Long-term sequelae refer to persistent symptoms or signs for >6 months after SARS-CoV-2 infection. The most common symptoms of sequelae are fatigue and neuropsychiatric symptoms (concentration difficulty, amnesia, cognitive dysfunction, anxiety, and depression). However, approved treatments have not been fully established. Herbal medicines are administered for 12 weeks to patients who continuously complain of fatigue or cognitive dysfunction for >4 weeks that only occurred after COVID-19 diagnoses. Based on the Korean Medicine syndrome differentiation diagnosis, patients with fatigue will be administered Bojungikgi-tang or Kyungok-go, whereas those with cognitive dysfunction will be administered Cheonwangbosim-dan. Results could support evidence that herbal medicines may mitigate fatigue and cognitive dysfunction caused by COVID-19. Furthermore, by investigating the effects of herbal medicines on changes in metabolite and immune response due to COVID-19, which may be responsible for sequelae, the potential of herbal medicines as one of the therapeutic interventions for post-acute sequelae of SARS-CoV-2 infection can be evaluated. Therefore, the effects of herbal medicine on fatigue and cognitive dysfunction sequelae due to COVID-19 will be elucidated in this study to provide an insight into the preparation of medical management for the post-acute sequelae of SARS-CoV-2 infection.

The most common symptom reported by patients after recovery from coronavirus disease 2019 (COVID-19) is fatigue. However, robust clinical evidence supporting the effectiveness of treatments and interventions for fatigue in COVID-19 survivors is lacking. This pilot clinical trial aims to assess the safety and efficacy of Kyungok-go, a herbal preparation targeting fatigue, in patients after recovering from COVID-19. The study will include 100 participants with persistent fatigue for more than 12 weeks after COVID-19 recovery. They will be randomly allocated into two groups: the Kyungok-go group (n = 50) and the placebo group (n = 50). Kyungok-go or placebo will be administered twice daily for 12 weeks, and the participants will be assessed at 4-week intervals. The primary outcome will be the change in the Fatigue Severity Scale score. Secondary outcomes will include cognitive function, physical function, quality of life, depression, sleep quality, medication adherence, and feasibility. This study is the first attempt to investigate the safety and efficacy of Kyungok-go for relieving fatigue related to long COVID. The results are expected to contribute to the establishment of a knowledge base and reveal the potential of herbal medicine prescriptions for managing and recovering from the most common sequelae of COVID-19. Trial registration number: KCT0008789.

Background: Infections of Coronavirus Disease-2019 (COVID-19) can cause long-term effects known as long COVID. This pilot study aimed to evaluate the feasibility of a clinical study as well as the efficacy and safety of traditional East Asian herbal medicines in alleviating fatigue and cognitive dysfunction “brain fog” in patients with long COVID. Methods: This prospective pilot study investigated the use of three types of herbal medicines, Bojungikki-tang (BIT), Kyungok-go (KOG), and Cheonwangbosim-dan (CBD), for a 12-week period as potential treatments for fatigue and cognitive dysfunction in patients with long COVID. Forty-five patients with long COVID were recruited, and one of three drugs was given based on the patient’s symptoms and pattern identification. The effect of herbal medications on fatigue and cognitive function outcomes was assessed over a 36-week period, with patient adherence closely monitored. Results: After 12 weeks of herbal drug administration, fatigue symptoms improved significantly across all groups, with treatment success rates of 80%, 53.33%, and 46.67% in the BIT, KOG, and CBD groups, respectively. However, “brain fog” symptoms showed less improvement, with treatment success rates of 40%, 46.67%, and 13.33% in the BIT, KOG, and CBD groups, respectively. All adverse events reported were mild and unrelated to the medication. The study design was found to be feasible with high medication adherence. Conclusions: This study demonstrated the feasibility of conducting a clinical trial with three herbal medicines to treat long COVID symptoms like fatigue and “brain fog.”

Anna Kim, Sang-Hyun Kim, Yong-Taek Oh. J Pharmacopuncture 2021;24:138-41. https://doi.org/10.3831/KPI.2021.24.3.138

Prescriptions of Local Botanicals for Emergency Use (K. Hyang’yak Kugŭppang 鄕藥救急方) is the oldest medical text extant on the Korean Peninsula and known to have been compiled during the latter half of the Koryŏ 高麗 dynasty (918–1392 ce). The key value of this work lies in the dissemination and praxis of medical knowledge. First, the author used annotations in order to record Koryŏ people’s pronunciations of the names of medicinal ingredients and symptoms introduced in the main body of the text. In addition, he made use of actual empirical cases to enhance the persuasiveness of treatment methods and integrated medicine newly introduced from Song 宋 China (960–1279) into medicine familiarly used from before. Finally, he edited this text with a focus on important and simple yet efficacious treatment methods. The book continued to be used steadily following publication. It was additionally printed no fewer than twice by the government of the Chosŏn 朝鮮 dynasty (1392–1910), which ousted Koryŏ, with its clinical usefulness heightened through the supplementation of explanations on medicinal ingredients use in these processes. In particular, the quotation of sentences from Prescriptions for Emergency Use in medical texts published by the Chosŏn government implies that the utility of the medical knowledge in this work was amply acknowledged. The intended readership of the medical information in Prescriptions for Emergency Use was the not the general populace who lived in the Korean Peninsula in the thirteenth-fourteenth centuries. They not only lacked the financial means to pay physicians but also were illiterate, so that they could not even read medical texts. In order for this work to be effective, it was necessary for it to address those who could read medical texts and put their contents into practice. In the end, the author of this book assumed scholar-gentry equipped with academic knowledge as its readers and sought to provide medical information tailored to their level and to realize medical service through them. Through this work, it is possible to see in a very concrete and vivid manner how medical knowledge was disseminated and, furthermore, how medical knowledge thus disseminated was put to use in an era when medical resources were insufficient.

This study examines the development of Onyeokhak (瘟疫学 epidemic medicine), Joseon Korea’s institutionalized, state-led model of epidemic medicine, and evaluates its unique position within the East Asian medical tradition. By analyzing foundational texts such as Donguibogam (「東醫寶鑑」 Mirror of Eastern Medicine ), Gani Byeokonbang (「簡易辟瘟方」 Simplified Formulas for Preventing Epidemic Diseases ) and Byeokyeok Sinbang (「辟疫神方」 Divine Prescriptions for Preventing Epidemics ), this research compares Joseon’s administrative and practical frameworks with the scholar-driven, theoretical evolution of Wen Bing (温病 warm disease) studies in China. Unlike the Chinese trajectory, where paradigms shifted through academic contestation, Joseon’s Onyeokhak was forged by government-mandated public health policies. This resulted in simplified and utilitarian manuals that prioritized vernacular accessibility and symptom-centered clinical protocols rather than abstract theoretical depth. The findings reveal that while Onyeokhak originated from bureaucratic necessity, it evolved into a dynamic system through context-sensitive adaptations, such as the exclusion of irrelevant endemic diseases and the implementation of stepwise clinical decision-making procedures. This study highlights the historical diversity of East Asian medicine and proposes that Joseon’s pragmatic, state-centered strategies offer valuable heuristics for modern emergency public health preparedness and risk communication.