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Non-thyroidal illness syndrome and SARS-CoV-2-associated multisystem inflammatory syndrome in children.
Calcaterra, V; Biganzoli, G; Dilillo, D; Mannarino, S; Fiori, L; Pelizzo, G; Zoia, E; Fabiano, V; Carlucci, P; Camporesi, A; Corti, C; Mercurio, G; Izzo, F; Biganzoli, E; Zuccotti, G.
  • Calcaterra V; Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Via Aselli 2, 27100, Pavia, Italy. valeria.calcaterra@unipv.it.
  • Biganzoli G; Pediatric Department, "V. Buzzi" Children's Hospital, 20154, Milan, Italy. valeria.calcaterra@unipv.it.
  • Dilillo D; Pharmacogenomics and Precision Therapeutics Master Degree, University of Milan, 20142, Milan, Italy.
  • Mannarino S; Pediatric Department, "V. Buzzi" Children's Hospital, 20154, Milan, Italy.
  • Fiori L; Pediatric Cardiology Unit, "Vittore Buzzi" Children's Hospital, 20154, Milano, Italy.
  • Pelizzo G; Pediatric Department, "V. Buzzi" Children's Hospital, 20154, Milan, Italy.
  • Zoia E; Pediatric Surgery Department, "Vittore Buzzi" Children's Hospital, University of Milan, 20154, Milan, Italy.
  • Fabiano V; Anesthesia and Intensive Care Unit, "Vittore Buzzi" Children's Hospital, 20154, Milano, Italy.
  • Carlucci P; Pediatric Department, "V. Buzzi" Children's Hospital, 20154, Milan, Italy.
  • Camporesi A; Department of Biomedical and Clinical Science "L. Sacco", University of Milan, 20157, Milan, Italy.
  • Corti C; Pediatric Department, "V. Buzzi" Children's Hospital, 20154, Milan, Italy.
  • Mercurio G; Anesthesia and Intensive Care Unit, "Vittore Buzzi" Children's Hospital, 20154, Milano, Italy.
  • Izzo F; Pediatric Cardiology Unit, "Vittore Buzzi" Children's Hospital, 20154, Milano, Italy.
  • Biganzoli E; Pediatric Department, "V. Buzzi" Children's Hospital, 20154, Milan, Italy.
  • Zuccotti G; Anesthesia and Intensive Care Unit, "Vittore Buzzi" Children's Hospital, 20154, Milano, Italy.
J Endocrinol Invest ; 45(1): 199-208, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1326868
ABSTRACT

PURPOSE:

COVID-19 disease may result in a severe multisystem inflammatory syndrome in children (MIS-C), which in turn may alter thyroid function (TF). We assessed TF in MIS-C, evaluating its impact on disease severity.

METHODS:

We retrospectively considered children admitted with MIS-C to a single pediatric hospital in Milan (November 2019-January 2021). Non-thyroidal illness syndrome (NTIS) was defined as any abnormality in TF tests (FT3, FT4, TSH) in the presence of critical illness and absence of a pre-existing hormonal abnormality. We devised a disease severity score by combining severity scores for each organ involved. Glucose and lipid profiles were also considered. A principal component analysis (PCA) was performed, to characterize the mutual association patterns between TF and disease severity.

RESULTS:

Of 26 (19 M/7F) patients, median age 10.7 (IQR 5.8-13.3) years, 23 (88.4%) presented with NTIS. A low FT3 level was noted in 15/23 (65.3%), while the other subjects had varying combinations of hormone abnormalities (8/23, 34.7%). Mutually correlated variables related to organ damage and inflammation were represented in the first dimension (PC1) of the PCA. FT3, FT4 and total cholesterol were positively correlated and characterized the second axis (PC2). The third axis (PC3) was characterized by the association of triglycerides, TyG index and HDL cholesterol. TF appeared to be related to lipemic and peripheral insulin resistance profiles. A possible association between catabolic components and severity score was also noted.

CONCLUSIONS:

A low FT3 level is common among MIS-C. TF may be useful to define the impact of MIS-C on children's health and help delineate long term follow-up management and prognosis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Euthyroid Sick Syndromes / Systemic Inflammatory Response Syndrome / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: J Endocrinol Invest Year: 2022 Document Type: Article Affiliation country: S40618-021-01647-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Euthyroid Sick Syndromes / Systemic Inflammatory Response Syndrome / SARS-CoV-2 / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: J Endocrinol Invest Year: 2022 Document Type: Article Affiliation country: S40618-021-01647-9