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Meta-Analysis
. 2022 May;16(5):102464.
doi: 10.1016/j.dsx.2022.102464. Epub 2022 Mar 18.

The prognostic values of thyroid disorders in predicting COVID-19 composite poor outcomes: A systematic review and meta-analysis

Hikmat Permana  1 , Erwin Affandi Soeriadi  2 , Fachreza Aryo Damara  3 , Nanny Natalia Mulyani Soetedjo  4
Affiliations
Meta-Analysis

The prognostic values of thyroid disorders in predicting COVID-19 composite poor outcomes: A systematic review and meta-analysis

Hikmat Permana et al. Diabetes Metab Syndr. 2022 May.

Abstract

Background and aims: In this meta-analysis, we aimed to evaluate the prognostic properties of thyroid disorder during admission on poor prognosis and factors that may influence the relationship in patients with COVID-19.

Methods: A systematic literature search of PubMed, EBSCO, and CENTRAL was conducted from inception to August 27, 2021. The main exposure was unspecified and specified thyroid disorders-hypothyroidism or hypothyroidism. The outcome of interest was the COVID-19 composite poor outcome that comprises of severity, mortality, ICU admission, and hospitalization.

Results: There were 24,734 patients from 20 studies. Meta-analysis showed that thyroid disorder was associated with composite poor outcome (OR 2.87 (95% CI 2.04-4.04), p < 0.001; I2 = 62.4%, p < 0.001). Meta regression showed that age (p = 0.047) and hypertension (p = 0.01), but not gender (p = 0.15), DM (p = 0.10), CAD/CVD (p = 0.38), obesity (p = 0.84), and COPD (p = 0.07) affected the association. Subgroup analysis showed that thyroid disorder increased risk of severe COVID-19 (OR 5.13 (95% CI 3.22-8.17), p < 0.05; I2 = 0%, p = 0.70) and mortality (OR 2.78 (95%CI 1.31-5.90), p < 0.05; I2 = 80%, p < 0.01). Pooled diagnostic analysis of thyroid disorder yielded a sensitivity of 0.22 (0.13-0.35), specificity of 0.92 (0.87-0.95), and AUC of 0.72. The probability of poor outcome was 38% in patients with thyroid disorder and 15% in patients without thyroid abnormality.

Conclusion: On-admission thyroid disorder was associated with poor prognosis in COVID-19 patients.

Keywords: COVID-19; Hypothyroidism; Prognosis; Thyroid disorder.

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Conflict of interest statement

Declaration of competing interest The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA literature search flowchart.
Fig. 2
Fig. 2
Pooled sensitivity and specificity of thyroid disorders for COVID-19 poor outcomes.
Fig. 3
Fig. 3
Summary receiver operating characteristics (SROC) of thyroid disorders for COVID-19 composite poor outcome.
Fig. 4
Fig. 4
Fagan's nomogram analysis elucidating the post-test probability of the presence of thyroid disorders in predicting COVID-19 poor outcomes.
See this image and copyright information in PMC

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