Abstract
Coronavirus Disease-2019 (COVID-19), an infectious disease associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a global emergency with high mortality. There are few effective treatments, and many severe patients are treated in an intensive care unit (ICU). The purpose of this study was to evaluate whether the Japanese Kampo medicine ninjin’yoeito (NYT) is effective in treating ICU patients with COVID-19. Nine patients with confirmed SARS-CoV-2 infection admitted to the ICU were enrolled in this study. All patients underwent respiratory management with invasive mechanical ventilation (IMV) and enteral nutrition. Four patients received NYT (7.5 g daily) from an elemental diet tube. We retrospectively examined the prognostic nutritional index (PNI), length of IMV, length of ICU stay, length of hospital stay, rate of tracheostomy, and mortality rate. The median age of the enrolled participants was 60.0 years (4 men and 5 women). The median body mass index was 27.6. The most common comorbidity was diabetes (4 patients, 44%), followed by hypertension (3 patients, 33%) and chronic kidney disease (2 patients, 22%). The median length of IMV, ICU stay, and hospital stay were all shorter in the NYT group than in the non-NYT group (IMV; 4.0 days vs 14.3 days, ICU; 5.3 days vs 14.5 days, hospital stay; 19.9 days vs 28.2 days). In the NYT and non-NYT groups, the median PNI at admission was 29.0 and 31.2, respectively. One week after admission, the PNI was 30.7 in the NYT group and 24.4 in non-NYT group. PNI was significantly (p = 0.032) increased in the NYT group (+13.6%) than in the non-NYT group (-22.0%). The Japanese Kampo medicine NYT might be useful for treating patients with severe COVID-19 in ICU. This study was conducted in a small number of cases, and further large clinical trials are necessary.
Keywords: COVID-19; Intensive care unit; Kampo; Ninjin’yoeito; Pneumonia; Prognostic nutritional index; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, Pneumonia, intensive care unit, Kampo, Ninjin'yoeito, Prognostic nutritional index, 【초록키워드】 coronavirus disease, SARS-CoV-2, coronavirus, clinical trial, intensive care, severe COVID-19, SARS-COV-2 infection, nutrition, hospital, intensive care unit, Comorbidity, Chronic kidney disease, Infectious disease, diabetes, severe acute respiratory syndrome Coronavirus, hypertension, ICU, Kampo, coronavirus disease-2019, Severe acute respiratory syndrome, body mass index, management, Patient, Kidney disease, ICU Patients, Severe patient, mortality rate, women, Japanese, prognostic, respiratory, enteral nutrition, Admission, Care, patients, Coronavirus-2, Invasive mechanical ventilation, tracheostomy, Hospital stay, followed by, body mass, acute respiratory syndrome, acute respiratory syndrome coronavirus, median age, acute respiratory syndrome coronavirus-2, high mortality, participant, men, IMV, effective, ICU patient, enrolled, evaluate, examined, significantly, conducted, median, treated, groups, diabete, the median, with COVID-19, 【제목키워드】 intensive care, Patient, severe coronavirus disease,