Non-Thyroidal Illness

Παππά, Θεοδώρα; Alevizaki, Maria

doi:10.1007/978-3-319-29195-6_26-1

Cited by 1 publication

(1 citation statement)

References 79 publications

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“…We considered the following thyroid hormone patterns as indicating non-thyroidal illness syndrome (NTIS): isolated hypotriiodothyroninemia (only low T3); Low T3 (<80 ng/dL) and low FT4 (<0.9 ng/dL) and normal TSH; low T3, FT4 below the mid-range of the reference values and low TSH ( 23 ). The two latter patterns have been associated with more severe or prolonged disease ( 24 ). Overt hypothyroidism was defined as high TSH with low FT4 and subclinical hypothyroidism as high TSH with FT4 within the normal range.…”

Section: Methodsmentioning

confidence: 99%

Thyroid hormone alterations in critically and non-critically ill patients with SARS-CoV-2 infection

Vassiliadi

Ilias²,

Pratikaki

et al. 2021

Endocrine Connections

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Objective: Following evolution of COVID-19 pandemic, reports pointed on a high prevalence of thyroiditis related thyrotoxicosis. Interpretation of thyroid tests during illness, however, is hampered by changes occurring in the context of non-thyroidal illness syndrome (NTIS). In order to elucidate these findings, we studied thyroid function in carefully selected cohorts of COVID-19 positive and negative patients. Design: Cohort observational study. Methods: We measured TSH, FT4, T3 within 24hours of admission in 196 patients without thyroid disease and/or confounding medications. 102 patients were SARS-CoV-2 positive; 41 admitted in the ICU, 46 in the ward and 15 outpatients. Controls consisted of 94 SARS-CoV-2 negative patients; 39 in the ICU and 55 in the ward. We designated the thyroid hormone patterns as consistent with NTIS, thyrotoxicosis and hypothyroidism. Results: A NTIS pattern was encountered in 60% of ICU and 36% of ward patients, with similar frequencies between SARS-CoV-2 positive and negative patients (46.0% vs 46.8%, p=NS). A thyrotoxicosis pattern was observed in 14.6% SARS-CoV-2 ICU patients vs. 7.7% in ICU negative (p=NS) and, overall in 8.8% of SARS-CoV-2 positive vs. 7.4% of negative patients. In these patients thyroglobulin levels were similar to those with normal thyroid function or NTIS. The hypothyroidism pattern was rare. Conclusions: NTIS pattern is common and relates to the severity of disease rather than SARS-CoV-2 infection. A thyrotoxicosis pattern is less frequently observed with similar frequency between patients with and without COVID-19. It is suggested that thyroid hormone monitoring in COVID-19 should not differ from other critically ill patients.

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Section: Methodsmentioning

confidence: 99%