Abstract
BackgroundThe outbreak of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide. SARS-CoV-2 has been found to cause multiple organ damage; however, little attention has been paid to the damage to the endocrine system caused by this virus, and the subsequent impact on prognosis. This may be the first research on the hypothalamic-pituitary-thyroid (HPT) axis and prognosis in coronavirus disease 2019 (COVID-19).MethodsIn this retrospective observational study, 235 patients were admitted to the hospital with laboratory-confirmed SARS-CoV-2 infection from 22 January to 17 March 2020. Clinical characteristics, laboratory findings, and treatments were obtained from electronic medical records with standard data collection forms and compared among patients with different thyroid function status.ResultsAmong 235 patients, 17 (7.23%) had subclinical hypothyroidism, 11 (4.68%) severe non-thyroidal illness syndrome (NTIS), and 23 (9.79%) mild to moderate NTIS. Composite endpoint events of each group, including mortality, admission to the ICU, and using IMV were observed. Compared with normal thyroid function, the hazard ratios (HRs) of composite endpoint events for mild to moderate NTIS, severe NTIS, subclinical hypothyroidism were 27.3 (95% confidence interval [CI] 7.07–105.7), 23.1 (95% CI 5.75–92.8), and 4.04 (95% CI 0.69–23.8) respectively. The multivariate-adjusted HRs for acute cardiac injury among patients with NTF, subclinical hypothyroidism, severe NTIS, and mild to moderate NTIS were 1.00, 1.68 (95% CI 0.56–5.05), 4.68 (95% CI 1.76–12.4), and 2.63 (95% CI 1.09–6.36) respectively.ConclusionsOur study shows that the suppression of the HPT axis could be a common complication in COVID-19 patients and an indicator of the severity of prognosis. Among the three different types of thyroid dysfunction with COVID-19, mild to moderate NTIS and severe NTIS have a higher risk of severe outcomes compared with subclinical hypothyroidism.
Highlights
The outbreak of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide
Our study shows that the suppression of the HPT axis could be a common complication in COVID-19 patients and an indicator of the severity of prognosis
Among the three different types of thyroid dysfunction with COVID-19, mild to moderate Non-thyroid illness syndrome (NTIS) and severe NTIS have a higher risk of severe outcomes compared with subclinical hypothyroidism
Summary
The outbreak of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide. SARS-CoV-2 has been found to cause multiple organ damage; little attention has been paid to the damage to the endocrine system caused by this virus, and the subsequent impact on prognosis This may be the first research on the hypothalamic-pituitary-thyroid (HPT) axis and prognosis in coronavirus disease 2019 (COVID-19). In a previous study on endocrine dysfunction caused by severe acute respiratory syndrome (SARS) [3], the hypothalamicpituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axis were candidate targets for SARS-CoV. SARS-CoV-2 could induce reversible thyroid dysfunction, and the low T3 syndrome could be associated with the severity of COVID-19 [7] These studies have shown that the HPT axis is altered in patients with SARS or COPD. Little is known about the relationship between COVID-19 and the HPT axis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
