The Role of Kampo in the COVID-19 Pandemic

Introduction

The COVID-19 pandemic, caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, continues to affect the world. Various vaccines have been developed and administered, and new therapeutic modalities have gradually improved their efficacy. However, SARS-CoV-2 is an RNA virus. Thus, it mutates quickly and continues to threaten numerous lives. Attending to patients with moderate disease before their condition worsens and reducing the post-disease sequelae are essential in managing coronavirus disease-2019 (COVID-19) patients. Kampo plays a significant role in achieving these goals. Kampo is often associated with the treatment of chronic disease and its role as a complementary therapy. However, the early application of Kampo in medicine has been traced to an anti-infection manual, called the Shanghanlun, developed in 200 A.D. It was used to treat typhoid fever and influenza, which were considered fatal. This knowledge was passed onto Japan and underwent unique local development. It was formally investigated in the Meiji era. With this, I would like to introduce the role of Kampo in the treatment of COVID19. Kampo compositions in this article are described in Table 1.

Table 1: Kampo compositions of Kakkonto, Shosaikotokakikyosekko, Saikatsugekito, Kakkontokasenkyushin’I, and Hochuekkito.

Discussion

Kampo Therapies for COVID-19

Kampo therapies for common colds have been well-established in Japan. Its safety profile and side effects are also well-understood [1-2]. Like common colds or influenza, COVID-19 presents with various symptoms, including fever, headache, sore throat, cough, joint pain, diarrhea and vomiting. Mild COVID-19 symptoms were effectively alleviated by Kakkonto, but severe sore throat and coughing were not. According to previous reports, Japanese Kampo doctors prescribed Saikatsugekito, a combination of Kakkonto and the anti-inflammatory Shosaikokakikyosekko, during the Spanish flu pandemic (1918-1920) Irie, et al. [3]. have successfully treated COVID-19 patients by prescribing this Kampo combination [4,5]. Kampo treatments were also effective against COVID-19 pneumonia when combined with Western medical therapies [6,7] (Figure 1) shows the effectiveness image of Saikatsugekito against COVID-19 [8].

Figure 1: KKT: Kakkonto, PR: Platycodon Grandiflorum Roots.

Kampo Treatments for Sequelae

After treatment, the taste and olfactory disorders typically persisted even when the other COVID-19 symptoms have improved. These were difficult to treat using Western medical therapies. COVID-19-related olfactory disorders were reportedly associated with inflammation and congestion, especially in the olfactory bulb and cleft Takayama, et al. [2] reported that Kakkontokasenkyushin’i effectively alleviated COVID-19-related olfactory disorders [9]. Its effectiveness was attributed to the antiviral and anti-inflammatory effects of Kakkontokasenkyushin’i. Moreover, it improves mucosal edema in the tissues of the olfactory bulb and cleft and protects against neural damage. Hochuekkito effectively alleviates general malaise following COVID-19 infection. It is also an immunostimulant, so it can prevent future infections [10].

Conclusion

Large-scale clinical studies on Kampo for COVID-19 are being conducted in Japan [11]. We recommend the application of Kampo in the medical treatment of COVID-19 infection and its sequelae.

Conflict of Interest

There are no conflicts of interest to declare.

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