Thyroid Hormone Changes in the Northern Area of Tianjin during the COVID-19 Pandemic

Abstract

Purpose. This study aimed to determine whether and how stress-induced thyroid hormone changes occur during the COVID-19 pandemic in the northern area of Tianjin. Methods. This study comprised two groups of study subjects in Tianjin: before (2019) and during (2020) the COVID-19 outbreak. Subjects were included if they had FT3, FT4, and TSH concentrations and thyroid TPOAb or TgAb information available. People who were pregnant, were lactating, or had mental illness were excluded. We used propensity score matching to form a cohort in which patients had similar baseline characteristics, and their anxiety level was measured by the Hamilton Anxiety Rating Scale (HAMA). Results. Among the 1395 eligible people, 224 in Group A and 224 in Group B had similar propensity scores and were included in the analyses. The detection rate of abnormal thyroid function was decreased in pandemic Group B (69.2% vs. 93.3%, χ2 = 42.725, p < 0.01 ), especially for hypothyroidism (14.29% vs. 35.71%, χ2 = 27.429, p < 0.01 ) and isolated thyroid-related antibodies (25.89% vs. 38.39%, χ2 = 8.023, p < 0.01 ). The level of FT4 (z = −2.821, p < 0.01 ) and HAMA score (7.63 ± 2.07 vs. 5.40 ± 1.65, t = 16.873, p < 0.01 ) went up in Group B; however, TSH (z = −5.238, p < 0.01 ), FT3 (z = −3.089, p = 0.002 ), TgAb (z = −11.814, p < 0.01 ), and TPOAb (z = −9.299, p < 0.01 ) were lower, and HAMA was positive with FT3 (r = 0.208, p < 0.01 ) and FT4 (r = 0.247, p < 0.01 ). Conclusion. People in the northern area of Tianjin during the COVID-19 outbreak were at an increased risk of higher FT4, lower FT3, and lower TSH. The HAMA scores increased in emergency situations and were positively correlated with the levels of FT3 and FT4.

Thyroxine changes in COVID-19 pandemic: A systematic review and meta-analysis

“…Immunoassays for thyroxine can be affected by alterations in serum binding protein that occurs in various physiological states (20). Decreased TSH and increased FT4 levels were reported in the healthy cohort during the COVID-19 outbreak (67). During the pandemic, relationships were found between thyroid diseases and psychiatric factors, such as anxiety and depression (68,69).…”

Associations of psychological status and ultrasonic characteristics of thyroid nodules in adults during the COVID-19 pandemic

“…Pregnant women in their first trimester in Shanghai during the COVID-19 outbreak were at an increased risk of having higher FT3 concentrations, lower FT4 concentrations, and isolated hypothyroxinemia ( Lin et al, 2020 ). People in the northern area of Tianjin during the COVID-19 outbreak were at an increased risk of higher FT4, lower FT3, and lower TSH ( Weiwei et al, 2022 ). A large number of studies had shown that negative psychological status was closely related to the occurrence and development of thyroid nodules, but the association between psychological status and ultrasonic manifestations of thyroid nodules had not been analyzed ( Mizokami et al, 2004 ; Jonsdottir and Sjörs, 2019 ).…”

Efficacy and Safety of Dapagliflozin versus Liraglutide in Patients with Overweight or Obesity and Type 2 Diabetes Mellitus: A Randomised Controlled Clinical Trial in Tianjin, China

“…Interventions based on lifestyle modifications are integral to the management of body weight [ 32 ]. It is possible that the sudden outbreak of the epidemic and local policies had a certain impact on the activities and emotions of patients and may even have affected thyroid function [ 33 ]. In our study, we also found that the quality of sleep had deteriorated in patients during the outbreak.…”