Thyroid disease and hypothyroidism are associated with poor COVID-19 outcomes: A systematic review, meta-analysis, and meta-regression

Background and aims: Coronavirus disease (COVID-19) still becomes a global burden that affected people in different groups. The aim of this study was to evaluate the association between thyroid disease and the outcome of COVID-19 patients. Method: This was a meta-analysis study from articles obtained through a systematic literature search to investigate the relationship between thyroid disease and COVID-19 outcomes. Composite poor outcomes comprised of severity, mortality, intensive care unit (ICU) admission, and hospitalization. Results: A total of 31339 patients from 21 studies included in this study. Thyroid disorder was associated with increased composite poor outcome (risk ratio (RR) 1.87 [95% confidence interval (CI) 1.53, 2.27], p < 0.001; 12 = 84%, p < 0.01), this included higher disease severity (RR 1.92 [1.40, 2.63], p < 0.05; 12 = 86%, p < 0.01), ICU admission (RR 1.61 [1.12, 2.32], p > 0.05; 12 = 32%, p < 0.05), mortality (RR 2.43 [1.44, 4.13], p < 0.05; 12 = 83%, p < 0.01), and hospitalization (RR 1.28 [1.17, 1.39], p < 0.05; 12 = 0%, p < 0.96). Meta-regression analysis indicated that age (p = 0.002) was a significant influence that affects the association. Also, the presence of unspecified thyroid disease (RR 1.91 [1.38, 2.65], p < 0.05; 12 = 81%, p < 0.01) and hypothyroidism (RR 1.90 [1.45, 2.55], p < 0.05; 12 = 85%, p < 0.01) during admission were associated with poor outcomes. Conclusion: Thyroid abnormalities increased the risk of COVID-19 composite poor outcomes and were influenced by the patient's age. Abnormal thyroid and hypothyroidism, but not hyperthyroidism, were associated with poor COVID-19 outcomes. (C) 2021 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Automated summary

This study found that patients with thyroid disorders are more likely to experience severe illness, mortality, ICU admission, and hospitalization in COVID-19 patients. Age is a significant factor influencing this association.