Skip to main content

ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1361479
This article is part of the Research Topic Endocrine Complications of COVID-19: Short and Long View all 8 articles

Association between thyroid function and prognosis of severe COVID-19 among patients with SARS-CoV-2 infection: a retrospective cohort study in China

Provisionally accepted
Yaling Yang Yaling Yang 1*Qian Lifang Qian Lifang 2Chenwei Wu Chenwei Wu 1Xinyue Xu Xinyue Xu 1Duoduo Qu Duoduo Qu 1Lihua Zhou Lihua Zhou 1Jia Liu Jia Liu 1Qin Zhu Qin Zhu 1Chunhong Wang Chunhong Wang 1Xiaolong Zhao Xiaolong Zhao 1*
  • 1 Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
  • 2 Qingpu Zhujiajiao People's Hospital, Shanghai, China

The final, formatted version of the article will be published soon.

    Objective: This study aims to examine the thyroid hormone profile and its association with severe coronavirus disease 2019 (COVID-19) in patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: This retrospective cohort study enrolled patients admitted to a tertiary hospital due to SARS-CoV-2 infection between February 18 and May 18, 2022. Clinical data were collected retrospectively from the electronic medical record system. Based on the thyroid function, patients were divided into five groups: normal, non-thyroid illness syndrome (NTIS), hypothyroidism, thyrotoxicosis, and unclassified. The association between thyroid function and severe COVID-19 was detected using multivariable logistic regression and restricted cubic splines analysis. Results: This study included 3,161 patients, with 7.7% of them developing severe COVID-19. 44.9% of the patients had normal thyroid function, 36.5% had NTIS, 6.7% had hypothyroidism, and 1.0% had thyrotoxicosis on admission. After adjusting for age, sex, and relevant clinical characteristics, NTIS and hypothyroidism were associated with increased risks of severe COVID-19 (odds ratio [OR] 2.38, 95% confidence interval [CI] 1.59-3.56 and OR 2.29, 95% CI 1.23-4.26, respectively), compared to normal thyroid function group. Among patients with NTIS or hypothyroidism, higher levels of total triiodothyronine (TT3) are associated with lower risks of severe COVID-19 (OR 0.73, 95% CI 0.64-0.82, for every 0.1nmol/L increase in TT3 level). Conclusion: Thyroid hormone profiles of NTIS or hypothyroidism are associated with increased risks of severe COVID-19. The decreased level of TT3 correlated with the increased risk of severe COVID-19 in patients with NTIS or hypothyroidism.

    Keywords: SARS-CoV-2, Severe COVID-19, Non-thyroid illness syndrome, Thyroid function, Total triiodothyronine

    Received: 26 Dec 2023; Accepted: 09 Sep 2024.

    Copyright: © 2024 Yang, Lifang, Wu, Xu, Qu, Zhou, Liu, Zhu, Wang and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Yaling Yang, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
    Xiaolong Zhao, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.