Preface

Since the end of 2019, the epidemic of Coronavirus Disease 2019 (COVID-19) centered in Wuhan, Hubei Province, has spread all over China due to the super human-to-human transmission of the virus, which affects the health status and even lives of thousands of people and causes serious public health problems and social/economic burdens.

The Central Committee of Communist Party of China and the State Council attach great importance to the epidemic and have promptly implemented a series of emergent health measures. Upon outbreak of the epidemic in Wuhan and its rapid spreading nationwide which once made the nation entirely caught off guard, Chinese President Xi Jinping has responded immediately to the unanticipated event, formulating strategic deployments for the prevention and control of the epidemic and launching national campaign against the virus. He put particular stress on that governments at all levels and health-related organizations must overwhelmingly place the safety of people′s lives and health in the first place and make the best efforts by prioritizing and implementing all necessary measures with the highest scientific and technological standards to terminate spread of COVID-19 until a final win of the battle. The supreme leader’s wise decision and firm determination immediately mobilized and motivated the whole nation to take serious and later confirmed to be effective actions consciously and confidently. The medical staffs and researchers led by Dr. Zhong Nanshan (medical doctor, professor and scientist, academician) stand in the front line of the batter fields and self-sacrifice to save and cherish the lives of others, with their full morality and virtue as well as their professional knowledge and skills. We could now declare with great pride that we won the battle and the Chinese model of combating COVID-19 created a miracle and set a benchmark in medicine and in human history！Yet, while COVID-19 is now well under control within China, the epidemic has become pandemic across more than 130 countries of all continents in this globe. Thus, human battle against COVID-19 is far from over. Nonetheless, a critical situation we human beings are facing is the overall lack of practical experience and guidelines in the management of patients who carry COVID-19.

National Health Commission of the People′s Republic of China has issued seven editions of Guidelines for the Diagnosis and Treatment of COVID-19 (Tentative 7th Edition) , elaborating the etiology, epidemiological characteristics, clinical characteristics, diagnostic criteria, clinical manifestations and treatment of COVID-19. Unfortunately, at present there have not been any proven effective and safe anti-coronavirus drugs for clinical applications. Even though, antiviral and anti-inflammatory agents are frequently used as“better-than-nothing”treatment of COVID-19 in China. However, while these drugs have demonstrated varying degrees of effectiveness against COVID-19, they in general come with various contraindications, unwanted drug interactions and adverse reactions, in addition to their uncertain efficacy. For example, glucocorticoids have strong antiinflammatory effects, but they can cause serious side effects if used improperly. Clearly, there is an urgent need to clarify and standardize the clinical applications of these drugs for COVID-19.

The most noticeable and typical pathological outcome of COVID-19 is an accumulation of a large volume of mucus and mucus suppository in the bronchial lumen, which is presumably caused by inflammation storm. The content on segmental expectorants is therefore covered in this manual. On the other hand, traditional Chinese medicine (TCM) emphasizes the concept of“FUZHENGQUXIE (invigorate the body defense and resistance systems and dispel pathogenic factors) ”in combating diseases and the approach of symptom-based therapy focusing on suppressing evil Qi (energy) and mobilizing healthy Qi. During the campaign against COVID-19, TCM has been employed alone or in combination with modern western medicine. In either way, TCM has demonstrated its appealing successfulness and unique advantages in improving clinical symptoms of COVID-19 and eliminating the virus from body, particularly in blocking the transition or degeneration of mild patients to critical ones and in reversing the critical patients as well by reducing complications and improving quality of life. Such advantages have also been evidenced in the patients of Italian population who received TCM treatment. It is therefore not exaggerated to state that the strategy of old drugs—new uses and combination of TCM and western medicine with mutual complementing advantages appears to be superior for the treatment of COVID-19. Hence, TCM is also included in this manual.

In preparing this book, the editorial board members followed the basic principles of Pharmacology (9th Edition) , People’s Medical Publishing House (Edited by Yang Baofeng and Chen Jianguo) and Guidelines for the Diagnosis and Treatment of COVID-19 (Tentative 7th Edition) , consulted several pharmaceutics monographs and incorporated the most updated knowledge about the COVID-19 from clinical practice and trials. This book aims to elaborate the pharmacological action, adverse reactions, incompatibility and clinical rational use of drugs and provide a basic reference guide for the pharmacological management of COVID-19. Overall, this manual covers the contents on antiviral drugs, traditional Chinese medicine and prescriptions. It must be noted that this manual is prepared as a reference guide for clinical medical staffs, pharmacists and other health-related personnel in fighting COVID-19 and it is in no way suggested as a substitution of medical and pharmacological guidelines. Some of the drugs described in this manual are not yet supported by evidence-based medicine for their efficacy against COVID-19 and cautions therefore must be taken in applying the contents to clinical practice.

This manual is prepared for timely matter based on limited information and time, and thus limitations are inevitable. Suggestions and criticisms will be greatly appreciated.

Yang Baofeng

March 3, 2020