期刊
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
卷 106, 期 2, 页码 E803-E811出版社
ENDOCRINE SOC
DOI: 10.1210/clinem/dgaa830
关键词
COVID-19; SARS-CoV-2; thyroid function; thyroid gland
资金
- National Institute for Health Research (NIHR)
- NIHR Imperial Clinical Research Facility
- NIHR Imperial Biomedical Research Centre at Imperial College Healthcare NHS Trust
- UK Medical Research Council (MRC)
- Biotechnology and Biological Sciences Research Council
- NIHR
- JP Moulton Charitable Foundation
- MRC Clinical Research Training Fellowship [MR/T006242/1]
- NIHR Clinician Scientist Award [CS-2018-18-ST2-002]
- NIHR Professorship [RP-2014-05-001]
Most patients with COVID-19 present with euthyroidism. Mild reductions in TSH and FT4 were observed in COVID-19 patients, consistent with a nonthyroidal illness syndrome. In survivors of COVID-19, thyroid function tests at follow-up returned to baseline.
Context The effects of COVID-19 on the thyroid axis remain uncertain. Recent evidence has been conflicting, with both thyrotoxicosis and suppression of thyroid function reported. Objective We aimed to detail the acute effects of COVID-19 on thyroid function and determine if these effects persisted on recovery from COVID-19. Design A cohort observational study was conducted. Participants and Setting Adult patients admitted to Imperial College Healthcare National Health Service Trust, London, UK, with suspected COVID-19 between March 9 to April 22, 2020, were included, excluding those with preexisting thyroid disease and those missing either free thyroxine (FT4) or thyrotropin (TSH) measurements. Of 456 patients, 334 had COVID-19 and 122 did not. Main Outcome Measures TSH and FT4 measurements were recorded at admission, and where available, in 2019 and at COVID-19 follow-up. Results Most patients (86.6%) presenting with COVID-19 were euthyroid, with none presenting with overt thyrotoxicosis. Patients with COVID-19 had a lower admission TSH and FT4 compared to those without COVID-19. In the COVID-19 patients with matching baseline thyroid function tests from 2019 (n = 185 for TSH and 104 for FT4), TSH and FT4 both were reduced at admission compared to baseline. In a complete case analysis of COVID-19 patients with TSH measurements at follow-up, admission, and baseline (n = 55), TSH was seen to recover to baseline at follow-up. Conclusions Most patients with COVID-19 present with euthyroidism. We observed mild reductions in TSH and FT4 in keeping with a nonthyroidal illness syndrome. Furthermore, in survivors of COVID-19, thyroid function tests at follow-up returned to baseline.
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