Correlation between inflammatory parameters and pituitary-thyroid axis in patients with COVID-19

Area of Science:

• Endocrinology
• Infectious Diseases
• Critical Care Medicine

Background:

• Inflammation is central to COVID-19 progression.
• Nonthyroidal illness syndrome (NTIS) is increasingly observed in COVID-19 patients.
• Thyroid hormone dysfunction may impact COVID-19 outcomes.

Purpose of the Study:

• To investigate the relationship between thyroid hormones and inflammation markers in COVID-19.
• To assess the association of thyroid hormones with disease severity and outcomes.
• To examine two specific NTIS profiles: low T3-normal/low FT4 and low T3-high FT4.

Main Methods:

• Recruited consecutive hospitalized COVID-19 patients.
• Measured thyroid hormones (T4, T3, FT4, FT3) and their ratios.
• Correlated hormone levels with inflammatory markers (albumin, ferritin, fibrinogen, ESR, CRP, LDH, D-dimer).

Main Results:

• Thyroid hormones correlated with inflammation markers; T3 and T3/T4 inversely correlated with most markers.
• A low T3/T4 ratio was associated with severe COVID-19 and mortality.
• The low T3/high FT4 NTIS profile correlated with lower albumin, higher ferritin, and increased disease severity.

Conclusions:

• Thyroid hormone levels are linked to inflammation and outcomes in COVID-19.
• A low T3/T4 ratio serves as a marker for severe disease and poor prognosis.
• Specific NTIS profiles, like low T3/high FT4, indicate heightened inflammation and severity.