ASSOCIATION OF THYROID FUNCTION TEST WITH POST-COVID-19 PCR-NEGATIVE PATIENTS
DOI:
https://doi.org/10.55519/JAMC-03-13472Keywords:
COVID-19, Hypothyroidism, Subclinical hypothyroidism, Thyroid functions, Thyroid hormoneAbstract
Background: Corona virus diseases-19 (COVID-19) infection has shown many complications in all organ systems, like thyroid gland, during the acute phase and in the post-COVID-19 period. The aim of this study was to find the risk of hypo-functioning thyroid gland during post COVID-19 period as a chronic complication for possible follow up and management implications. Methods: This combined retrospective-prospective study was conducted over a period of nine months at tertiary care hospitals, Ayub Medical Complex Abbottabad and King Abdullah Hospital, Mansehra. Through non-probability convenient sampling technique, data was collected from 160 records at the hospitals. Confirmed cases of COVID-19, after their consent, were measured for thyroid hormones at two, four and eight weeks. Data was analyzed using Chi-square test. p-value less than 0.05 was considered as significant. Results: Out of 160 study participants, majority 102 (63.75%) were males and 58 (36.25%) were females with mean age of study population of 47.41±14.29 years. The frequency of hypothyroidism decreased over eight weeks from 8 (38.09%) to 6 (28.57%). While subclinical hypothyroidism decreased from 14 (36.89%) to 12 (30.76%). There was a very highly significant (p= 0.0001) association between proportions of hypothyroidism, Euthyroid Sick Syndrome and Subclinical hypothyroidism, and proportions of euthyroid patients in post COVID-19 period over eight weeks. Conclusion: Subclinical hypothyroidism, overt hypothyroidism, Euthyroid Sick Syndrome, and thyrotoxicosis are manifestations of hypo functioning thyroid gland. There is a need to monitor patients over a period of as short as two weeks to two months and beyond for possible detection of these complications of COVID-19 for appropriate management.References
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42.
Pastor S, Molina Á, Sr., De Celis E. Thyrotoxic Crisis and COVID-19 Infection: An Extraordinary Case and Literature Review. Cureus. 2020;12(11):e11305.
Khatri A, Charlap E, Kim A. Subacute Thyroiditis from COVID-19 Infection: A Case Report and Review of Literature. Eur Thyroid J. 2021;9(6):324-8.
Yao XH, Li TY, He ZC, Ping YF, Liu HW, Yu SC, et al. [A pathological report of three COVID-19 cases by minimal invasive autopsies]. Zhonghua Bing Li Xue Za Zhi. 2020;49(5):411-7.
Cooper DS, Biondi B. Subclinical thyroid disease. Lancet. 2012;379(9821):1142-54.
Iitaka M, Momotani N, Hisaoka T, Noh JY, Ishikawa N, Ishii J, et al. TSH receptor antibody-associated thyroid dysfunction following subacute thyroiditis. Clin Endocrinol (Oxf). 1998;48(4):445-53.
Baldelli R, Nicastri E, Petrosillo N, Marchioni L, Gubbiotti A, Sperduti I, et al. Thyroid dysfunction in COVID-19 patients. J Endocrinol Invest. 2021;44(12):2735-9.
Campos-Barrera E, Alvarez-Cisneros T, Davalos-Fuentes M. Subacute Thyroiditis Associated with COVID-19. Case Rep Endocrinol. 2020;2020:8891539.
Brancatella A, Ricci D, Viola N, Sgrò D, Santini F, Latrofa F. Subacute Thyroiditis After Sars-COV-2 Infection. J Clin Endocrinol Metab. 2020;105(7).
Asfuroglu Kalkan E, Ates I. A case of subacute thyroiditis associated with Covid-19 infection. J Endocrinol Invest. 2020;43(8):1173-4.
Mattar SAM, Koh SJQ, Rama Chandran S, Cherng BPZ. Subacute thyroiditis associated with COVID-19. BMJ Case Rep. 2020;13(8).
