甲状腺疾病对预测 COVID-19 复合不良结局的预后价值：系统评价和荟萃分析。
The prognostic values of thyroid disorders in predicting COVID-19 composite poor outcomes: A systematic review and meta-analysis.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran - Dr Hasan Sadikin Hospital, Bandung, Indonesia.
Department of Nuclear Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia.
出版信息
Diabetes Metab Syndr. 2022 May;16(5):102464. doi: 10.1016/j.dsx.2022.102464. Epub 2022 Mar 18.
BACKGROUND AND AIMS
In this meta-analysis, we aimed to evaluate the prognostic properties of thyroid disorder during admission on poor prognosis and factors that may influence the relationship in patients with COVID-19.
METHODS
A systematic literature search of PubMed, EBSCO, and CENTRAL was conducted from inception to August 27, 2021. The main exposure was unspecified and specified thyroid disorders-hypothyroidism or hypothyroidism. The outcome of interest was the COVID-19 composite poor outcome that comprises of severity, mortality, ICU admission, and hospitalization.
RESULTS
There were 24,734 patients from 20 studies. Meta-analysis showed that thyroid disorder was associated with composite poor outcome (OR 2.87 (95% CI 2.04-4.04), p < 0.001; I = 62.4%, p < 0.001). Meta regression showed that age (p = 0.047) and hypertension (p = 0.01), but not gender (p = 0.15), DM (p = 0.10), CAD/CVD (p = 0.38), obesity (p = 0.84), and COPD (p = 0.07) affected the association. Subgroup analysis showed that thyroid disorder increased risk of severe COVID-19 (OR 5.13 (95% CI 3.22-8.17), p < 0.05; I = 0%, p = 0.70) and mortality (OR 2.78 (95%CI 1.31-5.90), p < 0.05; I = 80%, p < 0.01). Pooled diagnostic analysis of thyroid disorder yielded a sensitivity of 0.22 (0.13-0.35), specificity of 0.92 (0.87-0.95), and AUC of 0.72. The probability of poor outcome was 38% in patients with thyroid disorder and 15% in patients without thyroid abnormality.
CONCLUSION
On-admission thyroid disorder was associated with poor prognosis in COVID-19 patients.
背景与目的
在这项荟萃分析中，我们旨在评估 COVID-19 患者入院时甲状腺功能障碍与不良预后之间的关系，并探讨可能影响这种关系的因素。
方法
从建库至 2021 年 8 月 27 日，我们对 PubMed、EBSCO 和 CENTRAL 进行了系统的文献检索。主要暴露因素为未明确和明确的甲状腺疾病-甲状腺功能减退或甲状腺功能亢进。感兴趣的结局为 COVID-19 复合不良结局，包括病情严重程度、死亡率、入住 ICU 和住院时间。
结果
共有 20 项研究的 24734 例患者纳入本研究。荟萃分析显示，甲状腺功能障碍与复合不良结局相关（OR 2.87（95%CI 2.04-4.04），p<0.001；I²=62.4%，p<0.001）。元回归分析显示，年龄（p=0.047）和高血压（p=0.01），但不是性别（p=0.15）、糖尿病（p=0.10）、冠心病/脑血管病（p=0.38）、肥胖症（p=0.84）和慢性阻塞性肺疾病（p=0.07），会影响这种关联。亚组分析显示，甲状腺功能障碍增加了发生严重 COVID-19（OR 5.13（95%CI 3.22-8.17），p<0.05；I²=0%，p=0.70）和死亡（OR 2.78（95%CI 1.31-5.90），p<0.05；I²=80%，p<0.01）的风险。甲状腺功能障碍的汇总诊断分析显示，其灵敏度为 0.22（0.13-0.35），特异性为 0.92（0.87-0.95），AUC 为 0.72。患有甲状腺疾病的患者不良结局的概率为 38%，而无甲状腺异常的患者为 15%。
结论
入院时的甲状腺功能障碍与 COVID-19 患者的不良预后相关。
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