Euthyroid Sick Syndrome in Patients With COVID-19

Area of Science:

• Endocrinology
• Infectious Diseases
• Critical Care Medicine

Background:

• Coronavirus disease 2019 (COVID-19) impacts multiple organs, but its effect on thyroid function remains unclear.
• Euthyroid sick syndrome (ESS) is often associated with critical illness severity and poor prognosis.
• Investigating thyroid function in COVID-19 patients is crucial for understanding disease progression.

Purpose of the Study:

• To assess thyroid function in COVID-19 patients.
• To identify factors associated with outcomes in COVID-19 patients with ESS.
• To determine the predictive value of ESS for COVID-19 severity.

Main Methods:

• Clinical and laboratory data of COVID-19 patients with or without ESS were collected and analyzed.
• Kaplan-Meier curves and Cox regression models were used to correlate ESS with endpoints.
• Receiver operating characteristic (ROC) curves evaluated the predictive performance of FT3 and C-reactive protein (CRP) for disease severity.

Main Results:

• 27.52% of COVID-19 patients had ESS, exhibiting higher rates of fever, shortness of breath, hypertension, diabetes, and severe events.
• ESS patients showed elevated erythrocyte sedimentation rate, CRP, and procalcitonin, with lower lymphocyte counts.
• ESS was significantly associated with COVID-19 disease severity (HR = 2.515, P = 0.039).

Conclusions:

• Euthyroid sick syndrome is significantly associated with increased disease severity in COVID-19 patients.
• ESS correlates with heightened inflammatory markers, including CRP and erythrocyte sedimentation rate.
• FT3 and CRP demonstrate predictive value for severe COVID-19 outcomes.