Chakraborty U, Ghosh S, Chandra A, Ray AK. Subacute thyroiditis as a presenting manifestation of COVID-19: a report of an exceedingly rare clinical entity. BMJ Case Rep. 2020;13(12).
Su W, Zhao XQ, Wang M, Chen H, Li HW. Low T3 syndrome improves risk prediction of in-hospital cardiovascular death in patients with acute myocardial infarction. J Cardiol. 2018;72(3):215-9.
Zheng KI, Feng G, Liu WY, Targher G, Byrne CD, Zheng MH. Extrapulmonary complications of COVID-19: A multisystem disease? J Med Virol. 2021;93(1):323-35.
Xiong H, Yan P, Huang Q, Shuai T, Liu J, Zhu L, et al. A prognostic role for non-thyroidal illness syndrome in chronic renal failure:a systematic review and meta-analysis. Int J Surg. 2019;70:44-52.
Gao W, Guo W, Guo Y, Shi M, Dong G, Wang G, et al. Thyroid hormone concentrations in severely or critically ill patients with COVID-19. J Endocrinol Invest. 2021;44(5):1031-40.
Brancatella A, Ricci D, Cappellani D, Viola N, Sgrò D, Santini F, et al. Is Subacute Thyroiditis an Underestimated Manifestation of SARS-CoV-2 Infection? Insights From a Case Series. J Clin Endocrinol Metab. 2020;105(10).
Trimboli P, Cappelli C, Croce L, Scappaticcio L, Chiovato L, Rotondi M. COVID-19-Associated Subacute Thyroiditis: Evidence-Based Data From a Systematic Review. 2021;12.
Mondal S, DasGupta R, Lodh M, Ganguly A. Subacute thyroiditis following recovery from COVID-19 infection: novel clinical findings from an Eastern Indian cohort. Postgraduate Medical Journal. 2022:postgradmedj-2021-141429.
Dabas A, Singh H, Goswami B, Kumar K, Dubey A, Jhamb U, et al. Thyroid Dysfunction in COVID-19. Indian J Endocrinol Metab. 2021;25(3):198-201.
Liu J, Wu X, Lu F, Zhao L, Shi L, Xu F. Low T3 syndrome is a strong predictor of poor outcomes in patients with community-acquired pneumonia. Sci Rep. 2016;6:22271.
Guo J, Hong Y, Wang Z, Li Y. Prognostic Value of Thyroid Hormone FT3 in General Patients Admitted to the Intensive Care Unit. Biomed Res Int. 2020;2020:6329548.
Hercbergs A, Mousa SA, Davis PJ. Nonthyroidal Illness Syndrome and Thyroid Hormone Actions at Integrin αvβ3. The Journal of Clinical Endocrinology & Metabolism. 2018;103(4):1291-5.
Lania A, Sandri MT, Cellini M, Mirani M, Lavezzi E, Mazziotti G. Thyrotoxicosis in patients with COVID-19: the THYRCOV study. European Journal of Endocrinology. 2020;183(4):381-7.
Burekovic A, Halilovic D, Sahbaz A. Hypothyroidism and Subclinical Hypothyroidism as a Consequence of COVID-19 Infection. Med Arch. 2022;76(1):12-6.
Clausen CL, Rasmussen ÅK, Johannsen TH, Hilsted LM, Skakkebæk NE, Szecsi PB, et al. Thyroid function in COVID-19 and the association with cytokine levels and mortality. Endocrine Connections. 2021;10(10):1234-42.
Carlé A, Andersen SL, Boelaert K, Laurberg PJEjoe. Management of endocrine disease: subclinical thyrotoxicosis: prevalence, causes and choice of therapy. 2017;176(6):R325-R37.
Carella C, Mazziotti G, Amato G, Braverman L, Roti EJTJoCE, Metabolism. Interferon-α-related thyroid disease: Pathophysiological, epidemiological, and clinical aspects. 2004;89(8):3656-61.
Iyer PC, Cabanillas ME, Waguespack SG, Hu MI, Thosani S, Lavis VR, et al. Immune-related thyroiditis with immune checkpoint inhibitors. 2018;28(10):1243-51.
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