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Euthyroid sick syndrome as an early surrogate marker of poor outcome in mild SARS-CoV-2 disease.
Sparano, C; Zago, E; Morettini, A; Nozzoli, C; Yannas, D; Adornato, V; Caldini, E; Vaudo, M; Maggi, M; Petrone, L.
  • Sparano C; Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
  • Zago E; Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
  • Morettini A; Internal Medicine Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Nozzoli C; Internal Medicine Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Yannas D; Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
  • Adornato V; Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
  • Caldini E; Internal Medicine Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Vaudo M; Internal Medicine Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Maggi M; Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
  • Petrone L; Consorzio I.N.B.B, 00136, Rome, Italy.
J Endocrinol Invest ; 45(4): 837-847, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1544615
ABSTRACT

BACKGROUND:

The new coronavirus 19 disease (COVID-19) represents the current worldwide emergency. According to past evidence, a simple biomarker, such as low free triiodothyronine (fT3) levels, within the framework of euthyroid sick syndrome (ESS), might help to identify patients with unfavourable outcomes.

OBJECTIVE:

Evaluation of ESS significance in hospitalized mild COVID-19 patients.

DESIGN:

Prospective study, from 1 April 2020 to 31 May 2021.

PARTICIPANTS:

COVID-19 patients with mild disease at hospital admission. MAIN

MEASURES:

At hospital admission, eligible patients underwent a complete thyroid function evaluation. Subjects with previous thyroid disease or with thyroid-interfering medications were excluded. Levels of fT3 were correlated to biochemical markers and to patient outcome, the latter considered as favourable in the event of infection recovery and unfavourable in the event of death or transfer to an intensive care unit (ICU). KEY

RESULTS:

Of 600 screened patients, 506 were eligible for this study. Of those, 94 (19%) died during hospitalization and 80 (18%) required a transfer to ICU. The most frequent thyroid disorder was ESS (57%). Admission levels of fT3 were significantly lower within the unfavourable outcome subgroup (p < 0.001) and were negatively associated with several poor prognostic markers, including IL-6 (p < 0.001). In Kaplan-Meier and Cox regression analyses, fT3 was independently associated with poor outcome and death (p = 0.005 and p = 0.037, respectively). A critical fT3 threshold for levels < 2.7 pmol/l (sensitivity 69%, specificity 61%) was associated with a 3.5-fold increased risk of negative outcome (95%CI 2.34-5.34).

CONCLUSION:

Low fT3 levels, in the framework of ESS, resulted as being a valid predictor of unfavourable outcomes in a very early stage population of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Triiodothyronine / Euthyroid Sick Syndromes / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Endocrinol Invest Year: 2022 Document Type: Article Affiliation country: S40618-021-01714-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Triiodothyronine / Euthyroid Sick Syndromes / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Endocrinol Invest Year: 2022 Document Type: Article Affiliation country: S40618-021-01714-1