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Thyroid Dysfunction among the Patients with Critical COVID-19.

Hande Özportakal1, Şirin Menekşe2, Ece Altınay3

  • 1Department of Internal Medicine, Kartal Koşuyolu High Specialization Education and Research Hospital, İstanbul, Turkey.

Infectious Diseases & Clinical Microbiology
|April 18, 2024
PubMed
Summary

Critical COVID-19 patients admitted to the ICU frequently develop thyroid dysfunction (TD). TD is associated with higher inflammatory markers, cardiac troponin T levels, and APACHE-II scores in these critically ill patients.

Keywords:
APACHE II scoreCOVID-19cardiac troponin Teuthyroid sick syndromeinflammatory markersthyroid dysfunction

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Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • SARS-CoV-2 utilizes angiotensin-converting enzyme (ACE) as its functional receptor, primarily affecting the lungs.
  • ACE is also expressed in the thyroid gland, suggesting a potential link between COVID-19 and thyroid function.

Purpose of the Study:

  • To investigate the incidence of thyroid dysfunction (TD) in critically ill COVID-19 patients admitted to the ICU.
  • To compare TD incidence with inflammatory markers and disease severity.

Main Methods:

  • Retrospective study of 52 ICU patients with critical COVID-19.
  • Thyroid function tests (TSH, FT4, FT3) performed within 3 days of ICU admission.
  • TD defined by abnormal TSH, FT4, or FT3 levels; no prior thyroid history.

Main Results:

  • Thyroid dysfunction (TD) detected in 65.4% of patients.
  • TD patients showed decreased TSH, FT3, and FT4 levels.
  • TD associated with higher APACHE-II scores, white blood cell count, procalcitonin, C-reactive protein, and cardiac troponin T.

Conclusions:

  • Critically ill COVID-19 patients have an increased risk of developing TD.
  • Thyroid dysfunction in these patients correlates with inflammatory markers and disease severity scores.