Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
Dialysis Unit, 7 Navy Hospital, Gdańsk, Poland.
Front Endocrinol (Lausanne). 2022 Jul 29;13:939842. doi: 10.3389/fendo.2022.939842. eCollection 2022.
The ongoing COVID-19 pandemic calls for extensive research on various medical topics. Since the beginning of the pandemic, multiple studies investigated the impact of SARS CoV-2 on thyroid function. However, crucial data, such as trend progression over time or influence of commonly used drugs, might still be missing. We checked the thyroid function in 174 patients with PCR-confirmed COVID-19. Our research covered three separate time points of hospitalization (days 1, 4, and 10). We did not exclude patients treated with glucocorticoids but, instead, compared them with patients not treated with steroids. We correlated the results of thyroid function tests with markers of systemic inflammation. We checked if abnormal thyroid function can predict unfavorable outcomes defined as combined primary endpoint and/or secondary endpoints; the combined primary endpoint was the occurrence of death, mechanical ventilation, non-invasive ventilation, vasopressor infusion, or prolonged hospital stay, and the secondary endpoint was any of the listed events. In general, 80.46% of evaluated patients displayed abnormalities in thyroid function tests over at least one time point throughout the observation. We noticed a high prevalence of features typical for thyroid dysfunction in non-thyroidal illness (NTI). Free triiodothyronine (fT3) concentration was significantly lower in the group requiring glucocorticoids. Patients displaying abnormal thyroid function were statistically more likely to meet the predefined combined primary endpoint. We found that fT3 measured at admission could be perceived as an independent predictor of endpoint completion for all analyzed groups. Thyroid involvement is common in COVID-19. Our study supports the idea of thyroid function abnormalities being important clinical tools and allowing early recognition of possible detrimental outcomes of the disease.
持续的 COVID-19 大流行需要对各种医学主题进行广泛的研究。自大流行开始以来，多项研究调查了 SARS CoV-2 对甲状腺功能的影响。然而，关键数据，如随时间的趋势进展或常用药物的影响，可能仍然缺失。我们检查了 174 名经 PCR 确诊的 COVID-19 患者的甲状腺功能。我们的研究涵盖了住院期间的三个不同时间点（第 1、4 和 10 天）。我们没有排除接受糖皮质激素治疗的患者，而是将他们与未接受类固醇治疗的患者进行了比较。我们将甲状腺功能测试的结果与全身炎症标志物相关联。我们检查了异常甲状腺功能是否可以预测不良结局，定义为联合主要终点和/或次要终点；联合主要终点是死亡、机械通气、无创通气、血管加压素输注或延长住院时间的发生，次要终点是列出的任何事件之一。总的来说，在整个观察期间，至少有一个时间点评估的患者中，80.46%的患者甲状腺功能测试结果异常。我们注意到非甲状腺疾病（NTI）中甲状腺功能障碍的特征具有较高的普遍性。需要糖皮质激素的组游离三碘甲状腺原氨酸（fT3）浓度显著降低。甲状腺功能异常的患者在统计学上更有可能满足预设的联合主要终点。我们发现入院时测量的 fT3 可以被视为所有分析组完成终点的独立预测因子。甲状腺受累在 COVID-19 中很常见。我们的研究支持甲状腺功能异常是重要的临床工具的观点，并允许早期识别疾病可能产生的不利结局。
