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- Publisher Website: 10.1210/clinem/dgaa813
- Scopus: eid_2-s2.0-85100357954
- PMID: 33141191
- WOS: WOS:000637325300073
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Article: Thyroid Dysfunction in Relation to Immune Profile, Disease Status, and Outcome in 191 Patients with COVID-19
Title | Thyroid Dysfunction in Relation to Immune Profile, Disease Status, and Outcome in 191 Patients with COVID-19 |
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Authors | |
Keywords | COVID-19 SARS-CoV-2 Thyroid function tests Thyroiditis Euthyroid sick syndromes Thyroid gland |
Issue Date | 2021 |
Publisher | Oxford University Press. The Journal's web site is located at https://academic.oup.com/jcem |
Citation | The Journal of Clinical Endocrinology & Metabolism, 2021, v. 106 n. 2, p. e926-e935 How to Cite? |
Abstract | Objective:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related thyroiditis is increasingly recognized. The role of thyroid autoimmunity and SARS-CoV-2 viral load in SARS-CoV-2–related thyroid dysfunction is unclear. We evaluated the thyroid function of a cohort of coronavirus disease 2019 (COVID-19) patients, in relation to their clinical features, and biochemical, immunological, and inflammatory markers.
Methods:
Consecutive adult patients, without known thyroid disorders, admitted to Queen Mary Hospital for COVID-19 from July 21 to August 21, 2020, were included. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine (fT3), and antithyroid antibodies were measured on admission.
Results:
Among 191 patients with COVID-19 (mean age 53.5 ± 17.2 years; 51.8% male), 84.3% were mild, 12.6% were moderate, and 3.1% were severe. Abnormal thyroid function was seen in 13.1%. Ten patients had isolated low TSH, suggestive of subclinical thyrotoxicosis due to thyroiditis, although the contribution of autoimmunity was likely in 2 of them. Autoimmune thyroiditis probably also contributed to subclinical hypothyroidism in another patient. Ten patients had isolated low fT3, likely representing nonthyroidal illness syndrome. Lower SARS-Cov-2 polymerase chain reaction cycle threshold values and elevated C-reactive protein were independently associated with occurrence of low TSH (P = .030) and low fT3 (P = .007), respectively. A decreasing trend of fT3 with increasing COVID-19 severity (P = .032) was found. Patients with low fT3 had more adverse COVID-19-related outcomes.
Conclusion:
Around 15% of patients with mild to moderate COVID-19 had thyroid dysfunction. There may be a direct effect of SARS-CoV-2 on thyroid function, potentially leading to exacerbation of pre-existing autoimmune thyroid disease. Low fT3, associated with systemic inflammation, may have a prognostic significance. |
Persistent Identifier | http://hdl.handle.net/10722/294097 |
ISSN | 2021 Impact Factor: 6.134 2020 SCImago Journal Rankings: 2.206 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lui, DTW | - |
dc.contributor.author | Lee, CH | - |
dc.contributor.author | Chow, WS | - |
dc.contributor.author | Lee, ACH | - |
dc.contributor.author | Tam, AR | - |
dc.contributor.author | Fong, CHY | - |
dc.contributor.author | Law, CY | - |
dc.contributor.author | Leung, EKH | - |
dc.contributor.author | To, KKW | - |
dc.contributor.author | Tan, KCB | - |
dc.contributor.author | Woo, YC | - |
dc.contributor.author | Lam, CW | - |
dc.contributor.author | Hung, IFN | - |
dc.contributor.author | Lam, KSL | - |
dc.date.accessioned | 2020-11-23T08:26:17Z | - |
dc.date.available | 2020-11-23T08:26:17Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | The Journal of Clinical Endocrinology & Metabolism, 2021, v. 106 n. 2, p. e926-e935 | - |
dc.identifier.issn | 0021-972X | - |
dc.identifier.uri | http://hdl.handle.net/10722/294097 | - |
