Objective To observe the tongue manifestation of 139 patients with coronavirus disease 2019（COVID-19）

and to explore its relationship with the clinical classification. Methods Using the traditional method of tongue inspection in traditional Chinese medicine（TCM）

the tongue examination data of 139 inpatients with COVID-19 were collected

including tongue color

tongue shape

tongue coating color

and tongue coating quality. The characteristics of tongue quality and tongue coating of patients of mild

common

severe

and critical type were compared. Results In the 139 patients

there were 40 cases（28.78%） with dark tongue

36 cases（25.90%） with red tongue

33 cases（23.74%） with light red tongue. There were 85 cases（61.15%） with normal tongue shape

41 cases（29.50%） with tooth mark tongue

13 cases（9.35%） with cracked tongue. Tongue coating analysis was performed on 134 patients

including 79 cases（58.96%） with greasy coating

33 cases（24.63%） with thin tongue coating

22 cases（16.42%） with thick tongue coating

115 cases（85.82%） with moist tongue coating

and 19 cases（14.18%） with dry tongue coating; 94 cases（70.15%） with yellow tongue coating

40 cases（29.85%） with white tongue coating. There were statistically significant differences in tongue color

tongue shape

tongue coating thickness

degree of tongue coating moisturizing or dry

and tongue coating color distribution in patients of different clinical types（P<0.05 or P<0.01）. Compared with the common type

red tongue and dark red tongue were more common in the critical patients（P=0.004）

severe（P<0.001） and critical（P=0.002） patients are common to have cracked tongue

and thicker tongue coating was more common in critical patients. There were more thick tongue coating in critical patients（P<0.001） and more yellow tongue coating in severe patients（P=0.001）. Critical patients（P=0.012） accounted for a higher proportion; compared with ordinary and severe patients. Dry tongue coating was more common in critical patients（all P<0.001）. Conclusion Patients with COVID-19 may have red tongue

dark red tongue

cracked tongue

yellow coating

dry coating

and thick coating. As the condition is more serious

the epidemic pathogen may have the manifestations of heat and dryness transformation

and at the same time hurt the qi and yin.