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. 2020 Oct 7:11:566439.
doi: 10.3389/fendo.2020.566439. eCollection 2020.

Euthyroid Sick Syndrome in Patients With COVID-19

Runmei Zou  1 , Chenfang Wu  2 , Siye Zhang  2 , Guyi Wang  2 , Quan Zhang  3 , Bo Yu  2 , Ying Wu  2 , Haiyun Dong  2 , Guobao Wu  2 , Shangjie Wu  4 , Yanjun Zhong  2
Affiliations

Euthyroid Sick Syndrome in Patients With COVID-19

Runmei Zou et al. Front Endocrinol (Lausanne). .

Abstract

Background: Coronavirus disease 2019 (COVID-19) has been shown to affect almost every organ throughout the body. However, it is not clear whether the thyroid gland is impaired in COVID-19 patients. Euthyroid sick syndrome (ESS) is usually associated with the disease severity and deterioration prognosis in critical illness. In this study, the thyroid function of COVID-19 patients was assessed and factors associated with outcomes were analyzed to determine the potential predictive value of ESS.

Methods: Clinical and laboratory data of COVID-19 patients with or without ESS in Changsha, China, were collected and analyzed on admission. Kaplan-Meier curve and cox regression model were utilized to determine the correlation between ESS and the endpoints. Subsequently, a receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performances of FT3 and C-reactive protein (CRP) in the disease severity.

Results: Forty-one (27.52%) cases of COVID-19 patients diagnosed with ESS. ESS patients had higher proportions of fever, shortness of breath, hypertension, diabetes, and severe events than those of non-ESS patients. The levels of erythrocyte sedimentation rate and C-reactive protein, and the positive rate of procalcitonin were significantly higher, whereas the lymphocyte count was apparently lower in ESS patients than in non-ESS patients. The regression analysis showed that ESS was significantly associated with the disease severity of COVID-19 (HR = 2.515, 95% CI: 1.050-6.026, P = 0.039). The areas under the curve (AUCs) for predicting the severe disease were [0.809 (95% CI 0.727-0.892), P < 0.001] and [0.792 (95% CI 0.689-0.895), P < 0.001] for FT3 and CRP, respectively.

Conclusion: ESS was significantly associated with the disease severity and inflammatory parameters in COVID-19 patients.

Keywords: C-reactive protein; Coronavirus Disease 2019 (COVID-19); disease severity; euthyroid sick syndrome; thyroid function.

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Figures

Figure 1
Figure 1
The time-dependent risk of reaching to the severe events.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curves showed that the areas under the curve (AUCs) were 0.809 and 0.792 for FT3 (A) and C reactive protein (B), respectively.
See this image and copyright information in PMC

Comment in

  • Commentary: Euthyroid Sick Syndrome in Patients With COVID-19.
    Laurino A, Gencarelli M, Buci L, Raimondi L. Laurino A, et al. Front Endocrinol (Lausanne). 2021 Feb 10;12:633097. doi: 10.3389/fendo.2021.633097. eCollection 2021. Front Endocrinol (Lausanne). 2021. PMID: 33688850 Free PMC article. No abstract available.

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