Does COVID-19 affect thyroid more than non-COVID-19 infections? A retrospective study

Y. Ucal, M. Serdar, H. Karpuzoğlu, Neval Yurttutan Uyar, M. Kilercik, Mustafa Serteser, A. Ozpinar
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Abstract

To evaluate the thyroid hormone levels and infection markers in COVID-19 patients and compare them to those in non-COVID-19 patients with infection in a large retrospective dataset. In this study, thyroid-stimulating hormone (TSH), thyroid hormones (free T3 and free T4), and several infection markers were reviewed. The study group was divided into three groups that had no thyroid-related disorders: control patients (Group 0; n=7,981), COVID-19 patients (Group 1; n=222), and non-COVID-19 patients with infection (Group 2; n=477). The data were assessed for correlation and group comparisons. There was a reduction in median (25th–75th percentile) fT3 levels in COVID-19 patients 4.17 pmol/L (3.46–4.85) compared to non-COVID-19 patients with infection 4.65 pmol/L (4.12–5.15), p<0.0001. We detected a negative correlation between fT3 and neutrophil-to-lymphocyte ratio (NLR) in Group 1 (r=−0.534) and Group 2 (r=−0.346) (p<0.0001), indicating a relatively stronger link between fT3 and NLR in COVID-19 patients than non-COVID-19 patients with infection. Additionally, the fT3 levels remained significantly different between study groups when the model was adjusted for age, gender, and infection markers. COVID-19 and non-COVID-19 infections are associated with low fT3 levels, which likely represent the suppression of the hypothalamic-pituitary-thyroid axis from non-thyroidal illness syndrome.
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COVID-19对甲状腺的影响是否大于非COVID-19感染?一项回顾性研究
评估COVID-19患者的甲状腺激素水平和感染标志物,并在一个大型回顾性数据集中将其与非COVID-19感染患者的甲状腺激素水平和感染标志物进行比较。 本研究回顾了促甲状腺激素(TSH)、甲状腺激素(游离 T3 和游离 T4)和几种感染指标。研究组被分为三组,每组都没有甲状腺相关疾病:对照组患者(0组;人数=7981)、COVID-19患者(1组;人数=222)和非COVID-19感染患者(2组;人数=477)。对数据进行了相关性评估和分组比较。 COVID-19 患者的 fT3 水平中位数(第 25-75 百分位数)为 4.17 pmol/L (3.46-4.85),而非 COVID-19 感染者为 4.65 pmol/L (4.12-5.15),P<0.0001。我们发现,在第一组(r=-0.534)和第二组(r=-0.346)中,fT3 与中性粒细胞-淋巴细胞比率(NLR)呈负相关(p<0.0001),这表明 COVID-19 患者的 fT3 与 NLR 之间的联系比非 COVID-19 感染患者相对更强。此外,根据年龄、性别和感染指标调整模型后,研究组间的 fT3 水平仍有显著差异。 COVID-19和非COVID-19感染与低fT3水平有关,这可能代表了非甲状腺疾病综合征对下丘脑-垂体-甲状腺轴的抑制。
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