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 Ã, 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.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Abid Ali Khwaj, Sabahat Asghar, Samman Khurshid, Noreen Taj, Rubina Faisal Paul, Fozia Jehangir
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
