Association of hypothyroidism with acute COVID-19: a systematic review

Malik, Jahanzeb; Zaidi, Syed Muhammad Jawad; Waqar, Ali Umer; Khawaja, Hashir Fahim; Malik, Asmara; Ishaq, Uzma; Rana, Abdul Sattar; Awan, Ali Haider

doi:10.1080/17446651.2021.1968830

Cited by 14 publications

(10 citation statements)

References 25 publications

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“…Patients with thyroid dysfunction tended to have longer viral nucleic acid cleaning time in association with decreased number of lymphocytes and increased level of C-reactive protein ( 80 ). A positive correlation between low mean T3 level and clinical severity of COVID-19 was also reported ( 81 ). Consistently, in six articles qualified for the final analysis which included 1160 patients, most of the patients had lower mean T3 level and normal or low TSH level.…”

Section: Covid-19 and Endocrine Activitymentioning

confidence: 83%

Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19

et al. 2022

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Coronavirus disease 2019 or COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a significant threat to the health of human beings. While wearing mask, maintaining social distance and performing self-quarantine can reduce virus spreading passively, vaccination actively enhances immune defense against COVID-19. However, mutations of SARS-CoV-2 and presence of asymptomatic carriers frustrate the effort of completely conquering COVID-19. A strategy that can reduce the susceptibility and thus prevent COVID-19 while blocking viral invasion and pathogenesis independent of viral antigen stability is highly desirable. In the pathogenesis of COVID-19, endocrine disorders have been implicated. Correspondingly, many hormones have been identified to possess therapeutic potential of treating COVID-19, such as estrogen, melatonin, corticosteroids, thyroid hormone and oxytocin. Among them, oxytocin has the potential of both treatment and prevention of COVID-19. This is based on oxytocin promotion of immune-metabolic homeostasis, suppression of inflammation and pre-existing comorbidities, acceleration of damage repair, and reduction of individuals’ susceptibility to pathogen infection. Oxytocin may specifically inactivate SARS-COV-2 spike protein and block viral entry into cells via angiotensin-converting enzyme 2 by suppressing serine protease and increasing interferon levels and number of T-lymphocytes. In addition, oxytocin can promote parasympathetic outflow and the secretion of body fluids that could dilute and even inactivate SARS-CoV-2 on the surface of cornea, oral cavity and gastrointestinal tract. What we need to do now is clinical trials. Such trials should fully balance the advantages and disadvantages of oxytocin application, consider the time- and dose-dependency of oxytocin effects, optimize the dosage form and administration approach, combine oxytocin with inhibitors of SARS-CoV-2 replication, apply specific passive immunization, and timely utilize efficient vaccines. Meanwhile, blocking COVID-19 transmission chain and developing other efficient anti-SARS-CoV-2 drugs are also important. In addition, relative to the complex issues with drug applications over a long term, oxytocin can be mobilized through many physiological stimuli, and thus used as a general prevention measure. In this review, we explore the potential of oxytocin for treatment and prevention of COVID-19 and perhaps other similar pathogens.

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Section: Covid-19 and Endocrine Activitymentioning

confidence: 83%

Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19

et al. 2022

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“…Interestingly, increasing data suggest a bidirectional relationship between COVID-19 and thyroid dysfunction (e.g., through effects on immune system and induction of the cytokine storm by Sars-CoV-2, as well as preliminary findings on adverse effects of preexisting thyroid disease on the prognosis of COVID-19) [ 111 ]. In this context, given the possible effect of COVID-19 on thyroid dysfunction and AIT, it will also be interesting to further investigate the association of these conditions with Se deficiency and to evaluate the possible effects of Se in modulating the relationship between SARS-CoV-2 infection and thyroid pathophysiology ( Figure 3 ) [ 111 , 112 , 113 , 114 ].…”

