Assessment of Thyroid Function Tests in Patients with COVID-19 Infection and Their Relationship with Euthyroid Sick Syndrome

Yıl 2022, Cilt: 4 Sayı: 1, 90 - 94, 01.01.2022

Hümeyra Aslaner , Ali Ramazan Benli , Adil Çetin , Zeliha Kaya Erten , Selçuk Mıstık , Yasin Şimşek

https://doi.org/10.37990/medr.982352

Öz

Aim: Thyroid functions are affected by many factors functions such as some infections and drugs. This study aimed to investigate how the thyroid function tests were affected after COVID-19 infection and their relationship with euthyroid sick syndrome.
Material and Method: Our study was designed as a retrospective and case-control study. The participants consisted of two groups as the control and patient groups. Thyroid function tests (TFT), hemogram and routine biochemistry of the groups were assessed. In addition, the tests of the patient group within the last 6 months before the infection were assessed. The patients’ symptoms, presence of a chronic disease, smoking history, and clinical status during COVID-19 infection were recorded.
Results: A total of 473 people were included in the study. Of the participants, 54.5% were female. The white blood count (WBC), hemoglobin (HGB), platelet (PLT), and neutrophil (NEU) counts were higher in the patient group. Lymphocyte (LY) and mean platelet volume (MPV) counts were similar. Tyroid stimulating hormone (TSH) and triiodothyronine (T3) values of the patients were higher compared with the control group. The thyroxine (T4) level was similar in the two groups.TSH, T3 and T4 levels of the patient group before COVID-19 were higher than the results just after the quarantine process after COVID-19 infection.
Conclusion: Thyroid dysfunction develops in COVID-19 patients within the course of the disease. This condition can be partially explained with the euthyroid sick syndrome. It is also possible with the thyroid gland being the direct or indirect target of the virus. 

