Association between Thyroid Function and Prognosis of COVID-19: A Retrospective Observational Study. (2nd October 2021)

• Record Type: Journal Article
• Authors: Lang, Shan; Liu, Ye; Qu, Xue; Lu, Ran; Fu, Wei; Zhang, Wenhui; Wang, Haining; Hong, Tianpei
• Is Part Of: Endocrine research. Volume 46:Number 4(2021)
• Page Start: 170
• Page End: 177
• Publication Date: 2021-10-02
• Subjects: COVID-19 -- thyroid hormone -- free triiodothyronine -- euthyroid sick syndrome -- mortality; Endocrinology, Experimental -- Periodicals; Endocrinology -- Periodicals; Endocrinology -- Periodicals; Research -- Periodicals; 616.4
• DOI: 10.1080/07435800.2021.1924770
• Languages: English
• ISSNs: 0743-5800

Abstract

ABSTRACT: Background : Coronavirus disease 2019 (COVID-19) is a severe infectious illness. It has been reported that COVID-19 has an effect on thyroid function. However, the association between thyroid function and prognosis of COVID-19 is still unclear. Methods : This retrospective study included patients with COVID-19 admitted to Tongji Hospital in Wuhan from January 28 to April 4, 2020. Demographic, epidemiological, clinical, laboratory, treatment, and outcome data were collected from patients with laboratory-confirmed COVID-19. Patients without history of thyroid disease who had a thyroid function test at admission were enrolled in the final analysis. Risk factors of in-hospital death were explored using univariable and multivariable Cox regression analyses. Survival differences were assessed with Kaplan–Meier curves and log-rank test. Results : A total of 127 patients were included in this study, with 116 survivors and 11 non-survivors. The serum levels of thyroid stimulating hormone (TSH) [0.8 (0.5–1.7) vs . 1.9 (1.0–3.1) μIU/mL, P = .031] and free triiodothyronine (FT3 ) [2.9 (2.8–3.1) vs . 4.2 (3.5–4.7) pmol/L, P < .001] were lower in non-survivors than in survivors, and a low FT3 state (defined as FT3 < 3.1 pmol/L) at admission accounted for a higher proportion in non-survivors than in survivors (72.7% vs . 11.2%, P < .001). Univariate Cox regression analysis showed that FT3 level (HR 0.213, 95% CI: 0.101–0.451, P < .001) and the low FT3 state (HR 14.607, 95% CI: 3.873–55.081, P < .001) were negatively and positively associated with the risk of in-hospital death, respectively. Furthermore, multivariate Cox regression analysis revealed that a low FT3 state was associated with an increased risk of in-hospital death after adjusting for confounding factors (HR 13.288, 95% CI: 1.089–162.110, P = .043). Moreover, Kaplan-Meier curves indicated a lower survival probability in COVID-19 patients with a low FT3 status. Conclusion : Serum FT3 level is lower in non-survivors among moderate-to-critical patients with COVID-19, and the low FT3 state is associated with an increased risk of in-hospital mortality of COVID-19.