Section: Other Pathophysiological Conditions Beyond Intake Potentially Affecting Se Levels and The Relationship With Thyroid Functionmentioning

confidence: 99%

Selenium: An Element of Life Essential for Thyroid Function

et al. 2021

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Selenium (Se), a microelement essential for life, is critical for homeostasis of several critical functions, such as those related to immune–endocrine function and signaling transduction pathways. In particular, Se is critical for the function of the thyroid, and it is particularly abundant in this gland. Unfortunately, Se deficiency is a very common condition worldwide. Supplementation is possible, but as Se has a narrow safety level, toxic levels are close to those normally required for a correct need. Thus, whether the obtaining of optimal selenium concentration is desirable, the risk of dangerous concentrations must be equally excluded. This review addressed the contribution by environment and food intake on Se circulating levels (e.g., geographical factors, such as soil concentration and climate, and different quantities in food, such as nuts, cereals, eggs, meat and fish) and effects related to its deficiency or excess, together with the role of selenium and selenoproteins in the thyroid pathophysiology (e.g., Hashimoto’s thyroiditis and Graves’ disease).

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“…8 Current data shows that COVID-19 is associated with a broad spectrum of thyroid dysfunction, ranging from thyrotoxicosis to NTIS and hypothyroidism, that may worsen disease course and affect prognosis. 32,33,34,35,36 This was observed even in mild to moderate COVID-19 cases, independently of SARS-CoV-2 viral load, age and inflammation and tissue injury markers. 37 The cytokine storm and the dysregulated inflammation are believed to affect the thyroid gland, through the proinflammatory cytokines, which resembles the immune activation that occurs in immune-mediated thyroid diseases, causing damage and compromising function.…”

Section: Discussionmentioning

confidence: 91%

Hypothyroidism does not lead to worse prognosis in COVID-19: findings from the Brazilian COVID-19 registry

Pereira

Silveira

Guimarães

et al. 2021

Preprint

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BackgroundIt is not clear whether previous thyroid diseases influence the course and outcomes of COVID-19. The study aims to compare clinical characteristics and outcomes of COVID-19 patients with and without hypothyroidism.MethodsThe study is a part of a multicentric cohort of patients with confirmed COVID-19 diagnosis, including data collected from 37 hospitals. Matching for age, sex, number of comorbidities and hospital was performed to select the patients without hypothyroidism for the paired analysis.ResultsFrom 7,762 COVID-19 patients, 526 had previously diagnosed hypothyroidism (50%) and 526 were selected as matched controls. The median age was 70 (interquartile range 59.0-80.0) years-old and 68.3% were females. The prevalence of underlying comorbidities were similar between groups, except for coronary and chronic kidney diseases, that had a higher prevalence in the hypothyroidism group (9.7% vs. 5.7%, p=0.015 and 9.9% vs. 4.8%, p=0.001, respectively). At hospital presentation, patients with hypothyroidism had a lower frequency of respiratory rate > 24 breaths per minute (36.1% vs 42.0%; p=0.050) and need of mechanical ventilation (4.0% vs 7.4%; p=0.016). D-dimer levels were slightly lower in hypothyroid patients (2.3 times higher than the reference value vs 2.9 times higher; p=0.037). In-hospital management was similar between groups, but hospital length-of-stay (8 vs 9 days; p=0.029) and mechanical ventilation requirement (25.4% vs. 33.1%; p=0.006) were lower for patients with hypothyroidism. There was a trend of lower in-hospital mortality in patients with hypothyroidism (22.1% vs. 27.0%; p=0.062).ConclusionIn this large Brazilian COVID-19 Registry, patients with hypothyroidism had a lower requirement of mechanical ventilation, and showed a trend of lower in-hospital mortality. Therefore, hypothyroidism does not seem to be associated with a worse prognosis, and should not be considered among the comorbidities that indicate a risk factor for COVID-19 severity.

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Association of hypothyroidism with acute COVID-19: a systematic review

Cited by 14 publications

References 25 publications

Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19

Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19

Selenium: An Element of Life Essential for Thyroid Function

Hypothyroidism does not lead to worse prognosis in COVID-19: findings from the Brazilian COVID-19 registry

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