Ph.D. Candidate
School of Chinese Medicine,
Hong Kong Baptist University
Presenter/Author:
WANG Zhi Chun
Other Author:
ZHANG Shi Ping
Author Affiliation:
Hong Kong Baptist University, Hong Kong, China.
Keywords:
COVID-19, Febrile Disease, Tongue Diagnosis, Inflammatory Biomarkers, Tongue Coating Index
Abstract:
Background: COVID-19 is a highly infectious disease that could lead to severe health consequences. As such, an easy and convenient method of detecting and monitoring disease symptoms would be of practical value. Distinct tongue features have been reported in COVID-19 cases. Tongue diagnosis is a routine procedure in traditional Chinese medicine (TCM), especially in the diagnosis of febrile disease. To determine the characteristic of tongue coating features in COVID-19, this study investigated the tongue coating of COVID-19 subjects using non-COVID controls.
Methods: Tongue images taken by smartphones from three age-matched groups, namely, the COVID group (n=92), normal group (n=92) ), and non-COVID febrile group (n=92) were analyzed by two blinded raters according to a tongue coating scoring scheme, which assessed the levels of thick fur, slimy or greasy fur, discolored fur and the composite index of tongue coating. Changes in tongue coating of COVID subjects were also analyzed against inflammatory biomarkers.
Results: Compared with the control, significant increases in all coating indexes were found in the COVID group (P<0.001). No difference was observed between COVID and non-COVID febrile groups for all coating indexes measured. In COVID-19 subjects, their scores of coating indexes had weak but significant correlations with certain inflammatory biomarkers, including WBC, neutrophil, and neutrophil - lymphocyte ratio.
Conclusion: It is concluded that COVID-19 subjects have pathological tongue coating patterns that are associated with acute inflammatory responses, and the coating patterns may help to indicate the onset and resolution of the inflammatory responses.
Reference:
Xu, H., Zhong, L., Deng, J., Peng, J., Dan, H., Zeng, X., Li, T., & Chen, Q. (2020). High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International journal of o
Wang, Z. C., Zhang, S. P., Yuen, P. C., Chan, K. W., Chan, Y. Y., Cheung, C. H., ... & Zhang, X. (2020). Intra-rater and inter-rater reliability of tongue coating diagnosis in traditional chinese
Funding Source:
This study has been supported by funds from HKBU Faculty Research Grant (FRG2/17-18/095), a donation grant to HKBU by Ms. Flora Chan (NWSI-15-16-01, CMTR), Emergency Special Funding Project of the State Administration of Traditional Chinese Medicine (No. 2020ZYLCYJ05-12), and the Special Funding Project
Conflict of Interests:
All authors declare that they have no conflict of interest.
Ms. WANG Zhichun is a Ph.D. student in. Hong Kong Baptist University majoring in AI application in Traditional Chinese Medicine and telemedicine. As Chief Tech Officer in i-Heals limited, she is in charge of AI development and IT project management. Ms. WANG has built several AI models in tongue diagnosis and telemedicine winning Cyberport Creative Micro Fund and HSBC Future Skills Development Project. Corresponding research papers and patents have also been published. Ms. WANG is also a program committee member of International Conference on Traditional Chinese Medicine Tele-healthcare. She is interested in participating in academic research and commercial projects related to standardization and quantification of TCM.