ABSTRACT
OBJECTIVE: To summarize the potential characteristics of convalescent patients with coronavirus disease 2019 (COVID-19) in China based on emerging clinical tongue data and guide the treatment and recovery of COVID-19 patients from the perspective of Traditional Chinese Medicine tongue diagnosis. METHODS: In this study, we developed and validated radiomics-based and lab-based methods as a novel approach to provide individualized pretreatment evaluation by analyzing different features to mine the orderliness behind tongue data of convalescent patients. In addition, this study analyzed the tongue features of convalescent patients from clinical tongue qualitative values, including thick and thin, fur, peeling, fat and lean, tooth marks and cracked, and greasy and putrid fur. RESULTS: We included 2164 tongue images in total (34% from day 0, 35.4% from day 14 and 30.6% from day 28) from convalescent patients. The significance results are shown as follows. Firstly, as the recovery time prolongs, the L average values of tongue and coat decrease from 60.21 to 57.18 and from 60.06 to 57.03 respectively. Secondly, the decrease of abnormality rate of tongue coat, included greasy tongue fur, putrid fur, teeth-mark, thick-thin fur, are of significant statistical difference ( < 0.05). Thirdly, the average value of gray-level co-occurrence matrices increases from 0.173 to 0.194, the average value of entropy increases from 0.606 to 0.665, the average value of inverse difference normalized decrease from 0.981 to 0.979, and the average value of dissimilarity decrease from 0.1576 to 0.1828. The details of other radiomics features are describe in results section. CONCLUSIONS: Our experiment shows that patients in different recovery periods have a relationship with quantitative values of tongue images, including L color space of the tongue and coat radiomics features analysis. This relationship can help clinical doctors master the recovery and health of patients as soon as possible and improve their understanding of the potential mechanisms underlying the dynamic changes and mechanisms underlying COVID-19.