COVID -19 Hastalarında Tiroid Hormon Seviyelerinin Değerlendirilmesi

Year 2022, Volume: 55 Issue: 2, 86 - 88, 31.08.2022

Mina Gülfem Kaya , Recep Alanlı

https://doi.org/10.20492/aeahtd.1052222

Abstract

AMAÇ: COVID-19 birçok sistemi etkilediği gibi endokrin sistemi de etkilemektedir. Bu çalışmada; COVID-19 servisinde yatan hastaların, tiroid hormon düzeyi ile hastalık şidde-ti arasındaki ilişkiyi değerlendirmek amaçlandı.
GEREÇ VE YÖNTEM: Mart 2020 ile Kasım 2020 tarihleri arasında COVID-19 PCR testi pozitif saptanıp, hastaneye yatırılan ve yoğun bakım ihtiyacı olmayan hastalar, retrospek-tif olarak değerlendirildi. Çalışmaya 93 COVID-19 hastası ve benzer yaş ve cinsiyette olan 58 kontrol grubu alındı. COVID-19 ve kontrol grubunun demografik özellikleri, tiroid hormon seviyeleri ve diğer laboratuvar değerleri karşılaştırıldı. COVID-19 saptanan has-talar akciğer tomografi bulgularına göre; akciğer tutulumu olanlar ve olmayanlar olarak iki gruba ayrıldı.
BULGULAR: COVID 19 grubunda, serbest T3 ve serbest T4 düzeyleri, kontrol grubun-dan anlamlı olarak daha düşük saptanırken, TSH ve T3/T4 oranı arasında fark saptan-madı. COVID-19 olup, akciğer tutulumu eşlik edenlerde, akciğer tutulumu olmayanlara göre; yaş, aspartat aminotransferaz, C- reaktif protein ve laktat dehidrogenaz değerleri daha yüksek,
serbest T3, nötrofil ve lenfosit sayısı ile albümin değeri ise daha düşük saptandı. Pnömo-ni varlığı ile serbest T3 seviyeleri arasında ilişki saptandı.
SONUÇ: COVID-19 seyri sırasında hastalığın şiddetine bağlı olarak tiroid fonksiyonları değişebilir. Hastanede yatan hastalarda tiroid fonksiyon testlerini ölçmek hastalığın prognozu hakkında fikir verebilir.

Keywords

COVID-19, tiroid, tiroid dışı hastalık sendromu

Supporting Institution

yok

Project Number

yok

Thanks

yok

Assessment of Thyroid Hormone Levels in COVID -19 Patients

Abstract

OBJECTIVE: As COVID-19 affects many systems, it also affects the endocrine system. In this study, it was aimed to evaluate the relationship between thyroid hormone level and disease severity of patients hospitalized in the COVID-19 service.
MATERIALS AND METHODS: Between March 2020 and November 2020 hospitalized patients with positive COVID-19 PCR test and without need for intensive care were evaluated retrospectively. The study included 93 COVID-19 patients and 58 in control group of similar age and gender. Demographic characteristics, thyroid hormone levels and other laboratory values of COVID-19 and control group were compared. Patients with COVID-19 were divided into two groups as those with or without lung involvement according to the chest tomography findings.
RESULTS: In the COVID 19 group free T3 and free T4 levels were found to be significantly lower than the control group, while no difference was found between TSH and T3/T4 ratio. In patients with COVID-19 and lung involvement age, aspartate aminotransferase, C-reactive protein and lactate dehydrogenase values were higher; free T3, neutrophil and lymphocyte counts and albumin levels were found to be lower compared to those without lung involvement. There was a correlation between the presence of pneumonia and free T3 levels.
CONCLUSION: In the course of COVID-19, thyroid functions can change depending on the severity of the disease. Assessment of thyroid function tests in hospitalized patients may give an idea about the prognosis of the disease.

