Objective:

2

Since December 2019

an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan

and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations

we reviewed ancient classics and human studies.

Methods:

2

Historical records on prevention and treatment of infections in CM classics

clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza

and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February

2020. Research evidence included data from clinical trials

cohort or other population studies using CM for preventing contagious respiratory virus diseases.

Results:

2

The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in

Huangdi's Internal Classic

(Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36

95% confidence interval 0.24–0.52;

n

=4). For prevention of COVID-19

23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens

disperse wind and discharge heat

and resolve dampness. The most frequently used herbs included

Radix astragali

(Huangqi)

Radix glycyrrhizae

(Gancao)

Radix saposhnikoviae

(Fangfeng)

Rhizoma Atractylodis Macrocephalae

(Baizhu)

Lonicerae Japonicae Flos

(Jinyinhua)

and

Fructus forsythia

(Lianqiao).

Conclusions:

2

Based on historical records and human evidence of SARS and H1N1 influenza prevention

Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective

rigorous population studies are warranted to confirm the potential preventive effect of CM.