tetano
Editor, Senior Moderator
Endocr Res
. 2021 May 20;1-8.
doi: 10.1080/07435800.2021.1924770. Online ahead of print.
Association between Thyroid Function and Prognosis of COVID-19: A Retrospective Observational Study
Shan Lang[SUP] 1 [/SUP], Ye Liu[SUP] 1 [/SUP], Xue Qu[SUP] 1 [/SUP], Ran Lu[SUP] 1 [/SUP], Wei Fu[SUP] 1 [/SUP], Wenhui Zhang[SUP] 1 [/SUP], Haining Wang[SUP] 1 [/SUP], Tianpei Hong[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a severe infectious illness. It has been reported that COVID-19 has an effect on thyroid function. However, the association between thyroid function and prognosis of COVID-19 is still unclear.Methods: This retrospective study included patients with COVID-19 admitted to Tongji Hospital in Wuhan from January 28 to April 4, 2020. Demographic, epidemiological, clinical, laboratory, treatment, and outcome data were collected from patients with laboratory-confirmed COVID-19. Patients without history of thyroid disease who had a thyroid function test at admission were enrolled in the final analysis. Risk factors of in-hospital death were explored using univariable and multivariable Cox regression analyses. Survival differences were assessed with Kaplan-Meier curves and log-rank test.Results: A total of 127 patients were included in this study, with 116 survivors and 11 non-survivors. The serum levels of thyroid stimulating hormone (TSH) [0.8 (0.5-1.7) vs. 1.9 (1.0-3.1) ?IU/mL, P = .031] and free triiodothyronine (FT[SUB]3[/SUB]) [2.9 (2.8-3.1) vs. 4.2 (3.5-4.7) pmol/L, P < .001] were lower in non-survivors than in survivors, and a low FT[SUB]3[/SUB] state (defined as FT[SUB]3[/SUB] < 3.1 pmol/L) at admission accounted for a higher proportion in non-survivors than in survivors (72.7% vs. 11.2%, P < .001). Univariate Cox regression analysis showed that FT[SUB]3[/SUB] level (HR 0.213, 95% CI: 0.101-0.451, P < .001) and the low FT[SUB]3[/SUB] state (HR 14.607, 95% CI: 3.873-55.081, P < .001) were negatively and positively associated with the risk of in-hospital death, respectively. Furthermore, multivariate Cox regression analysis revealed that a low FT[SUB]3[/SUB] state was associated with an increased risk of in-hospital death after adjusting for confounding factors (HR 13.288, 95% CI: 1.089-162.110, P = .043). Moreover, Kaplan-Meier curves indicated a lower survival probability in COVID-19 patients with a low FT[SUB]3[/SUB] status.Conclusion: Serum FT[SUB]3[/SUB] level is lower in non-survivors among moderate-to-critical patients with COVID-19, and the low FT[SUB]3[/SUB] state is associated with an increased risk of in-hospital mortality of COVID-19.
Keywords: COVID-19; euthyroid sick syndrome; free triiodothyronine; mortality; thyroid hormone.
. 2021 May 20;1-8.
doi: 10.1080/07435800.2021.1924770. Online ahead of print.
Association between Thyroid Function and Prognosis of COVID-19: A Retrospective Observational Study
Shan Lang[SUP] 1 [/SUP], Ye Liu[SUP] 1 [/SUP], Xue Qu[SUP] 1 [/SUP], Ran Lu[SUP] 1 [/SUP], Wei Fu[SUP] 1 [/SUP], Wenhui Zhang[SUP] 1 [/SUP], Haining Wang[SUP] 1 [/SUP], Tianpei Hong[SUP] 1 [/SUP]
Affiliations
- PMID: 34014139
- DOI: 10.1080/07435800.2021.1924770
Abstract
Background: Coronavirus disease 2019 (COVID-19) is a severe infectious illness. It has been reported that COVID-19 has an effect on thyroid function. However, the association between thyroid function and prognosis of COVID-19 is still unclear.Methods: This retrospective study included patients with COVID-19 admitted to Tongji Hospital in Wuhan from January 28 to April 4, 2020. Demographic, epidemiological, clinical, laboratory, treatment, and outcome data were collected from patients with laboratory-confirmed COVID-19. Patients without history of thyroid disease who had a thyroid function test at admission were enrolled in the final analysis. Risk factors of in-hospital death were explored using univariable and multivariable Cox regression analyses. Survival differences were assessed with Kaplan-Meier curves and log-rank test.Results: A total of 127 patients were included in this study, with 116 survivors and 11 non-survivors. The serum levels of thyroid stimulating hormone (TSH) [0.8 (0.5-1.7) vs. 1.9 (1.0-3.1) ?IU/mL, P = .031] and free triiodothyronine (FT[SUB]3[/SUB]) [2.9 (2.8-3.1) vs. 4.2 (3.5-4.7) pmol/L, P < .001] were lower in non-survivors than in survivors, and a low FT[SUB]3[/SUB] state (defined as FT[SUB]3[/SUB] < 3.1 pmol/L) at admission accounted for a higher proportion in non-survivors than in survivors (72.7% vs. 11.2%, P < .001). Univariate Cox regression analysis showed that FT[SUB]3[/SUB] level (HR 0.213, 95% CI: 0.101-0.451, P < .001) and the low FT[SUB]3[/SUB] state (HR 14.607, 95% CI: 3.873-55.081, P < .001) were negatively and positively associated with the risk of in-hospital death, respectively. Furthermore, multivariate Cox regression analysis revealed that a low FT[SUB]3[/SUB] state was associated with an increased risk of in-hospital death after adjusting for confounding factors (HR 13.288, 95% CI: 1.089-162.110, P = .043). Moreover, Kaplan-Meier curves indicated a lower survival probability in COVID-19 patients with a low FT[SUB]3[/SUB] status.Conclusion: Serum FT[SUB]3[/SUB] level is lower in non-survivors among moderate-to-critical patients with COVID-19, and the low FT[SUB]3[/SUB] state is associated with an increased risk of in-hospital mortality of COVID-19.
Keywords: COVID-19; euthyroid sick syndrome; free triiodothyronine; mortality; thyroid hormone.