dc.description.abstract | Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related thyroiditis is increasingly recognized. The role of thyroid autoimmunity and SARS-CoV-2 viral load in SARS-CoV-2–related thyroid dysfunction is unclear. We evaluated the thyroid function of a cohort of coronavirus disease 2019 (COVID-19) patients, in relation to their clinical features, and biochemical, immunological, and inflammatory markers. Methods: Consecutive adult patients, without known thyroid disorders, admitted to Queen Mary Hospital for COVID-19 from July 21 to August 21, 2020, were included. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine (fT3), and antithyroid antibodies were measured on admission. Results: Among 191 patients with COVID-19 (mean age 53.5 ± 17.2 years; 51.8% male), 84.3% were mild, 12.6% were moderate, and 3.1% were severe. Abnormal thyroid function was seen in 13.1%. Ten patients had isolated low TSH, suggestive of subclinical thyrotoxicosis due to thyroiditis, although the contribution of autoimmunity was likely in 2 of them. Autoimmune thyroiditis probably also contributed to subclinical hypothyroidism in another patient. Ten patients had isolated low fT3, likely representing nonthyroidal illness syndrome. Lower SARS-Cov-2 polymerase chain reaction cycle threshold values and elevated C-reactive protein were independently associated with occurrence of low TSH (P = .030) and low fT3 (P = .007), respectively. A decreasing trend of fT3 with increasing COVID-19 severity (P = .032) was found. Patients with low fT3 had more adverse COVID-19-related outcomes. Conclusion: Around 15% of patients with mild to moderate COVID-19 had thyroid dysfunction. There may be a direct effect of SARS-CoV-2 on thyroid function, potentially leading to exacerbation of pre-existing autoimmune thyroid disease. Low fT3, associated with systemic inflammation, may have a prognostic significance. | - |
dc.language | eng | - |
dc.publisher | Oxford University Press. The Journal's web site is located at https://academic.oup.com/jcem | - |
dc.relation.ispartof | The Journal of Clinical Endocrinology & Metabolism | - |
dc.subject | COVID-19 | - |
dc.subject | SARS-CoV-2 | - |
dc.subject | Thyroid function tests | - |
dc.subject | Thyroiditis | - |
dc.subject | Euthyroid sick syndromes | - |
dc.subject | Thyroid gland | - |
dc.title | Thyroid Dysfunction in Relation to Immune Profile, Disease Status, and Outcome in 191 Patients with COVID-19 | - |
dc.type | Article | - |
dc.identifier.email | Lui, DTW: dtwlui@hku.hk | - |
dc.identifier.email | Lee, CH: pchlee@hku.hk | - |
dc.identifier.email | Chow, WS: chowws01@hkucc.hku.hk | - |
dc.identifier.email | Lee, ACH: achlee@hku.hk | - |
dc.identifier.email | Fong, CHY: kalofong@hku.hk | - |
dc.identifier.email | To, KKW: kelvinto@hku.hk | - |
dc.identifier.email | Tan, KCB: kcbtan@hkucc.hku.hk | - |
dc.identifier.email | Woo, YC: wooyucho@hku.hk | - |
dc.identifier.email | Lam, CW: ching-wanlam@pathology.hku.hk | - |
dc.identifier.email | Hung, IFN: ivanhung@hkucc.hku.hk | - |
dc.identifier.email | Lam, KSL: ksllam@hku.hk | - |
dc.identifier.authority | Lui, DTW=rp02803 | - |
dc.identifier.authority | Lee, CH=rp02043 | - |
dc.identifier.authority | To, KKW=rp01384 | - |
dc.identifier.authority | Tan, KCB=rp00402 | - |
dc.identifier.authority | Lam, CW=rp00260 | - |
dc.identifier.authority | Hung, IFN=rp00508 | - |
dc.identifier.authority | Lam, KSL=rp00343 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1210/clinem/dgaa813 | - |
dc.identifier.pmid | 33141191 | - |
dc.identifier.pmcid | PMC7665541 | - |
dc.identifier.scopus | eid_2-s2.0-85100357954 | - |
dc.identifier.hkuros | 318962 | - |
dc.identifier.hkuros | 323131 | - |
dc.identifier.volume | 106 | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | e926 | - |
dc.identifier.epage | e935 | - |
dc.identifier.isi | WOS:000637325300073 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0021-972X | - |