Chinese medicine practitioners' consensus on traditional Chinese medicine diagnostic patterns, symptoms, and herbal formulas for COVID-19 survivors: A Delphi study

Introduction: In April 2022, the "Guidance and recommendations on Chinese Medicine Rehabilitation during COVID-19 recovery stage (pilot version)" (the CM Rehabilitation Guidance) was formulated for Hong Kong COVID-19 survivors. However, no consensus regarding traditional Chinese medicine (TCM) diagnostic patterns, symptoms, and herbal formulas in the Guidance has been reached among Hong Kong Chinese medicine practitioners (CMPs). Thus, this study aimed to establish a consensus among them as a guidance for practice. Methods: A modified Delphi method was conducted from July 28 to September 14, 2022. Each survey gathered feedback by using a five-point Likert scale and open-ended questions. Descriptive statistics for quantitative data and thematic analysis for qualitative data were used. The consensus was defined as >= 80 % level of agreement with interquartile range (IQR) <= 1. Results: A total of 13 CMPs with clinical experience in managing COVID-19 survivors participated in the threeround Delphi survey. A final consensus was reached regarding the following: (1) the diagnostic pattern qi deficiency of the lung and spleen (median = 4; IQR = 0; level of agreement = 92.31 %) with six new suggested symptom items; (2) the diagnostic pattern dual deficiency of qi and yin (median = 4; IQR = 0.5; level of agreement = 100 %) with three new suggested symptom items; and (3) the suggested herbal formulas for these two diagnostic patterns after modification. Conclusions: Through the three-round Delphi survey, we established a modified CM Rehabilitation Guidance for Hong Kong COVID-19 survivors. The modified Guidance based on the views of Hong Kong CMPs with frontline clinical experience in COVID-19 should be more applicable to current COVID-19 survivors.