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

Zhongzhu Ai; Shanshan Zhou; Weinan Li; Mengfan Wang; Linqun Wang; Gangming Hu; Ran Tao; Xiaoqin Wang; Yinfeng Shen; Lihan Xie; Yuanming Ba; Hezhen Wu; YanFang Yang

doi:10.3389/fphar.2020.581277

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

Front Pharmacol. 2020 Oct 8:11:581277. doi: 10.3389/fphar.2020.581277. eCollection 2020.

Authors

Zhongzhu Ai¹, Shanshan Zhou², Weinan Li^{3

4}, Mengfan Wang¹, Linqun Wang², Gangming Hu⁵, Ran Tao^{6

7}, Xiaoqin Wang^{3

4}, Yinfeng Shen², Lihan Xie⁸, Yuanming Ba^{3

4}, Hezhen Wu¹, YanFang Yang¹

Affiliations

¹ Faculty of Pharmacy, Hubei University of Chinese Medicine, Wuhan, China.
² First Clinical College, Hubei University of Chinese Medicine, Wuhan, China.
³ Nephrology Department, Hubei Provincial Hospital of TCM, Hanchuan, China.
⁴ Nephrology Department, Hubei Provincial Traditional Chinese Medicine Research Institute, Wuhan, China.
⁵ TCM Department, Renmin Hospital of Hanchuan, Hanchuan, China.
⁶ Surgical Department, Hubei Provincial Hospital of TCM, Wuhan, China.
⁷ Surgical Department, Hubei Provincial Traditional Chinese Medicine Research Institute, Wuhan, China.
⁸ Nephrology Department, The Central Hospital of Wuhan, Wuhan, China.

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.

Keywords: COVID-19; Fei Yan NO1; SARS-CoV-2; clinical efficacy; network pharmacology.