Evaluation of the Relationship Between Hashimoto's Thyroiditis and the Course of COVID-19 Infection

Yıl 2021, , 803 - 809, 27.12.2021

Hasret Cengiz , Taner Demirci , Ceyhun Varım

https://doi.org/10.31832/smj.976529

Öz

Objectives: Coronavirus infection (COVID-19) has caused a worldwide pandemic and affected many systems. Hashimoto's Thyroiditis is one of the most common diseases in the community and is the prototype of autoimmune thyroid diseases. It is unknown how thyroid autoimmunity and thyroid dysfunction will affect the course of COVID-19. The aim of this study is to show the course of this infection in patients with Hashimoto's Thyroiditis.
Materials and Methods: A descriptive study was conducted in which adult patients with Hashimoto's Thyroiditis who received COVID-19 infection from April to October 2020 in our center were recruited retrospectivelly. Those with severe comorbid conditions that may affect the course of the disease,and using immunomodulatory and immunosuppressive drugs, and pregnant women were not included in the study.
Results: A total of 232 patients included. Median (IQR=interquartile) age value was 43 (34-54), and the male/female ratio was 21/211 (9.1%/90.9%). In our study, mortality due to COVID-19 in our patients was found to be consistent with the normal population in their age group (1,7%, n:4), and 7 patients were treated in the intensive care unit. A significant negative correlation was found between Anti-Tyroglobuline Antibody (Anti-Tg) and White Blood Cell (WBC) (r=-0.189, p=0.041), Neutrophil (r=-0.191, p=0.040), Neutrophil to Lymphocyte Ratio (NLR) (r=-0.244, p=0.008), Ferritin (r=-0.259, p=0.042).
Conclusion: The rate of patients with supressed Thyroid Stimulating Hormone (TSH) in intensive care unit was slightly higher, but since the number of events was low, this finding could not gain significance. Most patients with Hashimoto's Thyroiditis have had a mild infection. Thyroid autoimmunity does not appear to affect the COVID-19 infection’s course.

Anahtar Kelimeler

COVID-19, Hashimoto, Autoimmune Thyroid Disease

Hashimoto Tiroiditi ile COVID-19 Enfeksiyonu Gidişatı Arasındaki İlişkinin İncelenmesi

Öz

Amaç: Coronavirus enfeksiyonu (COVID-19) dünya çapında bir pandemiye yol açmış ve pek çok sistemi etkilemiştir. Hashimoto Tiroiditi toplumda sık görülen hastalıklardan birisi ve otoimmun tiroid hastalıklarının prototipidir. Tiroid otoimmunitesi ve tiroid fonksiyon bozukluğunun COVID-19 seyrini nasıl etkileyeceği bilinmemektedir.Bu çalışmadaki amaç bu enfeksiyonun Hashimoto Tiroiditi hastalarındaki seyrini göstermektir.
Gereç ve Yöntemler: Merkezimizde Nisan-Ekim 2020 tarihleri arasında gelen COVID-19 enfeksiyonu geçirmiş erişkin Hashimoto Tiroiditi hastalarının alındığı tanımlayıcı bir çalışma yapıldı. Hastalığın gidişatını etkileyebilecek ağır komorbid durumları olanlar ve immunmodülatuar ve immunsupresif ilaç kullanan kişiler ve gebeler çalışmaya alınmadı.
Bulgular: Total 232 hastada Median (IQR=interquartile) yaş değeri 43 (34-54),Erkek/kadın oranı 21/211 (9.1%/90.9%) idi. Hastalarımızda COVID-19 nedeni ile mortalite kendi yaş gruplarındaki normal toplum ile uyumlu (%1,7,n:4) bulunmuş olup 7 hasta yoğun bakımda tedavi görmüştür. Anti-Tiroglobulin Antikoru (Anti-Tg) ile Beyaz Kan Hücreleri (r=-0.189, p=0.041), Nötrofil (r=-0.191, p=0.040), Nötrofil-Lenfosit Oranı (r=-0.244, p=0.008) ve Ferritin (r=-0.259, p=0.042) ile arasında anlamlı düzeyde negatif korelasyon ilişkisi saptanmıştır.
Sonuç: Yoğun bakıma alınan hastalarda Tiroid Stimulan Hormonu (TSH) baskılı olanların oranı biraz yüksek çıkmış fakat vaka sayısı düşük olduğundan anlamlılık kazanmamıştır.Hashimoto Tiroiditi hastalarının çoğu enfeksiyonu hafif geçirmiştir. Tiroid otoimmunitesi COVID-19 enfeksiyonu seyrini etkilemiyor gibi görünmektedir.

