AUTHOR=Wei Jiaqi , Zhang Fenghua 

TITLE=Effects of SARS-CoV-2 infection on hypothyroidism and subclinical hypothyroidism: a meta-analysis

JOURNAL=Frontiers in Endocrinology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1291774

DOI=10.3389/fendo.2023.1291774

ISSN=1664-2392

ABSTRACT=<sec><title>Background</title><p>In recent years, the outbreak of COVID-19 caused by SARS-CoV-2 has been witnessed globally. However, the impact of SARS-CoV-2 infection on thyroid dysfunction and subclinical thyroid dysfunction remains unclear. Therefore, this meta-analysis aimed to assess the effects of SARS-CoV-2 infection on thyroid dysfunction and its relationship with the severity of COVID-19.</p></sec><sec><title>Methods</title><p>We systematically searched databases including PubMed, Willey Library, Embase, Web of Science, CNKI, Wanfang, and VIP. We focused on randomized controlled trials, case-control studies, and cohort studies published between December 2019 and August 2023, examining the association between SARS-CoV-2 infection and hypothyroidism, with a specific emphasis on the severity of the infection. The quality of the research was assessed using the Newcastle-Ottawa Scale (NOS), while statistical analysis was conducted using the meta and metafor packages in R 4.2.1 software.</p></sec><sec><title>Results</title><p>For the meta-analysis, a total of eight articles were identified based on strict inclusion and exclusion criteria. For the association between SARS-CoV-2 infection and hypothyroidism, three studies (266 samples) comparing TSH levels of COVID-19 and control groups showed no difference in TSH levels [SMD=-0.04,95%CI(-1.22,1.15),<italic>P=0.95</italic>]. Additionally, two studies examining TT3 (a sample of 176 cases) and two studies examining TT4 (a sample of 176 cases) also showed no difference in TT3 and TT4 between the COVID-19 group and the control group, respectively. However, when evaluating the severity of COVID-19, six studies (565 samples) showed that TSH in the severe group was significantly lower than in the mild group [SMD = -0.55, 95% CI (-0.96, -0.14)], while FT3 was also lower in the severe group [SMD = -0.96, 95% CI (-1.24, -0.67)]. No noticeable differences were observed between the severe and mild groups in their TT3, FT4, and TT4 levels.</p></sec><sec><title>Conclusion</title><p>SARS-CoV-2 infection may have detrimental effects on thyroid function in individuals with severe symptoms. More research is needed to confirm and explore this relationship.</p></sec><sec><title>Systematic Review Registration</title><p><uri xlink:href="https://www.crd.york.ac.uk/PROSPERO" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/PROSPERO</uri>, identifier CRD42023486042.</p></sec>