Thyroid function abnormalities in COVID-19 patients

Abstract

Background 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 84 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. Findings We found that the levels of TT3 and TSH were lower in COVID-19 patients than control groups (p<0·001). 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 (74·6% vs. 23·8%, p < 0·001). Patients with thyroid dysfunction tended to have increased interval time for negative conversion of viral nucleic acid (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). 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. Interpretations Thyroid 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. Funding This study was supported by Zhejiang Provincial Science and technology department key R & D plan emergency project (No. 2020c03123-8).