Outcomes of Patients With Hypothyroidism and COVID-19: A Retrospective Cohort Study

Maaike Van Gerwen,Mathilda Alsen,Joshua Barlow,Eric Genden,Douglas Tremblay,Leonard Naymagon,Christine Little,Catherine F Sinclair

doi:10.3389/fendo.2020.00565

Maaike Van Gerwen, Mathilda Alsen + Show 6 more

Open Access

https://doi.org/10.3389/fendo.2020.00565

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Abstract

Coronavirus diseases (COVID-19) is associated with high rates of morbidity and mortality and worse outcomes have been reported for various morbidities. The impact of pre-existing hypothyroidism on COVID-19 outcomes remains unknown. The aim of the present study was to identify a possible association between hypothyroidism and outcomes related to COVID-19 including hospitalization, need for mechanical ventilation, and all-cause mortality. All patients with a laboratory confirmed COVID-19 diagnosis in March 2020 in a large New York City health system were reviewed. Of the 3703 COVID-19 positive patients included in present study, 251 patients (6.8%) had pre-existing hypothyroidism and received thyroid hormone therapy. Hypothyroidism was not associated with increased risk of hospitalization [Adjusted Odds Ratio (ORadj): 1.23 (95% Confidence Interval (CI): 0.88- 1.70)], mechanical ventilation [ORadj: 1.17 (95% CI: 0.81–1.69)] nor death [ORadj: 1.07 (95% CI: 0.75–1.54)]. This study provides insight into the role of hypothyroidism on the outcomes of COVID-19 positive patients, indicating that no additional precautions or consultations are needed. However, future research into the potential complications of COVID-19 on the thyroid gland and function is warranted.

Highlights

Coronavirus disease (COVID-19), the disease caused by severe acute coronavirus 2 (SARS-CoV-2), has spread dramatically worldwide and is associated with high rates of morbidity and mortality [1, 2]
This large, retrospective cohort study showed that hypothyroidism is not associated with increased risk of Adjusted analysis* ORadj
The current recommendations by the American Thyroid Association (ATA) for patients with hypothyroidism are accurate and no additional precautions are needed for patients suffering from hypothyroidism

Summary

Introduction

Coronavirus disease (COVID-19), the disease caused by severe acute coronavirus 2 (SARS-CoV-2), has spread dramatically worldwide and is associated with high rates of morbidity and mortality [1, 2]. Male gender and the presence of multiple comorbidities have been identified as the main risk factors for more severe disease and worse outcomes [3, 4]. There is some epidemiological evidence that certain comorbidities are associated with worse outcomes. It has been established that angiotensin-converting enzyme-2 (ACE2) is the functional host receptor for SARS-CoV-2, ACE2 is expressed in various cells in different organs, including the thyroid gland [5, 6]. Data on thyroid function or thyroid pathology in COVID-19 patients is not yet available destruction of follicular cells was seen in an autopsy study of SARS infected

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