Thyroid function abnormalities in COVID-19 patients

ABSTRACT

BackgroundThe novel coronavirus COVID-19, has caused a worldwide pandemic, impairing several human organs and systems. Whether COVID-19 affects human thyroid function remains unknown. Methods84 hospitalized COVID-19 patients in the First Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China) were respectively enrolled in this study. In addition, 91 other patients with pneumonia and 807 healthy subjects were included as controls. FindingsWe found that the levels of TT3 and TSH were lower in COVID-19 patients than control groups (p<0{middle dot}001). Within the group of COVID-19 patients, 61.9% patients (52/84) presented with thyroid function abnormalities. We found a larger proportion of patients in severe condition exhibited thyroid dysfunction than mild/moderate cases (74{middle dot}6% vs. 23{middle dot}8%, p < 0{middle dot}001). Patients with thyroid dysfunction tended to have increased interval time for negative conversion of viral nucleic acid (14{middle dot}1 {+/-} 9{middle dot}4 vs. 10{middle dot}6 {+/-} 8{middle dot}3 days, p = 0{middle dot}088). To note, thyroid dysfunction was also associated with decreased lymphocytes (p < 0{middle dot}001) and increased CRP (p = 0{middle dot}002). In 7 patients with dynamic changes of thyroid function, we observed the levels of TT3 and TSH gradually increased and reached normal range without thyroid hormone replacement at Day 30 post-admission. The correlation between TT3 and TSH level seemed to be positive rather than negative in the early stage, and gradually turned to be negatively related over time. InterpretationsThyroid function abnormalities are common in COVID-19 patients, especially in severe cases. This might be caused by virus attack and damage to the thyroid-pituitary axis. Therefore, more attention should be paid to thyroid function during treatment of COVID-19, and close follow-up is also needed after discharge. FundingThis study was supported by Zhejiang Provincial Science and technology department key R & D plan emergency project (No. 2020c03123-8).