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J Endocrinol Invest . Thyroid hormone concentrations in severely or critically ill patients with COVID-19

tetano

Editor, Senior Moderator
J Endocrinol Invest


. 2020 Nov 2.
doi: 10.1007/s40618-020-01460-w. Online ahead of print.
Thyroid hormone concentrations in severely or critically ill patients with COVID-19


W Gao[SUP] 1 [/SUP], W Guo[SUP] 2 [/SUP], Y Guo[SUP] 2 [/SUP], M Shi[SUP] 2 [/SUP], G Dong[SUP] 2 [/SUP], G Wang[SUP] 3 [/SUP], Q Ge[SUP] 4 [/SUP], J Zhu[SUP] 5 [/SUP], X Zhou[SUP] 6 [/SUP]



Affiliations

Abstract

Objective: COVID-19 is a new coronavirus infectious disease. We aimed to study the characteristics of thyroid hormone levels in patients with COVID-19 and to explore whether thyroid hormone predicts all-cause mortality of severely or critically ill patients.
Methods: The clinical data of 100 patients with COVID-19, who were admitted to Wuhan Tongji Hospital from February 8 to March 8, 2020, were analyzed in this retrospective study. The patients were followed up for 6-41 days. Patients were grouped into non-severe illness and severe or critical illness, which included survivors and non-survivors. Multivariate Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality in association with continuous and the lower two quartiles of thyroid hormone concentrations in severely or critically ill patients.
Results: The means of free T3 (FT3) were 4.40, 3.73 and 2.76 pmol/L in non-severely ill patients, survivors and non-survivors, respectively. The lower (versus upper) two quartiles of FT3 was associated with all-cause mortality HR (95% CI) of 9.23 (2.01, 42.28). The HR (95% CI) for all-cause mortality in association with continuous FT3 concentration was 0.41 (0.21, 0.81). In the multivariate-adjusted models, free T4 (FT4), TSH and FT3/FT4 were not significantly related to all-cause mortality. Patients with FT3 less than 3.10 pmol/L had increased all-cause mortality.
Conclusion: FT3 concentration was significantly lower in patients with severe COVID-19 than in non-severely ill patients. Reduced FT3 independently predicted all-cause mortality of patients with severe COVID-19.

Keywords: COVID-19; Mortality; Nonthyroidal illness; Thyroid hormone.
 
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