Endocrine Follow-up During Post-Acute COVID-19: Practical Recommendations Based on Available Clinical Evidence

Pal, Rimesh; Joshi, Ameya; Bhadada, Sanjay Kumar; Banerjee, Mainak; Suresh, V.; Mukhopadhyay, Satinath

doi:10.1016/j.eprac.2022.02.003

Cited by 23 publications

(26 citation statements)

References 76 publications

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“…We found that patients who had abnormal TFTs upon reassessment were more likely to have abnormal TFTs in acute COVID-19. Taken together, our results showed that while abnormal TFTs in acute COVID-19 should be reassessed to ensure resolution, routine thyroid function monitoring among COVID-19 survivors is probably unnecessary, in line with the current recommendations [39], The strength of our study was the systematic reassessment of both thyroid function and anti-thyroid antibodies over 6 months. The fact that the COVID-19 severity was non-severe for most patients in our cohort means that our results are generalisable.…”

Section: Discussionsupporting

confidence: 79%

“…We found that patients who had abnormal TFTs upon reassessment were more likely to have abnormal TFTs in acute COVID-19. Taken together, our results showed that while abnormal TFTs in acute COVID-19 should be reassessed to ensure resolution, routine thyroid function monitoring among COVID-19 survivors is probably unnecessary, in line with the current recommendations [ 39 ], except perhaps those who have been treated with interferon in acute COVID-19.…”

Section: Discussionsupporting

confidence: 78%

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A prospective follow-up on thyroid function, thyroid autoimmunity and long COVID among 250 COVID-19 survivors

et al. 2023

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Purpose We evaluated the evolution of thyroid function and autoimmunity among COVID-19 survivors over 6 months in relation to interferon beta-1b treatment and long COVID. Methods We included COVID-19 survivors managed in a major COVID-19 centre between July 2020 and May 2021 who were reassessed three and/or six months after acute COVID-19. Thyroid function tests (TFTs) and anti-thyroid antibody titres were measured at acute COVID-19, 3-month and 6-month. Results 250 COVID-19 survivors were included (mean age 52.7 years, 50.4% men). Persistent thyroid function abnormalities were more likely in those with abnormal TFTs in acute COVID-19 ( P < 0.001). Among 51 patients with abnormal TFTs in acute COVID-19, 82.4% resolved upon follow-up. Of 199 patients with normal TFTs in acute COVID-19, only 4.5% had incident abnormal TFTs, more likely in interferon-treated patients ( P = 0.044) and none clinically overt. Among 129 patients with complete 6-month follow-up for anti-thyroid antibody titres, there was no significant change overall, except for modest increase in anti-thyroid antibody titres among the 84 interferon-treated patients ( P < 0.05 at both 3 months and 6 months). Long COVID occurred in 19.5% and 10.4% at 3 and 6 months respectively, where TFTs and anti-thyroid antibody titres were not predictive of its occurrence. Conclusion Over 6 months, most abnormal TFTs in acute COVID-19 resolved, with no significant incident thyroid dysfunction. SARS-CoV-2 infection did not lead to change in thyroid autoimmunity, while interferon treatment was associated with modest increase in anti-thyroid antibody titres. Thyroid function and anti-thyroid antibodies did not play a significant role in long COVID.

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Section: Discussionsupporting

confidence: 79%

“…We found that patients who had abnormal TFTs upon reassessment were more likely to have abnormal TFTs in acute COVID-19. Taken together, our results showed that while abnormal TFTs in acute COVID-19 should be reassessed to ensure resolution, routine thyroid function monitoring among COVID-19 survivors is probably unnecessary, in line with the current recommendations [ 39 ], except perhaps those who have been treated with interferon in acute COVID-19.…”

Section: Discussionsupporting

confidence: 78%

A prospective follow-up on thyroid function, thyroid autoimmunity and long COVID among 250 COVID-19 survivors

et al. 2023

View full text Add to dashboard Cite

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“…Finally, in COVID-19 survivors, more than 3 months after negative test for SARS-CoV-2, a non-significant difference in calcium levels was observed compared to healthy matched for age and sex subjects, possibly confirming the casual relationship between COVID-19 and hypocalcemia, and its transient nature once the patient recovered from the acute viral syndrome [ 35 ]. These data does not entirely support a routine estimation of serum calcium in all post-COVID-19 patients [ 36 ]. However, it appears reasonable to assess calcium and VD levels in the follow-up of patients with symptomatic hypocalcemia during the acute disease and eventually consider to supplement VD in those with persistently altered biochemical results.…”

Section: Hypocalcemiamentioning

confidence: 95%

The osteo-metabolic phenotype of COVID-19: an update

et al. 2022

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“…Furthermore, subgroup analysis based on steroid use amongst moderate/severe cases did not reveal any difference in the strength of association between new-onset T2DM and COVID-19 [9] . Therefore, clinicians need to screen for adverse metabolic consequences frequently during post-acute COVID-19 phase regardless of the disease severity or history of steroid use during acute phase [18] .…”

Section: Discussionmentioning

confidence: 99%