Mining intrinsic information of convalescent patients after suffering coronavirus disease 2019 in Wuhan

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(P<0.05).Thirdly,the average value of gray-level cooccurrence 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.

Dynamics of the SARS-CoV-2 antibody response up to 10 months after infection

COVID-19 caused by SARS-CoV-2 infection has caused substantial morbidity and mortality worldwide and paralyzed the international economy.Understanding the magnitude and duration of the antibody response to SARS-CoV-2 is important to achieve a balance between curbing the pandemic and minimizing adverse effects on society.1 Although the antibody response to SARS-CoV-2 within 9 months has been extensively studied,2,3,4,5,6 little is known about the magnitude and kinetics of antibody responses for over 9 months.Moreover,with limited observations over 9 months(n<100),2,7,8 several studies have produced inconsistent conclusions about antibody dynamics,suggesting different rates of antiviral antibody positivity at the last follow-up.2,7,8 These studies have been limited by a lack of measurement of neutralizing antibodies(NAbs),7 of inclusion of mild or asymptomatic cases,2,8 and of further exploration of potential predisposing factors for antibody dynamics.2,7 Considering the individual heterogeneity(such as disease severity)8 and time-dependent nature1 of the immune response,in-depth characterization of SARS-CoV-2 antibody kinetics across disease severity groups over a long period is urgently needed.Therefore,we repeatedly tested IgM,IgG,viral spike protein receptor-binding dom(anti-RBD)IgG,and NAb titers in COVID-19 patients during a follow-up period of up to 10 months and explored potential predisposing factors of antibody titers during follow-up.

Distinct gut microbiota and health outcomes in asymptomatic infection,viral nucleic acid test re-positive,and convalescent COVID-19 cases

Gut microbiota composition is suggested to associate with coronavirus disease 2019(COVID-19)severity,but the impact of gut microbiota on health outcomes is largely unclear.We recruited 81 individuals from Wuhan,China,including 13 asymptomatic infection cases(Group A),24 COVID-19 convalescents with adverse outcomes(Group C),31 severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)re-positive cases(Group D),and 13 non-COVID-19 healthy controls(Group H).The microbial features of Groups A and D were similar and exhibited higher gut microbial diversity and more abundant short-chain fatty acid(SCFA)-producing species than Group C.Group C was enriched with opportunistic pathogens and virulence factors related to adhesion and toxin production.The abundance of SCFA-producing species was negatively correlated,while Escherichia coli was positively correlated with adverse outcomes.All three groups(A,C,and D)were enriched with the mucusdegrading species Akkermansia muciniphila,but decreased with Bacteroides-encoded carbohydrate-active enzymes.The pathways of vitamin B6 metabolic and folate biosynthesis were decreased,while selenocompound metabolism was increased in the three groups.Specifically,the secondary bile acid(BA)metabolic pathway was enriched in Group A.Antibiotic resistance genes were common among the three groups.Conclusively,the gut microbiota was related to the health outcomes of COVID-19.Dietary supplementations(SCFAs,BA,selenium,folate,vitamin B6)may be beneficial to COVID-19 patients.