Thyroid Function Abnormalities in COVID-19 Patients

  1. Weibin Wang
  2. Xingyun Su
  3. Yongfeng Ding
  4. Weina Fan
  5. Weibin Zhou
  6. Junwei Su
  7. Zhendong Chen
  8. Hong Zhao
  9. Kaijin Xu
  10. Qin Ni
  11. Xiaowei Xu
  12. Yunqing Qiu
  13. Lisong Teng

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Abstract

The novel coronavirus COVID-19, has caused a worldwide pandemic, impairing several human organs and systems. Whether COVID-19 affects human thyroid function remains unknown.

Methods

Eighty-four hospitalized COVID-19 patients in the First Affiliated Hospital, Zhejiang University School of Medicine (Hangzhou, China) were retrospectively enrolled in this study, among which 22 cases had complete records of thyroid hormones. In addition, 91 other patients with pneumonia and 807 healthy subjects were included as controls.

Results

We found that levels of total triiodothyronine (TT3) and thyroid stimulating hormone (TSH) were lower in COVID-19 patients than healthy group (p < 0.001). Besides, TSH level in COVID-19 patients was obviously lower than non-COVID-19 patients (p < 0.001). Within the group of COVID-19, 61.9% (52/84) patients presented with thyroid function abnormalities and the proportion of thyroid dysfunction was higher in severe cases than mild/moderate cases (74.6 vs. 23.8%, p < 0.001). Patients with thyroid dysfunction tended to have longer viral nucleic acid cleaning time (14.1 ± 9.4 vs. 10.6 ± 8.3 days, p = 0.088). To note, thyroid dysfunction was also associated with decreased lymphocytes (p < 0.001) and increased CRP (p = 0.002). 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.

Conclusion

Thyroid function abnormalities are common in COVID-19 patients, especially in severe cases. This might be partially explained by nonthyroidal illness syndrome.

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  1. Version published to 10.3389/fendo.2020.623792
  2. Version published to 10.1101/2020.06.15.20130807v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2020.06.15.20130807: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: All the cases were obtained with informed consent.
    IRB: The research was approved by the Ethics Committee of the First Affiliated Hospital, Zhejiang University School of Medicine. Data Collection and Procedures: We compared age, gender, and thyroid function including triiodothyronine (TT3), thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) among COVID-19, non-COVID-19 pneumonia patients and healthy subjects.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    interferon-γ), auto-antibodies (thyroglobulin antibody, thyroid peroxidase antibody), and interval time for negative conversion of viral nucleic acid were analyzed.
    ( thyroglobulin
    suggested: None
    Software and Algorithms
    SentencesResources
    Statistical Analysis: Statistical analysis was conducted by SPSS (version 21·0)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several limitations which might cause potential bias. Firstly, the study is retrospective and single centered, with limited sample size. More patients from multiple centers should be analyzed in future. Secondly, since little attention has been paid during the treatment of COVID-19, only 22 patients have complete thyroid function including FT3 and FT4. Lastly, COVID-19 patients were admitted to hospital at different stages and most of them were not dynamically monitored in thyroid function.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.06.15.20130807v1 on medRxiv