Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19
Abstract Background The outbreak of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide. SARS-CoV-2 has been found to cause multiple organ damage; however, little attention has been paid to the damage to the endocrine system caused by this virus, and the s...
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oai:doaj.org-article:bce9cae63b554aa2b94820f75685cbf12021-11-21T12:02:15ZSuppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-1910.1186/s12902-021-00896-21472-6823https://doaj.org/article/bce9cae63b554aa2b94820f75685cbf12021-11-01T00:00:00Zhttps://doi.org/10.1186/s12902-021-00896-2https://doaj.org/toc/1472-6823Abstract Background The outbreak of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide. SARS-CoV-2 has been found to cause multiple organ damage; however, little attention has been paid to the damage to the endocrine system caused by this virus, and the subsequent impact on prognosis. This may be the first research on the hypothalamic-pituitary-thyroid (HPT) axis and prognosis in coronavirus disease 2019 (COVID-19). Methods In this retrospective observational study, 235 patients were admitted to the hospital with laboratory-confirmed SARS-CoV-2 infection from 22 January to 17 March 2020. Clinical characteristics, laboratory findings, and treatments were obtained from electronic medical records with standard data collection forms and compared among patients with different thyroid function status. Results Among 235 patients, 17 (7.23%) had subclinical hypothyroidism, 11 (4.68%) severe non-thyroidal illness syndrome (NTIS), and 23 (9.79%) mild to moderate NTIS. Composite endpoint events of each group, including mortality, admission to the ICU, and using IMV were observed. Compared with normal thyroid function, the hazard ratios (HRs) of composite endpoint events for mild to moderate NTIS, severe NTIS, subclinical hypothyroidism were 27.3 (95% confidence interval [CI] 7.07–105.7), 23.1 (95% CI 5.75–92.8), and 4.04 (95% CI 0.69–23.8) respectively. The multivariate-adjusted HRs for acute cardiac injury among patients with NTF, subclinical hypothyroidism, severe NTIS, and mild to moderate NTIS were 1.00, 1.68 (95% CI 0.56–5.05), 4.68 (95% CI 1.76–12.4), and 2.63 (95% CI 1.09–6.36) respectively. Conclusions Our study shows that the suppression of the HPT axis could be a common complication in COVID-19 patients and an indicator of the severity of prognosis. Among the three different types of thyroid dysfunction with COVID-19, mild to moderate NTIS and severe NTIS have a higher risk of severe outcomes compared with subclinical hypothyroidism.Juan ZhengZhenhai CuiNingjie ShiShenghua TianTing ChenXueyu ZhongKangli QiuJiaoyue ZhangTianshu ZengLulu ChenHuiqing LiBMCarticleCoronavirus disease 2019Hypothalamic-pituitary-thyroid axisNon-thyroidal illness syndromeSubclinical hypothyroidismDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENBMC Endocrine Disorders, Vol 21, Iss 1, Pp 1-9 (2021) |
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DOAJ |
| collection |
DOAJ |
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EN |
| topic |
Coronavirus disease 2019 Hypothalamic-pituitary-thyroid axis Non-thyroidal illness syndrome Subclinical hypothyroidism Diseases of the endocrine glands. Clinical endocrinology RC648-665 |
| spellingShingle |
Coronavirus disease 2019 Hypothalamic-pituitary-thyroid axis Non-thyroidal illness syndrome Subclinical hypothyroidism Diseases of the endocrine glands. Clinical endocrinology RC648-665 Juan Zheng Zhenhai Cui Ningjie Shi Shenghua Tian Ting Chen Xueyu Zhong Kangli Qiu Jiaoyue Zhang Tianshu Zeng Lulu Chen Huiqing Li Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19 |
| description |
Abstract Background The outbreak of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide. SARS-CoV-2 has been found to cause multiple organ damage; however, little attention has been paid to the damage to the endocrine system caused by this virus, and the subsequent impact on prognosis. This may be the first research on the hypothalamic-pituitary-thyroid (HPT) axis and prognosis in coronavirus disease 2019 (COVID-19). Methods In this retrospective observational study, 235 patients were admitted to the hospital with laboratory-confirmed SARS-CoV-2 infection from 22 January to 17 March 2020. Clinical characteristics, laboratory findings, and treatments were obtained from electronic medical records with standard data collection forms and compared among patients with different thyroid function status. Results Among 235 patients, 17 (7.23%) had subclinical hypothyroidism, 11 (4.68%) severe non-thyroidal illness syndrome (NTIS), and 23 (9.79%) mild to moderate NTIS. Composite endpoint events of each group, including mortality, admission to the ICU, and using IMV were observed. Compared with normal thyroid function, the hazard ratios (HRs) of composite endpoint events for mild to moderate NTIS, severe NTIS, subclinical hypothyroidism were 27.3 (95% confidence interval [CI] 7.07–105.7), 23.1 (95% CI 5.75–92.8), and 4.04 (95% CI 0.69–23.8) respectively. The multivariate-adjusted HRs for acute cardiac injury among patients with NTF, subclinical hypothyroidism, severe NTIS, and mild to moderate NTIS were 1.00, 1.68 (95% CI 0.56–5.05), 4.68 (95% CI 1.76–12.4), and 2.63 (95% CI 1.09–6.36) respectively. Conclusions Our study shows that the suppression of the HPT axis could be a common complication in COVID-19 patients and an indicator of the severity of prognosis. Among the three different types of thyroid dysfunction with COVID-19, mild to moderate NTIS and severe NTIS have a higher risk of severe outcomes compared with subclinical hypothyroidism. |
| format |
article |
| author |
Juan Zheng Zhenhai Cui Ningjie Shi Shenghua Tian Ting Chen Xueyu Zhong Kangli Qiu Jiaoyue Zhang Tianshu Zeng Lulu Chen Huiqing Li |
| author_facet |
Juan Zheng Zhenhai Cui Ningjie Shi Shenghua Tian Ting Chen Xueyu Zhong Kangli Qiu Jiaoyue Zhang Tianshu Zeng Lulu Chen Huiqing Li |
| author_sort |
Juan Zheng |
| title |
Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19 |
| title_short |
Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19 |
| title_full |
Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19 |
| title_fullStr |
Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19 |
| title_full_unstemmed |
Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19 |
| title_sort |
suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with covid-19 |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/bce9cae63b554aa2b94820f75685cbf1 |
| work_keys_str_mv |
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| _version_ |
1718419327210749952 |