Thyroid Disfunction in Critically Ill COVID-19 Patients. Relationship with In-Hospital Mortality

María Antonieta Ballesteros Vizoso1, Albert Figueras Castilla2, Antonia Barceló1,3

  • 1Servei d'Anàlisi Clíniques, Hospital Universitari Son Espases, 07120 Palma, Spain.

Insights

Thyroid dysfunction is common in critically ill COVID-19 patients. Free thyroxine (fT4) levels on day 5 in the ICU predict in-hospital mortality, highlighting thyroid hormone monitoring

Area of Science:

  • Endocrinology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Thyroid dysfunction is frequently observed in critical illness but has not been extensively studied in COVID-19 patients.
  • Understanding thyroid hormone profiles in severe COVID-19 is crucial for predicting patient outcomes.

Purpose of the Study:

  • To investigate the relationship between thyroid hormone levels and in-hospital mortality in critically ill COVID-19 patients.
  • To identify specific thyroid hormone parameters that can serve as predictors of mortality.

Main Methods:

  • Prospective, single-center study of 78 critically ill COVID-19 patients admitted to the ICU.
  • Thyroid hormones (including free thyroxine - fT4) measured at ICU admission and on day 5.
  • Multiple logistic regression and ROC analysis used to assess mortality predictors.

Main Results:

  • In-hospital mortality rate was 29.5%.
  • Variables associated with mortality included age, prior beta-blocker use, and fT4 levels on day 5.
  • Free thyroxine (fT4) at day 5 demonstrated an AUC of 0.69 for predicting in-hospital mortality.

Conclusions:

  • Critically ill COVID-19 patients exhibit significant thyroid hormone alterations.
  • Day 5 fT4 levels in the ICU are associated with in-hospital mortality, suggesting its utility as a prognostic marker.

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