ObjectiveTo systematically review the efficacy and safety of traditional Chinese medicine (TCM) and antiviral antibody therapy in the treatment of COVID-19. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data, VIP and SinoMED databases were electronically searched to collect randomized controlled trials (RCTs) on efficacy and safety of traditional Chinese medicine and antiviral antibody therapies for COVID-19 from inception to June 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using Stata 14.0 software. ResultsA total of 44 RCTs were included. The results of network meta-analysis showed that, for mortality rate, the rank of cumulative probability was: TCM+ standard care (SC) (100%)>convalescent plasma (CP)+SC (42%)>SC (8%). In terms of hospital stay time, the rank of cumulative probability was: TCM+SC (95.5%)>SC (31.4%)>CP+SC (23.2%). In terms of time to viral clearance, the rank of cumulative probability was: TCM+SC (97.4%)>SC (37.4%)>CP+SC (15.2%). In the aspect of mechanical ventilation rate, the rank of cumulative probability was: TCM+SC (98.9%)>CP+SC (42.9%)>SC (8.3%). In the aspect of adverse reactions/events, the rank of cumulative probability was: TCM+SC (99.9%)>SC (47.9%)>CP+SC (2.2%). ConclusionThe current evidence shows that TCM combined with SC is the most effective treatment in reducing mortality, shortening hospitalization time and viral negative conversion time, reducing mechanical ventilation rate, and the incidence of adverse reactions/events is low. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.