Keywords

thyroid, COVID-19, non-thyroidal illness syndrome

Project Number

yok

References

• Referans1.Tang X, Du RH, Wang R, Cao TZ, Guan LL, Yang CQ et al (2020) Comparison of hospi-talized patients with ARDS caused by COVID-19 and H1N1. Chest 158(1):195–205
• Referans 2.R. Baldelli, E. Nicastri, N. Petrosillo et al.Thyroid dysfunction in COVID-19 patients Jo-urnal of Endocrinological Investigation volume 44, pages2735–2739 (2021)
• Referans 3. 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 Apr 28;9(1):45. doi: 10.1186/s40249-020-00662-x.
• Referans 4. 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 Jun;75(6): e14129. doi: 10.1111/ijcp.14129.
• Referans 5. Brancatella A, Ricci D, Viola N, Sgrò D, Santini F, Latrofa F. Subacute Thyroiditis After Sars-COV-2 Infection. J Clin Endocrinol Metab. 2020 Jul 1;105(7): dgaa276. doi: 10.1210/clinem/dgaa276
• Referans 6. Asfuroglu Kalkan E, Ates I. A case of subacute thyroiditis associated with Covid-19 infection. J Endocrinol Invest. 2020 Aug;43(8):1173-1174. doi: 10.1007/s40618-020-01316-3.
• Referans 7. Chen M, Zhou W, Xu W. Thyroid Function Analysis in 50 Patients with COVID-19: A Retrospective Study. Thyroid. 2021 Jan;31(1):8-11. doi: 10.1089/thy.2020.0363.
• Referans 8. David Tak Wai Lui, Chi Ho Lee, Wing Sun Chow et al. Role of non-thyroidal illness syndrome in predicting adverse outcomes in COVID-19 patients predominantly of mild-tomoderate severity Clin Endocrinol (Oxf). 2021 Sep;95(3):469-477. doi: 10.1111/cen.14476.
• Referans 9. Leow MK, Kwek DS, Ng AW, Ong KC, Kaw GJ, Lee LS. Hypocortisolism in survivors of severe acute respiratory syndrome (SARS). Clin Endocrinol (Oxf). 2005 Aug;63(2):197-202. doi: 10.1111/j.1365-2265.2005. 02325.x
• Referans 10. Tao Chen,Di Wu,1,Huilong Chen et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020; 368: m1091
• Referans 11.Wang F, Pan W, Wang H, Wang S, Pan S, et al. (2012) Relationship between thyroid function and ICU mortality: a prospective observation study. Crit Care 16: R11.
• Referans 12. Rothberger GD, Valestra PK, Knight K, Desai AK, Calixte R, et al. (2019) Low free T3 is associated with worse outcomes in patients in the ICU requiring invasive mechanical ventilation. J Intensive Care Med https://doi.org/ 10.1177/0885066619890822.
• Referans 13. Kim JG, Shin H, Kim W, Lim TH, Jang B, et al. (2018) The value of decreased thyroid hormone for predicting mortality in adult septic patients: a systematic review and meta-analysis. Sci Rep 8: 14137.
• Referans 14. Angelousi AG, Karageorgopoulos DE, Kapaskelis AM, Falagas ME (2011) Association between thyroid function tests at baseline and the outcome of patients with sepsis or septic shock: a systematic review. Eur J Endocrinol 164:147–155.
• Referans 15. Runmei Zou, Chenfang Wu,Siye Zhang et al. Euthyroid Sick Syndrome in Patients With COVID-19 Front Endocrinol (Lausanne) 2020 Oct 7;11:566439. doi: 10.3389/fendo.2020.566439.
• Referans 16. Aziz M, Fatima R, Lee-Smith W, Assaly R. The association of low serum albumin level with severe COVID-19: a systematic review and meta-analysis. Crit Care. 2020 May 26;24(1):255. doi: 10.1186/s13054-020-02995-3.
• Referans 17. Alanlı, R. , Küçükay, M. B. , Yalçın, S. & Beşirbellioğlu, B. A. (2020). COVID-19 pati-ents in an university hospital; clinical characteristics and relationship with accompanying diseases, a prospective study. Cumhuriyet Medical Journal, 42 (2), 185-191 . DOI: 10.7197/cmj.vi.756746