Euthyroid Sick Syndrome in Patients With COVID-19

• Published in: Frontiers in endocrinology (Lausanne) Vol. 11; p. 566439
• Main Authors: Zou, Runmei, Wu, Chenfang, Zhang, Siye, Wang, Guyi, Zhang, Quan, Yu, Bo, Wu, Ying, Dong, Haiyun, Wu, Guobao, Wu, Shangjie, Zhong, Yanjun
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 07.10.2020
• Subjects: Adult; Aged; Aged, 80 and over; Betacoronavirus - isolation & purification; C-reactive protein; China - epidemiology; Coronavirus Disease 2019 (COVID-19); Coronavirus Infections - epidemiology; Coronavirus Infections - immunology; Coronavirus Infections - mortality; Coronavirus Infections - virology; COVID-19; disease severity; Endocrinology; euthyroid sick syndrome; Euthyroid Sick Syndromes - complications; Female; Humans; Male; Middle Aged; Pandemics; Pneumonia, Viral - epidemiology; Pneumonia, Viral - immunology; Pneumonia, Viral - mortality; Pneumonia, Viral - virology; Prognosis; Retrospective Studies; SARS-CoV-2; Severity of Illness Index; Survival Rate; thyroid function; Thyroid Function Tests; Young Adult; China; thyroid function; C-reactive protein; Coronavirus Disease 2019 (COVID-19); euthyroid sick syndrome; disease severity
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2020.566439

Coronavirus disease 2019 (COVID-19) has been shown to affect almost every organ throughout the body. However, it is not clear whether the thyroid gland is impaired in COVID-19 patients. Euthyroid sick syndrome (ESS) is usually associated with the disease severity and deterioration prognosis in critical illness. In this study, the thyroid function of COVID-19 patients was assessed and factors associated with outcomes were analyzed to determine the potential predictive value of ESS. Clinical and laboratory data of COVID-19 patients with or without ESS in Changsha, China, were collected and analyzed on admission. Kaplan-Meier curve and cox regression model were utilized to determine the correlation between ESS and the endpoints. Subsequently, a receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performances of FT3 and C-reactive protein (CRP) in the disease severity. Forty-one (27.52%) cases of COVID-19 patients diagnosed with ESS. ESS patients had higher proportions of fever, shortness of breath, hypertension, diabetes, and severe events than those of non-ESS patients. The levels of erythrocyte sedimentation rate and C-reactive protein, and the positive rate of procalcitonin were significantly higher, whereas the lymphocyte count was apparently lower in ESS patients than in non-ESS patients. The regression analysis showed that ESS was significantly associated with the disease severity of COVID-19 (HR = 2.515, 95% CI: 1.050-6.026, = 0.039). The areas under the curve (AUCs) for predicting the severe disease were [0.809 (95% CI 0.727-0.892), < 0.001] and [0.792 (95% CI 0.689-0.895), < 0.001] for FT3 and CRP, respectively. ESS was significantly associated with the disease severity and inflammatory parameters in COVID-19 patients.