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新冠疫情期间,青少年新发 Graves 病的发病率和严重程度增加。

Increased Incidence and Severity of New Graves Disease Diagnoses in Youth During the COVID-19 Pandemic.

机构信息

Department of Pediatrics, Hasbro Children's Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Lifespan Biostatistics, Epidemiology, and Research Design, Brown University, Providence, Rhode Island.

出版信息

Endocr Pract. 2023 May;29(5):349-352. doi: 10.1016/j.eprac.2023.01.011. Epub 2023 Feb 2.

Abstract

OBJECTIVE

Graves disease (GD), an autoimmune disease of the thyroid, is likely caused by a combination of genetic predisposition and environmental triggers. Recent data suggest that COVID-19 may be associated with the development of autoimmune disease. The aim of this study was to assess the incidence and characteristics of new GD diagnoses in youth prior to and during the COVID-19 pandemic.

METHODS

We performed a retrospective chart review of all new GD diagnoses in patients aged 0 to 18 years diagnosed at a tertiary care pediatric hospital between January 1, 2018, and December 31, 2021.

RESULTS

Over a 4-year period, 51 patients had been diagnosed with new-onset GD. We observed an increased incidence in new-onset GD during the pandemic compared with that in the 2 prior years (P = .01). During the pandemic period, heart rates (P = .03) as well as systolic (P = .005) and diastolic (P = .01) blood pressures were higher at initial evaluation, patients more frequently reported palpitations (P = .03) and tremors (P = .04), and an increased proportion of patients required beta-blockade treatment at diagnosis (P = .002). The percentage of patients requiring thionamide treatment and thionamide doses had been similar over time.

CONCLUSION

We identified an increase in new-onset pediatric GD diagnoses during the COVID-19 pandemic. In addition, youths had increased severity of symptoms and more frequently required beta-blockade treatment at diagnosis. Further study of the relationship between COVID-19 and autoimmune thyroid disease is needed.

摘要

目的

格雷夫斯病(GD)是一种甲状腺自身免疫性疾病,可能由遗传易感性和环境诱因共同引起。最近的数据表明,COVID-19 可能与自身免疫性疾病的发展有关。本研究旨在评估 COVID-19 大流行前后青少年新发 GD 诊断的发病率和特征。

方法

我们对 2018 年 1 月 1 日至 2021 年 12 月 31 日期间在一家三级儿科医院诊断为 0 至 18 岁的所有新发 GD 患者进行了回顾性图表审查。

结果

在 4 年期间,有 51 名患者被诊断为新发 GD。与前 2 年相比,我们观察到大流行期间新发 GD 的发病率增加(P =.01)。在大流行期间,初始评估时的心率(P =.03)以及收缩压(P =.005)和舒张压(P =.01)更高,更多的患者报告心悸(P =.03)和震颤(P =.04),并且在诊断时需要β受体阻滞剂治疗的患者比例增加(P =.002)。随着时间的推移,需要硫脲类药物治疗和硫脲类药物剂量的患者比例相似。

结论

我们发现 COVID-19 大流行期间新发儿科 GD 诊断增加。此外,青少年的症状严重程度增加,并且在诊断时更频繁地需要β受体阻滞剂治疗。需要进一步研究 COVID-19 与自身免疫性甲状腺疾病之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd55/9892249/d1d2fd57b4e5/gr1_lrg.jpg

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