Is non-thyroidal illness syndrome (NTIS) a clinical predictor of COVID-19 mortality in critically ill oldest old patients?

Okoye, Chukwuma; Niccolai, Filippo; Rogani, Sara; Lemmi, Bianca; Peta, Umberto; Vecchio, Stefania; Morelli, Valentina; Caraccio, N; Calsolaro, Valeria; Monzani, Fabio

doi:10.1007/s40618-022-01806-6

Cited by 6 publications

(4 citation statements)

References 9 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There was no significant difference in the prevalence of SES between the groups (66.3% vs. 67.9%). SES was also not associated with increased mortality in this study 50 . A study by Gong et al described low TSH as an independent predictor of 90 mortality among COVID-19 patients 33 .…”

Section: Discussioncontrasting

confidence: 56%

Thyroid Function Abnormalities and Outcomes in Hospitalized Patients with COVID-19 Infection: A Cross-Sectional Study

et al. 2023

View full text Add to dashboard Cite

Thyroid gland can be affected by the COVID-19 infection. The pattern of thyroid function abnormality reported in COVID-19 is variable; in addition, some drugs used in COVID-19 patients like glucocorticoids and heparin can affect the thyroid function tests (TFT). We conducted an observational, cross-sectional study of thyroid function abnormalities with thyroid autoimmune profile in COVID-19 patients with varying severity from November 2020 to June 2021. Serum FT4, FT3, TSH, anti-TPO, and anti-Tg antibodies were measured before the initiation of treatment with steroids and anti-coagulants. A total of 271 COVID-19 patients were included in the study, of which 27 were asymptomatic and remaining 158, 39, and 47 were classified to mild, moderate and severe categories, respectively, according to MoHFW, India criteria. Their mean age was 49±17 years and 64.9% were males. Abnormal TFT was present in 37.2% (101/271) patients. Low FT3, low FT4, and low TSH were present in 21.03%, 15.9% and 4.5% of patients, respectively. Pattern corresponding to sick euthyroid syndrome was the most common. Both mean FT3 and FT3/FT4 ratio decreased with increasing severity of COVID-19 illness (p=0.001). In multivariate analysis, low FT3 was associated with increased risk of mortality (OR 12.36, 95% CI: 1.23–124.19; p=0.033). Thyroid autoantibodies were positive in 58 (27.14%) patients; but it was not associated with any thyroid dysfunction. Thyroid function abnormality is common among COVID-19 patients. Both low FT3 and FT3/FT4 ratio are indicators of disease severity while low FT3 is a prognostic marker of COVID-19 associated mortality.

show abstract

Section: Discussioncontrasting

confidence: 56%

Thyroid Function Abnormalities and Outcomes in Hospitalized Patients with COVID-19 Infection: A Cross-Sectional Study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…NTIS patients were more likely to engage in unhealthy behaviors such as smoking and drinking, and co-morbidities such as diabetes and hypertension were also substantially different between the two groups. [17].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical characteristics of non-thyroidal illness syndrome with non-critically ill patients in rehabilitation specialist hospital

Wang,

Li,

Liu

et al. 2023

Preprint

View full text Add to dashboard Cite

Backgroud To investigate the prevalence and clinical characteristics of Non-thyroid illness syndrome(NTIS) patients in specialized rehabilitation hospital. Methods 6 799 patients admitted to our institution between January 2019 and May 2022, and analyzed retrospectively. There were 2,702 patients with NTIS and 2,207 patients with euthyroid sick syndrome (ESS). Plasma thyroid hormone was detected using chemiluminescence instrument and its associated reagents, and SPSS 21.0 was used for statistical analysis. Results the incidence of NTIS was 39.7% in rehabilitation specialized hospital, and the total length of hospitalization for patients with NTIS was substantially longer than for patients without NTIS. The incidence rates of unhealthy behaviors, such as smoking and drinking, and diseases such as diabetes and hypertension, were substantially higher in the NTIS group than in the non-NTIS group. Only BNP, APTT, and TT did not differ significantly between the two groups, all others laboratory results demonstrated statistically significant differences. Comparison of thyroid function between the two groups showed that fT3, TT4, and TSH values with the NTIS group were lower than the wtihout NTIS group, while fT4 and TT3 showed opposite results In NTIS patients, the pattern of only fT3 decreaseingwas 71.8%, followed by fT3 and fT4 simultaneously decreasing was 25.7%. Correlation analysis showed that fT3 positively correlated with TT4 was 0.811, while fT3 negatively correlated with fT4 and TT3 was − 0.703 and − 0.647, respectively, and without any correlation with TSH. PCT, WBC, hs-CRP, N/L%, and fT3 had negative correlations of -0.48, -0.46, -0.39, and − 0.35, respectively. Conclusion The incidence of NTIS patients in rehabilitation specialized hospitals is high. These patients have a lengthy hospitalization period, a state of high inflammation, impaired liver and renal function, coagulation disorders, and fibrinolytic activation.

show abstract

“…The marked changes in cytokines that follow infection are well described to alter deiodination pathways contributing to low T3 syndrome [1]. Interestingly, an Italian study of older adults with pneumonia reported that two-thirds of patients had low T3 syndrome on admission to hospital, and the prevalence did not differ between those with and without COVID [6]. Furthermore, low serum T3 concentrations were found in the vast majority of children with multisystem inflammatory syndrome following COVID [7].…”

Section: Coronavirus Disease 2019mentioning

confidence: 99%

The use of triiodothyronine during critical illness

Maiden,

Forehan

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

View full text Add to dashboard Cite

Purpose of review Thyroid hormone physiology changes during critical illness. Circulating concentration of triiodothyronine (T3), the active form of thyroid hormone decreases. It has long been uncertain whether this represents a pathologic change or if it is an adaptive phenomenon. Controlled clinical trials have been required to understand whether replacing and restoring serum T3 levels is therapeutic. Recent findings Clinical trials of T3 have recently been proposed with some completed. These have been conducted in patients with sepsis, myocardial infarction, infants undergoing cardiac surgery, and acute respiratory distress syndrome. Of the completed trials, T3 administration restored serum concentrations, but was not accompanied by significant clinical benefit. Importantly, restoring serum T3 levels did not cause any adverse effects. Summary If T3 is to be considered a therapeutic target in critical illness, further studies should consider the stage of disease it is administered, and whether there are other surrogate measures to assess adequacy of hormone replacement over and above serum T3 concentrations.

show abstract

Is non-thyroidal illness syndrome (NTIS) a clinical predictor of COVID-19 mortality in critically ill oldest old patients?

Cited by 6 publications

References 9 publications

Thyroid Function Abnormalities and Outcomes in Hospitalized Patients with COVID-19 Infection: A Cross-Sectional Study

Thyroid Function Abnormalities and Outcomes in Hospitalized Patients with COVID-19 Infection: A Cross-Sectional Study

Prevalence and clinical characteristics of non-thyroidal illness syndrome with non-critically ill patients in rehabilitation specialist hospital

The use of triiodothyronine during critical illness

Contact Info

Product

Resources

About