-COVID symptoms started a median of 4 weeks after acute infection.

Apart from fatigue, the most common post-COVID complaints were limited performance (78 percent) and exertional dyspnoea (61 percent). Other complaints were memory/concentration impairment (53 percent), headache (51 percent), and depressed mood (49 percent).

Acupuncture, Chinese meds top alternatives

TCM treatment began 4 weeks following symptom onset. The most frequently applied TCM modalities were acupuncture (84 percent) and Chinese pharmacological treatment (77 percent). Other methods were nutritional counselling (41 percent), indirect moxibustion (28 percent), and ear acupuncture (18 percent), among others.

The most common pharmacological formulae used were Xiao Chai Hu Tang and Gui Zhi Tang (10 percent for both), followed by Liu Jun Zi Tang, Ban Xia Xie Xin Tang, and Gua Lou Gui Zhi Tang (9 percent each).

“[Taken together,] the results suggest that TCM treatments focusing on acupuncture and Chinese pharmacotherapy could be helpful for a wide range of post-COVID symptoms, including mental, neurological, cardiovascular, and musculoskeletal conditions,” the investigators said.

Limitations that should be taken into context include the trial’s retrospective nature and small sample size, which necessitate larger, randomized studies, they noted.

The researchers also called for trials with subgroup analyses to assess potential sex-specific differences in treatment outcomes, differences in the efficacy of certain TCM approaches for various symptom clusters, and predictors of a favourable treatment response.

“[Moreover,] the assessment of symptom improvement relied on the evaluation by TCM physicians rather than the perspective of the patients themselves. Future research should prioritize patient experiences,” they added.