Conventional and Kampo Medicine Treatment for Mild-to-moderate COVID-19: A Multicenter, Retrospective, Observational Study by the Integrative Management in Japan for Epidemic Disease (IMJEDI Study-observation).

Objective Patients in whom coronavirus disease 2019 (COVID-19) was suspected or confirmed between January 1, 2020, and October 31, 2021, were enrolled from Japanese hospitals in this multicenter, retrospective, observational study. Methods Data on the treatment administered (including conventional and Kampo medicine) and changes in common cold-like symptoms (such as fever, cough, sputum, dyspnea, fatigue, and diarrhea) were collected from their medical records. The primary outcome was the number of days without a fever (with a body temperature <37°C). The secondary outcomes were symptomatic relief and the worsening of illness, defined as the presence of a condition requiring oxygen inhalation. The outcomes of patients treated with and without Kampo medicine were compared. Patients We enrolled 962 patients, among whom 528 received conventional and Kampo treatment (Kampo group) and 434 received conventional treatment (non-Kampo group). Results Overall, after adjusting for the staging of COVID-19 and risk factors, there were no significant between-group differences in the symptoms or number of days being afebrile. After performing propensity score matching and restricting the included cases to those with confirmed COVID-19 who did not receive steroid administration and initiated treatment within 4 days from the onset, the risk of illness worsening was significantly lower in the Kampo group than in the non-Kampo group (odds ratio=0.113, 95% confidence interval: 0.014-0.928, p=0.0424). Conclusion Early Kampo treatment may suppress illness worsening risk in COVID-19 cases without steroid use. Further randomized controlled studies are needed to confirm the clinical benefit of Kampo medicine for COVID-19.

[Home medical care using long-term care insurance--centered on home oxygen therapy].

About two-thirds of the patients undergoing home oxygen therapy apply for the Long-term Care Insurance. Most of them are aged 75 or over but the degree of necessity of care is relatively low. Two-thirds of them apply for the insurance for the medical care-related reason, which are twice as many as those apply for the insurance because for the medical care-related reason. Medical cares covered by the Long-term Care Insurance include disease control by the visiting nurse, the assistance for the hospital visit using visiting care or day service/day care and respiratory rehabilitation using day care. Special elderly nursing homes are the good place to accept elderly people living alone. The merit of the Long-term Care Insurance is rapid information supply from various professionals to doctors. Since it is also possible to disseminate the doctor's instruction to each staff, it is possible to carry out disease control at home as if they were admitted to the hospital. For these reasons, the Long-term Care Insurance is extremely effective to prolong the period when patients undergoing oxygen therapy are treated at home or to improve their QOL.