Permana Hikmat, Soeriadi Erwin Affandi, Damara Fachreza Aryo, Soetedjo Nanny Natalia Mulyani
Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
Department of Nuclear Medicine, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
Indian J Endocrinol Metab. 2022 Nov-Dec;26(6):510-517. doi: 10.4103/ijem.ijem_20_22. Epub 2022 Dec 20.
The relationship between thyroid metabolism and coronavirus disease 2019 (COVID-19) inflammation has been extensively investigated. This meta-analysis aimed to evaluate the prognostic properties of unspecified thyroid disorders, hypothyroidism and hyperthyroidism for predicting poor COVID-19 outcomes.
We conducted systematic literature searching through multiple databases-PubMed, EBSCO and CENTRAL up until 27 September 2021. The main exposure was unspecified thyroid disorders, hypothyroidism or hypothyroidism on-admission status. The outcome of interest was the COVID-19 composite poor outcome that comprises severity, mortality, ICU admission and hospitalisation.
There were 24517 patients from 20 studies. Meta-analysis showed that thyroid disorder, regardless of its type, was associated with COVID-19 poor outcome (OR 2.92 (95% CI 2.09 - 4.08), < 0.001; = 71%, < 0.001). Unspecified thyroid disorder has a sensitivity of 0.17 (0.08-0.33), specificity of 0.94 (0.88-0.97) and Area Under Curve (AUC) of 0.66. Hypothyroidism has a sensitivity of 0.24 (0.12-0.42), specificity of 0.92 (0.87-0.96) and AUC of 0.77. Hyperthyroidism has a sensitivity of 0.05 (0.02-0.11), specificity of 0.98 (0.88-1.00) and AUC of 0.36. In this pooled analysis, the posttest probability of unspecified thyroid disease, hypothyroidism and hyperthyroidism were 42%, 27% and 8% for poor outcomes, respectively.
Thyroid disorders are associated with poor COVID-19 prognosis.
甲状腺代谢与2019冠状病毒病（COVID-19）炎症之间的关系已得到广泛研究。本荟萃分析旨在评估未明确的甲状腺疾病、甲状腺功能减退和甲状腺功能亢进对预测COVID-19不良结局的预后特性。
我们通过多个数据库——PubMed、EBSCO和CENTRAL进行系统文献检索，截至2021年9月27日。主要暴露因素为未明确的甲状腺疾病、甲状腺功能减退或入院时甲状腺功能减退状态。感兴趣的结局是COVID-19综合不良结局，包括严重程度、死亡率、入住重症监护病房（ICU）和住院情况。
来自20项研究的24517名患者。荟萃分析表明，无论甲状腺疾病类型如何，均与COVID-19不良结局相关（比值比[OR]为2.92[95%置信区间（CI）为2.09 - 4.08]，P<0.001；I² = 71%，P<0.001）。未明确的甲状腺疾病敏感性为0.17（0.08 - 0.33），特异性为0.94（0.88 - 0.97），曲线下面积（AUC）为0.66。甲状腺功能减退敏感性为0.24（0.12 - 0.42），特异性为0.92（0.87 - 0.96），AUC为0.77。甲状腺功能亢进敏感性为0.05（0.02 - 0.11），特异性为0.98（0.88 - 1.00），AUC为0.36。在这项汇总分析中，未明确的甲状腺疾病、甲状腺功能减退和甲状腺功能亢进导致不良结局的检验后概率分别为42%、27%和8%。
甲状腺疾病与COVID-19预后不良相关。
