Zhong Mingyao, Gao Yue, Hu Hongling, Zhu Xuan, Gan Lulu, Li Ling, Xiang Cheng, Yan Yimin, Dai Zhe
Department of Endocrinology, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, The Central Hospital of Xiaogan, Xiaogan, Hubei, China.
Department of Internal Medicine, Medical College of Wuhan University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2023 Jul 13;14:1154007. doi: 10.3389/fendo.2023.1154007. eCollection 2023.
To investigate the relationship of low T3 syndrome with disease severity in patients with COVID-19.
The clinical data of 145 patients with COVID-19 were retrospectively collected, and patients were divided into a low T3 group and a normal T3 group. Logistic regression models were used to assess predictive performance of FT3. Receiver operating characteristic (ROC) analysis was used to evaluate the use of low T3 syndrome in predicting critical disease. Kaplan-Meier analysis was used to analyze the impact of low T3 syndrome on mortality.
The prevalence of low T3 level among COVID-19 patients was 34.48%. The low T3 group was older, and had lower levels of hemoglobin, lymphocytes, prealbumin, and albumin, but higher levels of white blood cells, neutrophils, CRP, ESR, and D-dimer (all <0.05). The low T3 group had greater prevalences of critical disease and mortality (all 0.05). Multivariate logistic regression analysis showed that the Lymphocytes, free T3 (FT3), and D-dimer were independent risk factors for disease severity in patients with COVID-19. ROC analysis showed that FT3, lymphocyte count, and D-dimer, and all three parameters together provided reliable predictions of critical disease. Kaplan-Meier analysis showed the low T3 group had increased mortality (<0.001). Six patients in the low T3 group and one patient in the normal T3 group died. All 42 patients whose T3 levels were measured after recovery had normal levels after discharge.
Patients with COVID-19 may have transient low T3 syndrome at admission, and this may be useful for predicting critical illness.
探讨新型冠状病毒肺炎（COVID-19）患者低T3综合征与疾病严重程度的关系。
回顾性收集145例COVID-19患者的临床资料，将患者分为低T3组和正常T3组。采用Logistic回归模型评估游离三碘甲状腺原氨酸（FT3）的预测性能。采用受试者工作特征（ROC）分析评估低T3综合征对危重症的预测价值。采用Kaplan-Meier分析低T3综合征对死亡率的影响。
COVID-19患者中低T3水平的患病率为34.48%。低T3组患者年龄较大，血红蛋白、淋巴细胞、前白蛋白和白蛋白水平较低，但白细胞、中性粒细胞、C反应蛋白（CRP）、红细胞沉降率（ESR）和D-二聚体水平较高（均P<0.05）。低T3组危重症和死亡率的患病率更高（均P<0.05）。多因素Logistic回归分析显示，淋巴细胞、FT3和D-二聚体是COVID-19患者疾病严重程度的独立危险因素。ROC分析显示，FT3、淋巴细胞计数和D-二聚体以及这三个参数共同对危重症有可靠的预测价值。Kaplan-Meier分析显示低T3组死亡率增加（P<0.001）。低T3组有6例患者死亡，正常T3组有1例患者死亡。所有42例康复后检测T3水平的患者出院后T水平均正常。
COVID-19患者入院时可能存在短暂的低T3综合征，这可能有助于预测危重症。
