The efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments A protocol for a systematic review and meta-analysis

Background Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease, which is pandemic, infectious, and high mortality. Many commonly discussed medications being used to treat COVID-19 are not without potentially harmful side effects such as heart, liver, kidney problems, or other clinical symptoms. Acupuncture is a nonpharmacological method. When a needle is inserted into an acupuncture point, traumatic physical stimulation occurs, and then the neuroendocrine immune regulation network is activated. This study aimed to evaluate the efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments. Methods From their inception to December 10, 2020, the following electronic databases will be searched to identify relevant studies: MEDLINE, PubMed, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and the Chinese Biomedical Literature Database (CBM), without any language restrictions. Randomized controlled trials and credible clinical observations without randomization include patients diagnosed with COVID-19, and receiving western medicine treatments or acupuncture, with no restrictions on disease stage, age, sex, or ethnicity. Primary outcomes would be used to evaluate the mortality rate, C-reactive protein (CRP), creatine, troponin, liver enzymes (aspartate aminotransferase and alanine aminotransferase), blood pressure, clinical symptoms (including fever, fatigue, myalgia, cough, skin rash, nausea, vomiting, and diarrhea), and serum cytokine levels. Secondary outcome would be used to evaluate the adverse events of acupuncture. Risk of bias will be assessed by 2 review authors independently according to the guidelines set out in the Cochrane Handbook for Systematic Reviews of Interventions. Discussion This is the first to evaluate the efficacy of acupuncture for improving the side effects of COVID-19 western medicine treatments. A longer follow-up should be considered in future studies. Conclusion This systematic review and meta-analysis would provide evidence of acupuncture specifically focused on its effectiveness and safety for patients with COVID-19 western medications adverse effects. Registration: Registered in the PROSPERO database (CRD42020189494).