Department of Endocrinology and Metabolism, Ankara University, Ankara, Turkey.
Department of Endocrinology and Metabolism, Faculty of Medicine, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey.
Clin Endocrinol (Oxf). 2021 Oct;95(4):628-637. doi: 10.1111/cen.14486. Epub 2021 May 3.
There are scarce published data in differentiated thyroid cancer patients about new coronavirus disease 2019 (COVID-19) disease outcomes and mortality. Here, we evaluated COVID-19 infection outcomes and mortality in thyroid cancer patients with COVID-19 infection.
We included a cohort of patients with thyroid cancer with PCR-confirmed COVID-19 disease from 11 March to 30 May 2020 from the Turkish Ministry of Health database in our nationwide, retrospective study. We compared the mortality and morbidity of COVID patients with or without thyroid cancer. Univariate and multivariate analyses were used to assess the independent factors for mortality, length of hospital stay and intensive care unit (ICU) admission and mechanical ventilation. We also analysed the effect of radioiodine treatment on severity and death rate of COVID-19 disease.
We evaluated 388 COVID-19 patients with thyroid cancer [median age: 54 years, interquartile range (IQR) 18 years, males: 23%] and age and gender-matched 388 COVID-19 patients without thyroid cancer. Patients with thyroid cancer had a similar mortality ratio compared with the non-cancer group. Among patients with thyroid cancer, age, presence of diabetes mellitus, asthma/COPD, heart failure, chronic kidney disease, prior coronary artery disease, RAS blocker usage and low lymphocyte count were associated with mortality. Radioactive iodine (RAI) treatment and cumulative radioactive iodine dosage did not negatively affect the severity and mortality of COVID-19 disease in our patient group.
Our study indicated that history of thyroid cancer did not have an increased risk of mortality or morbidity in COVID-19 disease. Besides, RAI therapy history and doses of radioactive iodine did not affect mortality or outcome.
关于新冠肺炎（COVID-19）疾病结局和死亡率，分化型甲状腺癌患者的相关数据十分匮乏。在此，我们评估了 COVID-19 感染的甲状腺癌患者的感染结局和死亡率。
在这项全国性的回顾性研究中，我们从土耳其卫生部的数据库中纳入了 2020 年 3 月 11 日至 5 月 30 日期间经聚合酶链反应（PCR）确诊为 COVID-19 的甲状腺癌患者队列。我们比较了 COVID 患者中有和无甲状腺癌患者的死亡率和发病率。采用单变量和多变量分析来评估死亡率、住院时间、重症监护病房（ICU）入住率和机械通气的独立影响因素。我们还分析了放射性碘治疗对 COVID-19 严重程度和死亡率的影响。
我们评估了 388 例患有甲状腺癌的 COVID-19 患者（中位年龄：54 岁，四分位距[IQR]为 18 岁，男性占 23%），并与年龄和性别相匹配的 388 例无甲状腺癌的 COVID-19 患者进行了比较。患有甲状腺癌的患者与非癌症组的死亡率比值相似。在患有甲状腺癌的患者中，年龄、糖尿病、哮喘/COPD、心力衰竭、慢性肾脏病、既往冠状动脉疾病、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（RAS 阻滞剂）的使用和低淋巴细胞计数与死亡率相关。放射性碘（RAI）治疗和累积放射性碘剂量并未对我们患者群体的 COVID-19 疾病严重程度和死亡率产生负面影响。
我们的研究表明，甲状腺癌病史并不会增加 COVID-19 疾病的死亡率或发病率。此外，RAI 治疗史和放射性碘剂量不会影响死亡率或结局。