Anahtar Kelimeler

Euthyroid Sick Syndrome, Thyroid Dysfunction, Covid-19

Kaynakça

• 1. E.N. Pearce, A.P. Farwell, L.E. Braverman, Thyroiditis. New England Journal of Medicine, 2003; 348 (26): 2646-2655.
• 2. D. Genç Demirağ , M. Pekkenç Abatay, İ. Karataş Eray, Enough to Remember: Subacute Thyroiditis, Ankara Med J. 2019; 19(1): 210-212.
• 3. R.M. Ruggeri, A, Campennì, M. Siracus, G. Frazzetto, D. Gullo, Subacute thyroiditis in a patient infected with SARS-COV-2: an endocrine complication linked to the COVID-19 pandemic. Hormones, 2021;20(1): 219-221.
• 4. IJ. Chopra, JM. Hershman, WM. Pardridge, JT. Nicoloff, Thyroidfunction in nonthyroidalillness. AnnInternMed 1983; 98:946-52.
• 5. L. Wawrzynska, A. Sakowicz ,S. Filipecki, Euthyroid sick syndrome with respiratory failure. Pneumonol Alergol Pol 1996; 64:193-199.
• 6. U. Tellini, L. Pellizzari, B. Pravadelli, Euthyroid sick syndrome in patients with respiratory failure. MinervaMed 1999; 90: 111-21.
• 7. M. Girvent , S. Maestro, Hernandez R, et al. Euthyroid sick syndrome, associated endocrine abnormalities and outcome in elderly patients under going emergency operation. Surgery 1998; 123: 560-7.
• 8. T.Acter, N.Uddin,J. Das, A.Akhter, TR. Choudhury, S.Kim, Evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as coronavirus disease 2019 (COVID-19) pandemic: A global health emergency. Science of the Total Environment.2020;730,138996.
• 9. E. Worldmeter, Coronavirus Update (Live):2021 https://www.worldometers.info/coronavirus.
• 10. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19, 2020. https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
• 11. H.Aslaner, H.A. Aslaner, M.B. Gökçek, A.R. Benli, O.Yıldız. The effect of chronic diseases, age and gender on morbidity and mortality of covid-19 infection. Iranian Journal of Public Health, 2021;50(4), 721.
• 12. LI, Yong, et al. Organ function support in patients with coronavirus disease 2019: Tongji experience. Frontiers of medicine, 2020;14(2): 232, doi: 10.1007/s11684-020-0774-9.
• 13. W. Wang, X. Su, Y. Ding, W. Fan, J. Su, Z. Chen et al. Thyroid function abnormalities in COVID-19 patients. Frontiers of Endocrinology,2021;11,1-7.
• 14. B. Khoo, T. Tan, S. A. Clarke, E.G. Mills, B. Patel,M. Modi, W.S. Dhillo, Thyroid function before, during, and after COVID-19. The Journal of Clinical Endocrinology & Metabolism,2021;106(2),803-811.
• 15. Lania A, Sandri MT, Cellini M, Mirani M, Lavezzi E, Mazziotti G. Thyrotoxicosis in patients with COVID-19: the THYRCOV study. Eur J Endocrinol. 2020;183(4):381-387.
• 16. Ruggeri, R. M., Campennì, A., Siracusa, M., Frazzetto, G., & Gullo, D. Subacute thyroiditis in a patient infected with SARS-COV-2: an endocrine complication linked to the COVID-19 pandemic. Hormones, 2021;20(1), 219-221.
• 17. Dworakowska, D., Grossman, A. B., Thyroiddisease in the time of COVID-19. Endocrine, 2021;68, 471-474.
• 18. Chen M, Zhou W, Xu W. ThyroidFunction Analysis in 50 Patientswith COVID-19: A RetrospectiveStudy. Thyroid. 2021;31(1):8-11.
• 19. Muller I, Cannavaro D, Dazzi D, Covelli D, Mantovani G, Muscatello A, Ferrante E, Orsi E, Resi V, Longari V, Cuzzocrea M, Bandera A, Lazzaroni E, Dolci A, Ceriotti F, Re TE, Gori A, Arosio M, Salvi M. SARS-CoV-2-related atypicalthyroiditis. LancetDiabetesEndocrinol. 2020;8(9):739-741.
• 20. W. Gao, W. Guo, Y. Guo, M. Shi, G. Dong, G. Wang, Q. Ge, J. Zhu, X. Zhou.. Thyroidhormoneconcentrations in severelyorcriticallyillpatientswith COVİD-19. Journal of EndocrinologicalInvestigation 2021;44:5, 1031-1040.
• 21. Chan JF, Yip CC, To KK, Tang TH, Wong SC, Leung KH, et al. ImprovedMolecularDiagnosis of COVİD-19 bytheNovel, HighlySensitiveandSpecific COVİD-19-RdRp/Hel Real-Time ReverseTranscription-PCR Assay Validated In Vitroand with Clinical Specimens. J ClinMicrobiol,2020;58 (5):310-320.
• 22. Mehta, P., McAuley, D. F., Brown, M., Sanchez, E., Tattersall, R. S., & Manson, J. J. COVID-19: consider cytokine storm syndromes and immunosuppression. The lancet,2021; 395(10229), 1033-1034.
• 23. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol, 2017;39(5):529–39.
• 24. Fliers E, Bianco AC, Langouche L, Boelen A. Thyroid function in critically ill patients. Lancet Diabetes Endocrinol 2015; 3(10):816–25.
• 25. Van den Berghe G. Non-thyroidal illness in the ICU: a syndrome with different faces. Thyroid Off J Am Thyroid Assoc,2014;24(10):1456–65.
• 26. Harris A, Al Mushref M. Graves' Thyrotoxicosis Following SARS-CoV-2 Infection. AACE Clin Case Rep. 2021;7(1):14-16.
• 27. Tee, L. Y., Hajanto, S., & Rosario, B. H. COVID-19 complicated by Hashimoto’s thyroiditis. Singapore Med J, 2020;10.