Thyroid Function Abnormalities and Outcomes in Hospitalized Patients
                    with COVID-19 Infection: A Cross-Sectional Study

Deepika Patel; Dukhabandhu Naik; Sadishkumar Kamalanathan; Kadhiravan Tamilarasu; Jayaprakash Sahoo; Ayan Roy; Chandhana Merugu; Varun Suryadevara

doi:10.1055/a-2014-4634

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2023; 55(03): 169-175
DOI: 10.1055/a-2014-4634

Original Article: Endocrine Care

Thyroid Function Abnormalities and Outcomes in Hospitalized Patients with COVID-19 Infection: A Cross-Sectional Study

Authors

Deepika Patel

¹Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Dukhabandhu Naik

¹Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Sadishkumar Kamalanathan

¹Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Kadhiravan Tamilarasu

²Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Jayaprakash Sahoo

¹Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Ayan Roy

³Endocrinology and Metabolism, All India Institute of Medical Sciences – Kalyani, Kalyani, India
Chandhana Merugu

¹Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
Varun Suryadevara

¹Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Abstract

Thyroid gland can be affected by the COVID-19 infection. The pattern of thyroid function abnormality reported in COVID-19 is variable; in addition, some drugs used in COVID-19 patients like glucocorticoids and heparin can affect the thyroid function tests (TFT). We conducted an observational, cross-sectional study of thyroid function abnormalities with thyroid autoimmune profile in COVID-19 patients with varying severity from November 2020 to June 2021. Serum FT4, FT3, TSH, anti-TPO, and anti-Tg antibodies were measured before the initiation of treatment with steroids and anti-coagulants. A total of 271 COVID-19 patients were included in the study, of which 27 were asymptomatic and remaining 158, 39, and 47 were classified to mild, moderate and severe categories, respectively, according to MoHFW, India criteria. Their mean age was 49±17 years and 64.9% were males. Abnormal TFT was present in 37.2% (101/271) patients. Low FT3, low FT4, and low TSH were present in 21.03%, 15.9% and 4.5% of patients, respectively. Pattern corresponding to sick euthyroid syndrome was the most common. Both mean FT3 and FT3/FT4 ratio decreased with increasing severity of COVID-19 illness (p=0.001). In multivariate analysis, low FT3 was associated with increased risk of mortality (OR 12.36, 95% CI: 1.23–124.19; p=0.033). Thyroid autoantibodies were positive in 58 (27.14%) patients; but it was not associated with any thyroid dysfunction. Thyroid function abnormality is common among COVID-19 patients. Both low FT3 and FT3/FT4 ratio are indicators of disease severity while low FT3 is a prognostic marker of COVID-19 associated mortality.

Key words

SARS-CoV2 - low FT3 syndrome - mortality - sick euthyroid syndrome - thyroiditis

Full Text

References

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