Evaluation of Thyroid Status in Hospitalized Patients with COVID-19.

Abstract

Background: Preliminary data suggest that thyroid dysfunction may commonly occur in association with coronavirus disease-2019 (COVID-19). Objective: To clarify the significance of abnormal thyroid tests in patients with COVID-19 admitted to the hospital. Methods: PUBMED search of English literature until September 22, 2020. Since there is lack of randomized trials, case reports, retrospective studies, and National guidelines are reviewed. Results: Retrospective studies suggest that 7%-60% of patients with COVID-19 admitted to the hospital display thyroid hormone alterations typical of non-thyroidal illness (NTI). The extent of thyroid hormone changes correlates with severity of COVID-19. In NTI, thyroid hormones normalize with recovery of COVID-19 without specific treatment. Measurement of thyroid hormones in admitted COVID-19 patients without symptoms or signs suggestive of abnormal thyroid function may lead to unnecessary further investigations and increase cost. In addition, routine measurement of thyroid hormones can create confusion in interpretation of results. Other new onset thyroid diseases are rarely reported in admitted COVID-19 patients. Only 4 well-documented cases of subacute thyroiditis were reported in association with infection with COVID-19. Conclusions: Alterations of thyroid hormones due to NTI are common in hospitalized patients with COVID-19 and return to normal spontaneously with recovery without thyroid-directed therapy. Routine measurement of thyroid hormones is not indicated in patients who do not have pertinent thyroid symptoms or signs.