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Background: Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease with a high fatality rate. Up to now, there are an estimated 26 million confirmed cases and 865,000 deaths around the world. But no effective way can control this disease. As the country that first discovered and treated the COVID-19, China has formed relatively mature prevention and treatment methods such as “3 prescriptions and 3 drugs.” Xuan Fei Bai Du Fang, as a member of “3 prescriptions and 3 drugs,” has very good clinical effects Methods: The PubMed, EMBASE, ClinicalTrials.gov, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched for randomized controlled studies published to date. This study only screens clinical randomized controlled trials on QFBDF for COVID-19 to evaluate its efficacy and safety. Import all literatures that meet the requirements into Endnote X9 software. The information was finally cross-checked by 2 reviewers. Papers selected for review were assessed for risk of bias according to the criteria. Quality assessment on design of study, risk of bias, indirectness and imprecision were assessed using the GRADE framework. Where sufficient studies were available, publication bias was assessed visually using funnel plots. Relative risks for primary and secondary outcomes were calculated on an intent-to-treat basis and pooled using random effects meta-analysis. the continuous is expressed by mean difference or standard mean difference, eventually the data is synthesized using a fixed effect model or a random effect model depending on whether or not heterogeneity exists. The heterogeneity of studies will be evaluated by Q-test and I2 statistic with RevMan5.3. Results: The time from a positive diagnosis to a negative result of 2 consecutive nucleic acid tests (not on the same day), cure rate. The results of our research will be published in a peer-reviewed journal. Conclusion: The purpose of this systematic review is to provide new evidence for the effectiveness and safety of Xuan Fei Bai Du Fang in the treatment of COVID-19. PROSPERO registration number: CRD42020213950.

Rationale: In patients with pituitary thyroid hormone resistance, the ability of the pituitary gland to detect (and down-regulate) the increase of triiodothyronine is selectively impaired, while the periphery remains sensitive to triiodothyronine levels, producing symptoms of peripheral thyrotoxicity. Subsequently, there is no feedback of pituitary production of thyroid-stimulating hormone (TSH), which is responsible for this hyperthyroidism. Patient concerns: We report a case of a 46-year-old Chinese woman diagnosed with a thyroid nodule, with normal thyroid function. She underwent conventional subtotal thyroidectomy, and replacement therapy (levothyroxine) was used for as convention. However, it was later proven that she had pituitary resistance to thyroid hormone, as supra-physiological doses of levothyroxine were required to normalize TSH levels, which resulted in peripheral thyrotoxicity. Diagnoses: Based on the patient's symptoms, laboratory tests results, imaging examinations, and genetic analysis (which noted a gene mutation), a diagnosis of pituitary resistance to thyroid hormones was confirmed. Interventions: The dose of levothyroxine was adjusted periodically and β-adrenergic blocker was used as symptomatic treatment. Outcomes: The outcome in the reported case has been satisfactory despite the persistence of non-suppressed TSH. Lessons: An inappropriate level of TSH should always be evaluated. We found a new mutation (H435A) of the thyroid hormone receptor beta gene, which allowed for the establishment of a definitive diagnosis.