Anahtar Kelimeler

COVID-19, Hashimoto Tiroiditi;, Otoimmun Tiroid Hastalığı

Kaynakça

• Chen W, Tian Y, Li Z, Zhu J, Wei T, Lei J. Potential Interaction Between SARS-CoV-2 and Thyroid: A Review. Endocrinology. 2021;162(3):bqab004.
• Duntas LH, Jonklaas J. COVID-19 and Thyroid Diseases: A Bidirectional Impact. J Endocr Soc. 2021;5(8):bvab076.
• Li MY, Li L, Zhang Y, Wang XS. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 2020;9(1):45.
• Șandru F, Carsote M, Petca RC, Gheorghisan-Galateanu AA, Petca A, Valea A, et al. COVID-19-related thyroid conditions (Review). Exp Ther Med. 2021;22(1):756.
• Ragusa F, Fallahi P, Elia G, Gonnella D, Paparo SR ,Giusti C,et al. Hashimotos’ Thyroiditis: Epidemiology Pathogenesis Clinic and Therapy. Best Pract Res Clin Endocrinol Metab. 2019;33(6):101367.
• Dworakowska D, Grossman AB. Thyroid disease in the time of COVID-19.Endocrine. 2020;68(3):471-474.
• Speer G, Somogyi P. Thyroid complications of SARS and coronavirus disease 2019 (COVID-19).Endocr J. 2021;68(2):129-136.
• Kakodkar P, Kaka N, Baig MN. A comprehensive literature review on the clinical presentation, and management of the pandemic coronavirus disease 2019 (COVID-19). Cureus 2020;12(4):e7560.
• Stokes EK, Zambrano LD, Anderson KN, Marder EP,Raz KM, Felix SEB.et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep.2020;69(24):759-765.
• Cunningham JW, Vaduganathan M, Claggett BL, Jering KS, Bhatt AS, Rosenthal N Clinical Outcomes in Young US Adults Hospitalized With COVID-19. JAMA Intern Med.2020;181(3):379-381.
• Güner R, Hasanoğlu İ, Kayaaslan B, Aypak A, Kaya Kalem A, Eser F et al. COVID-19 experience of the major pandemic response center in the capital: results of the pandemic's first month in Turkey.Turk J Med Sci. 2020;50(8):1801-1809.
• Coperchini F, Chiovato L,Croce L,Magri F,Rotondi M. The cytokine storm in Covid-19: an overview of the involvement ofthe chemokine/chemokine-receptor system. Cytokine Growth Factor Rev.2020;53:25-32.
• Muller I,Cannavaro D, Dazzi D, Covelli D,Mantovani G,Muscatello A. et al. SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrinol.2020;8(9):739-741.
• Zhang Y, Lin F, Tu W, Zhang J, Choudhry AA, Ahmed O.et al Thyroid dysfunction may be associated with poor outcomes in patients with COVID-19. medical team from Xiangya Hospital to support Hubei, China. Mol Cell Endocrinol. 2021;521:111097.
• Georges JL, Cochet H, Roger G,Jemaa HB, Soltani J, Azowa J-B et al. [Association of hypertension and antihypertensive agents and the severity of COVID-19 pneumonia. A monocentric French prospective study]. Ann Cardiol Angeiol (Paris).2020;69(5):247-254.
• Hariyanto TI, Kurniawan A. Thyroid disease is associated with severe coronavirus disease 2019 (COVID-19) infection.Diabetes Metab Syndr. 2020;14(5):1429-1430.
• Lagadinou M, Zareifopoulos N, Karela A, Kyriakopoulou O, Velissaris D. Are patients with autoimmune disease at greater risk of developing severe COVID-19? J Clin Med Res.2020;12(8):539-41.
• Daraei M, Hasibi M, Abdollahi H, Hazaveh MM, Zebaradst J, Hajinoori M, et al Possible role of hypothyroidism in the prognosis of COVID-19. Intern Med J.2020;50(11):1410-1412.
• Van Gerwen M, Alsen M, Little C,Barlow J ,Genden E, Naymagon L,et al. Risk factors and outcomes of COVID-19 in New York City; a retrospective cohort study. J Med Virol.2021;93(2):907-915.
• Brix TH, Hegedüs L, Hallas J, Lund LC. Risk and course of SARS-CoV-2 infection in patients treated for hypothyroidism and hyperthyroidism.Lancet Diabetes Endocrinol.2021 ;9(4):197-199.
• Güven M, Gültekin H. The prognostic impact of thyroid disorders on the clinical severity of COVID-19: Results of single-centre pandemic hospital. Int J Clin Pract. 2021 ;75(6):e14129.
• Lisco G, De Tullio A, Jirillo E, Giagulli VA, De Pergola G, Guastamacchia E et al. Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects.J Endocrinol Invest. 2021;25:1-14.