Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, China.
Front Endocrinol (Lausanne). 2024 Jul 16;15:1412320. doi: 10.3389/fendo.2024.1412320. eCollection 2024.
SARS-CoV-2 can invade the thyroid gland. This study was to delineate the risk of thyroid dysfunction amidst the prevalence of the Omicron variant, and to investigate the correlation between thyroid function and Coronavirus disease 2019 (COVID-19) outcomes. The study also aimed to ascertain whether thyroid dysfunction persisted during COVID-19 recovery phase.
This was a retrospective cohort study. COVID-19 patients from the Renmin Hospital of Wuhan University, China during the epidemic of Omicron variants were included, and their thyroid function were analyzed in groups.
A history of thyroid disease was not associated with COVID-19 outcomes. COVID-19 can lead to a bimodal distribution of thyroid dysfunction. The severity of COVID-19 was inversely proportional to the levels of thyroid- stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), leading to a higher prevalence of thyroid dysfunction. Severe COVID-19 was a risk factor for euthyroid sick syndrome (ESS) (OR=22.5, 95% CI, 12.1 - 45.6). Neutrophil to lymphocyte ratio mediated the association between severe COVID-19 and ESS (mediation effect ratio = 41.3%, p < 0.001). ESS and decreased indicators of thyroid function were associated with COVID-19 mortality, while high levels of FT3 and FT4 exhibited a protective effect against death. This effect was more significant in women (p < 0.05). During the recovery period, hyperthyroidism was quite uncommon, while a small percentage of individuals (7.7%) continued to exhibit hypothyroidism.
COVID-19 severity was linked to thyroid dysfunction. Severe COVID-19 increased the risk of ESS, which was associated with COVID-19 mortality. Post-recovery, hyperthyroidism was rare, but some individuals continued to have hypothyroidism.
SARS-CoV-2 可侵犯甲状腺。本研究旨在描述奥密克戎变异株流行期间甲状腺功能障碍的风险，并探讨甲状腺功能与 2019 冠状病毒病（COVID-19）结局之间的相关性。本研究还旨在确定 COVID-19 恢复期是否存在持续的甲状腺功能障碍。
这是一项回顾性队列研究。纳入了中国武汉大学人民医院 COVID-19 奥密克戎变异株流行期间的 COVID-19 患者，并对其甲状腺功能进行分组分析。
有甲状腺疾病史与 COVID-19 结局无关。COVID-19 可导致甲状腺功能障碍呈双峰分布。COVID-19 的严重程度与促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）水平呈反比，导致甲状腺功能障碍的发生率更高。重症 COVID-19 是甲状腺功能正常的病态综合征（ESS）的危险因素（OR=22.5，95%CI，12.1-45.6）。中性粒细胞与淋巴细胞比值介导了重症 COVID-19 与 ESS 之间的关联（中介效应比=41.3%，p<0.001）。ESS 和甲状腺功能降低指标与 COVID-19 死亡率相关，而 FT3 和 FT4 水平升高对死亡具有保护作用。在女性中，这种作用更为显著（p<0.05）。在恢复期，甲亢并不常见，而有一小部分患者（7.7%）仍存在甲状腺功能减退。
COVID-19 的严重程度与甲状腺功能障碍相关。重症 COVID-19 增加了 ESS 的风险，而 ESS 与 COVID-19 死亡率相关。恢复期后，甲亢罕见，但部分患者仍存在甲状腺功能减退。
