Thyroid hormone concentrations in severely or critically ill patients with COVID-19
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ORIGINAL ARTICLE
Thyroid hormone concentrations in severely or critically ill patients with COVID‑19 W. Gao1 · W. Guo2 · Y. Guo2 · M. Shi2 · G. Dong2 · G. Wang3 · Q. Ge4 · J. Zhu1 · X. Zhou5 Received: 12 September 2020 / Accepted: 22 October 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Objective COVID-19 is a new coronavirus infectious disease. We aimed to study the characteristics of thyroid hormone levels in patients with COVID-19 and to explore whether thyroid hormone predicts all-cause mortality of severely or critically ill patients. Methods The clinical data of 100 patients with COVID-19, who were admitted to Wuhan Tongji Hospital from February 8 to March 8, 2020, were analyzed in this retrospective study. The patients were followed up for 6–41 days. Patients were grouped into non-severe illness and severe or critical illness, which included survivors and non-survivors. Multivariate Cox proportional hazards analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality in association with continuous and the lower two quartiles of thyroid hormone concentrations in severely or critically ill patients. Results The means of free T3 (FT3) were 4.40, 3.73 and 2.76 pmol/L in non-severely ill patients, survivors and non-survivors, respectively. The lower (versus upper) two quartiles of FT3 was associated with all-cause mortality HR (95% CI) of 9.23 (2.01, 42.28). The HR (95% CI) for all-cause mortality in association with continuous FT3 concentration was 0.41 (0.21, 0.81). In the multivariate-adjusted models, free T4 (FT4), TSH and FT3/FT4 were not significantly related to all-cause mortality. Patients with FT3 less than 3.10 pmol/L had increased all-cause mortality. Conclusion FT3 concentration was significantly lower in patients with severe COVID-19 than in non-severely ill patients. Reduced FT3 independently predicted all-cause mortality of patients with severe COVID-19. Keywords Thyroid hormone · Nonthyroidal illness · COVID-19 · Mortality Weibo Gao and Wei Guo are joint first authors. Jihong Zhu and Xianghai Zhou are joint senior authors. * J. Zhu [email protected] * X. Zhou [email protected] 1
Emergency Department, Peking University People’s Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing 100044, China
2
Trauma Center, Peking University People’s Hospital, Beijing, China
3
Department of Critical Care Medicine, Peking University People’s Hospital, Beijing, China
4
Department of Critical Care Unit, Peking University Third Hospital, Beijing, China
5
Department of Endocrinology and Metabolism, Peking University People’s Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing 100044, China
Introduction Coronavirus disease 2019 (COVID-19) is an acute respiratory tract infection of unknown origin, which broke out in Wuhan, China in January 2020 and spread rapidly across the country and the world afterward. According to a previous report from the Chinese Center for Disease Control and Prevention,
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