Objective:

2

To systematically review the clinical practice guidelines for the treatment of coronavirus disease 2019 (COVID-19) patients with Chinese herbal medicine (CHM)

summarize their recommendations and evaluate their qualities.

Methods:

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Electronic databases

websites of governments

academic associations or organizations for eligible guidelines were searched up to April 2020. Information were extracted to summarize recommendations for the use of Chinese herbal formulae and Chinese patent medicine (CPM) for COVID-19 patients. The methodological quality and reporting quality of the included guidelines were independently evaluated

using the Appraisal of Guidelines for REsearch and Evaluation (AGREE) Ⅱ tool and Reporting Items for Practice Guidelines in healthcare (RIGHT) statement

respectively.

Results:

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Totally 45 guidelines were identified: 42 (93%) suggested specific CM formulae for treating COVID-19 patients; and 35 (78%) assigned patients diagnosed with COVID-19 to 4 stages (early

development

critical and recovery). The recommended formulae and CPMs for each stage with diverse syndrome types have been summarized. Most of the included guidelines were of low methodological quality

with only one achieving moderate quality of AGREE Ⅱ. The frequency with which the 35 items in the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist were reported averaged 36.5% across the 45 guidelines.

Conclusions:

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This systematic review has summarized current recommendations for treating COVID-19 patients with CHM and shows that the general quality of present guidelines is quite low. The development of future guidelines should include increased awareness of the features of good quality guidelines.