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

• Published in: Diabetes & metabolic syndrome clinical research & reviews Vol. 16; no. 5; p. 102464
• Main Authors: Permana, Hikmat, Soeriadi, Erwin Affandi, Damara, Fachreza Aryo, Mulyani Soetedjo, Nanny Natalia
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.05.2022; Diabetes India. Published by Elsevier Ltd
• Subjects: COVID-19; COVID-19 - diagnosis; COVID-19 - epidemiology; Humans; Hypothyroidism; Prognosis; Reviews and Meta-analysis; SARS-CoV-2; Thyroid Diseases - complications; Thyroid Diseases - diagnosis; Thyroid Diseases - epidemiology; Thyroid disorder; COVID-19; Thyroid disorder; Prognosis; Hypothyroidism
• ISSN: 1871-4021; 1878-0334
• DOI: 10.1016/j.dsx.2022.102464

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. 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. 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. On-admission thyroid disorder was associated with poor prognosis in COVID-19 patients. •Thyroid disorder was associated with three-fold higher odds of developing poor COVID-19 outcomes.•Thyroid disorder has a sensitivity of 22% and specificity of 92% with AUC of 0.72 for poor outcomes in COVID 19.•The results of this meta-analysis may be affected by heterogeneity and publication bias.