Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Pavia, Italy.
Front Endocrinol (Lausanne). 2023 Jul 14;14:1192561. doi: 10.3389/fendo.2023.1192561. eCollection 2023.
Patients with severe COVID-19 often experience long-lasting disabilities that can improve after pulmonary rehabilitation. Moreover patients with severe COVID-19 display thyroid function alterations due to a non-thyroidal illness syndrome (NTIS). The aim of our study was to evaluate thyroid function parameters among patients hospitalized for COVID-19 who were eligible or not to respiratory rehabilitation and their modifications during follow-up.
Post-COVID-19 patients referred to a Respiratory Rehabilitation Unit were evaluated. Outpatients, not candidate for rehabilitation, were enrolled as Control group. Patients who had completed a 4-week-rehabilitation program were enrolled as Rehabilitation Group. All patients were evaluated at T0 (4 weeks after the discharge home in Control Group and after completion of rehabilitation in Rehabilitation Group) and at T1 (3 months after T0).
The final study group included 39 patients (20 in the Rehabilitation group and 19 in the Control group). Patients in the Rehabilitation Group had more frequently received invasive or non-invasive ventilation, had a longer length-of-stay in referring hospitals, had a higher number of comorbidities and displayed a worse performance at 6-minute-walking-test (6MWT) and Short-Physical-Performance-Battery-test (SPPB). FT3 values were lower at T0 in the Rehabilitation Group, while TSH and FT4 values were similar in the two groups. While no significant modifications in thyroid-function-parameters were observed in the Control Group, a significant increase in FT3 value was observed in the Rehabilitation Group at T1. Participants of both groups had improved the results of 6MWT at T1, while SPPB values improved only in the Rehabilitation Group.
COVID-19 patients after pulmonary rehabilitation experience an increase in FT3 values during follow-up, paralleled with an amelioration of functional capabilities.
患有严重 COVID-19 的患者常经历可在肺康复后改善的长期残疾。此外，严重 COVID-19 患者由于非甲状腺疾病综合征（NTIS）而表现出甲状腺功能改变。我们研究的目的是评估因 COVID-19 住院且有或无资格进行呼吸康复的患者的甲状腺功能参数及其在随访期间的变化。
评估了转诊至呼吸康复科的 COVID-19 后患者。门诊患者，无康复候选资格，被纳入对照组。完成 4 周康复计划的患者被纳入康复组。所有患者在 T0（对照组中出院后 4 周和康复组中完成康复后）和 T1（T0 后 3 个月）进行评估。
最终研究组包括 39 名患者（康复组 20 名，对照组 19 名）。康复组患者更频繁地接受有创或无创通气，在转院医院的住院时间更长，合并症更多，6 分钟步行试验（6MWT）和简短身体机能测试（SPPB）的表现更差。康复组 T0 时 FT3 值较低，而两组 TSH 和 FT4 值相似。对照组甲状腺功能参数无明显变化，而康复组 T1 时 FT3 值明显增加。两组患者的 6MWT 结果均在 T1 时改善，而 SPPB 值仅在康复组改善。
肺康复后 COVID-19 患者在随访期间 FT3 值增加，同时功能能力改善。
