2019冠状病毒病患者甲状腺功能障碍的患病率：一项系统评价
Prevalence of thyroid dysfunction in patients with COVID-19: a systematic review.
作者信息
Giovanella Luca, Ruggeri Rosaria M, Ovčariček Petra Petranović, Campenni Alfredo, Treglia Giorgio, Deandreis Desiree
机构信息
Clinic for Nuclear Medicine and Competence Centre for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Via A. Gallino 12, 6500 Bellinzona, Switzerland.
Clinic for Nuclear Medicine, University Hospital and University of Zurich, Zürich, Switzerland.
出版信息
Clin Transl Imaging. 2021;9(3):233-240. doi: 10.1007/s40336-021-00419-y. Epub 2021 Mar 11.
PURPOSE
Currently, there is an increasing interest regarding the impact of COVID-19 on the thyroid function. As several recent reports have described the onset of thyroid dysfunction in patients diagnosed with COVID-19, we performed a systematic review to assess the prevalence of thyroid dysfunction in patients with COVID-19 as this information could be clinically relevant for the management of these patients.
METHODS
A comprehensive computer literature search using PubMed/Medline and Cochrane databases was performed until November 14, 2020 to search original articles evaluating thyroid dysfunction in COVID-19 patients. Information about thyroid dysfunction assessed by thyroid function test was retrieved by the eligible articles. Qualitative analysis (systematic review) only was performed whether a significant heterogeneity of data was detected.
RESULTS
Seven studies including 1237 patients with COVID-19 were included. A significant heterogeneity across the studies was found. Most COVID-19 patients were euthyroid with TSH levels in the normal range (from 44 to 94% of the COVID-19 patients assessed in the included studies). The prevalence of thyroid dysfunction in COVID-19 patients (defined as abnormal thyroid function tests) largely varies among the included studies between 13 and 64% of COVID-19 patients as well as clinical presentation. A positive correlation between thyroid dysfunction and clinical severity of COVID-19 was reported.
CONCLUSION
Literature data show that thyroid dysfunction is present in a significant percentage of patients with COVID-19. Assessment of thyroid function may be considered in symptomatic COVID-19 patients to have a baseline before introducing thyroid-interfering drugs and those requiring high-intensity care. Further, well-designed studies are needed to better elucidate the impact of COVID-19 on thyroid function and inform thyroid function testing and thyroid dysfunction management in COVID-19 patients.
目的
目前，新冠病毒病（COVID-19）对甲状腺功能的影响越来越受到关注。由于最近有几份报告描述了新冠病毒病确诊患者出现甲状腺功能障碍，我们进行了一项系统评价，以评估新冠病毒病患者甲状腺功能障碍的患病率，因为这些信息可能对这些患者的管理具有临床意义。
方法
使用PubMed/Medline和Cochrane数据库进行全面的计算机文献检索，直至2020年11月14日，以检索评估新冠病毒病患者甲状腺功能障碍的原始文章。符合条件的文章检索了通过甲状腺功能测试评估的甲状腺功能障碍信息。无论是否检测到数据的显著异质性，仅进行定性分析（系统评价）。
结果
纳入了7项研究，共1237例新冠病毒病患者。研究间存在显著异质性。大多数新冠病毒病患者甲状腺功能正常，促甲状腺激素（TSH）水平在正常范围内（在所纳入研究中评估的新冠病毒病患者的44%至94%）。在所纳入的研究中，新冠病毒病患者甲状腺功能障碍（定义为甲状腺功能测试异常）的患病率差异很大，在新冠病毒病患者中为13%至64%，临床表现也有所不同。有报告称甲状腺功能障碍与新冠病毒病的临床严重程度呈正相关。
结论
文献数据表明，相当比例的新冠病毒病患者存在甲状腺功能障碍。对于有症状的新冠病毒病患者，在使用干扰甲状腺的药物之前以及那些需要高强度护理的患者中，可考虑评估甲状腺功能以获得基线数据。此外，需要设计良好的研究来更好地阐明新冠病毒病对甲状腺功能的影响，并为新冠病毒病患者的甲状腺功能检测和甲状腺功能障碍管理提供依据。
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