Director of Clinical Pharmacology Department Department of Pharmacy, Zhongnan Hospital, Wuhan University Wuhan, China (People's Republic)
Background: Xuebijing (XBJ) injection is a traditional Chinese patent medicine launched in 2003 and widely used in the treatment of severe pneumonia and sepsis in China. It has been recommended to treat severe COVID-19 cases in the six successive versions of the COVID-19 Diagnosis and Treatment Protocol issued by the Chinese Health Commission in 2020, though its evidence for treating COVID-19 is insufficient.
Objectives: This multicenter retrospective study aimed to assess the association between XBJ treatment and the clinical outcomes of in-hospital COVID-19 patients.
Methods: We included hospitalized patients confirmed with diagnosis of COVID-19 from December 19th, 2019 to April 26, 2020 in four hospitals in Wuhan, China.. Data on patients’ characteristics, treatments, and outcomes were extracted from the electronic medical records. The association of XBJ use with COVID-19 related clinical outcomes and mortality was evaluated through propensity score matching (PSM) to obtain a 1:4 balanced cohort and logistic regression adjusting for confounders.
Results: Of the 2147 severe and critically severe patients included, 10.7 % received XBJ treatment. PSM analysis revealed no significant association between XBJ use and mortality (adjusted odds ratio (OR), 0.68[0.41, 1.14], p=0.142). Additionally, XBJ use was not significantly associated with the negative conversion rate of SARS-CoV-2 in the PSM model (adjusted OR, 2.33 [0.70, 7.73], p=0.167). Regarding the safety of XBJ, the incidences of acute kidney injury (crude rate, 15.3% vs. 7.1%; adjusted OR, 0.92 [0.55, 1.52], p=0.761) and acute liver injury (crude rate, 27.2% vs. 16.8%; adjusted OR, 1.15 [0.80, 1.63], p =0.446) were comparable among patients receiving XBJ treatment and those not receiving XBJ.
Conclusions: XBJ use was not associated with mortality and the negative conversion rate of SARS-CoV-2. In terms of safety, XBJ did not have a significant effect on the incidences of acute kidney injury and acute liver injury.
