Thyroid Hormone Profile and Its Prognostic Impact on the Coronavirus Disease 2019 in Korean Patients

Js, Ahn; Lee, Min Kyung; Lee, Jae Hyuk; Sohn, Seo Young

doi:10.3803/enm.2021.1109

Cited by 25 publications

(32 citation statements)

References 34 publications

(70 reference statements)

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“…A study consisting of 50 patients demonstrated that a more severe COVID-19 maybe linked with a lower TSH (19). Subsequently, the clinical data of 119 patients showed that TSH levels were significantly lower in patients with severe to critical disease than in those with nonsevere disease (4). Moreover, what we know is that ESS is common in various acute and chronic conditions as a risk factor for the severity of diseases.…”

Section: Discussionmentioning

confidence: 99%

“…It is necessary to find biomarkers of disease severity and death to identify earlier, intervene effectively, and save lives ultimately. Previous studies suggested that changes in thyroid function relevant parameters have been thought to be significant in COVID-19 patients (3)(4)(5). However, the effects of COVID-19 on the thyroid axis and the crosstalk between the thyroid axis and inflammation/coagulopathy/fibrinolysis during the SARS-CoV-2 infection remain not very clear.…”

Section: Introductionmentioning

confidence: 99%

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The Association Between FT3 With the Outcome and Inflammation/Coagulopathy/Fibrinolysis of COVID-19

et al. 2022

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BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has caused substantial threats to people’s physical health and lives, claiming the lives of over 5 million people worldwide. It is imperative to identify the disease severity and intervene with effective therapy as early as possible. Previous studies have shown that low free triiodothyronine (FT3) may possess the predictive value on COVID-19 prognosis.MethodsIn this retrospective cohort study, 15-day clinical and laboratory data of 186 hospitalized patients of COVID-19 after admission were analyzed. Groups were based on the disease severity of COVID-19, survival or non-survival, and presence or absence of euthyroid sick syndrome (ESS). Categorical variables were compared with the chi-square test or Fisher’s exact test. Continuous variables were tested by Wilcoxon rank-sum test for the non-normal distribution. Spearman correlations were used to assess the correlations between FT3 with clinic parameters of multiple time points.ResultsThe non-survival patients had significant lower levels of FT3 (3.24 ± 0.42 vs. 4.19 ± 0.08 pmol/L, p < 0.05) and thyroid-stimulating hormone (TSH) (0.69 ± 0.19 vs. 2.32 ± 0.2 uIU/ml, p < 0.05), and the FT3 of severe patients was significantly lower than that of non-severe patients (3.67 ± 0.14 vs. 4.33 ± 0.09 pmol/L, p < 0.05). Fifty-nine cases of COVID-19 patients were diagnosed with ESS. Compared with non-ESS patients, those with ESS were older and had higher proportions of fever, shortness of breath, hypertension, diabetes, severe disease, and mortality. In addition, the correlation analysis between FT3 and clinical parameters showed that FT3 were positively related to the lymphocyte count and albumin and negatively correlated with C-reactive protein, erythrocyte sedimentation rate, and D-dimer at all time points in the first 15 days after admission.ConclusionLow FT3 had a significant predictive value on the prognosis of COVID-19 patients, and FT3 was significantly related with clinic parameters of inflammation/coagulopathy/fibrinolysis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Association Between FT3 With the Outcome and Inflammation/Coagulopathy/Fibrinolysis of COVID-19

et al. 2022

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“…Similar to the HPA axis, there is also evidence that suggests reduced activity of the hypothalamic pituitary thyroid axis. The levels of total triiodothyronine (T3) and thyroid stimulating hormone (TSH) are lower in COVID-19 patients ( 78 , 79 ). It was also reported that within the group of COVID-19 cases, 61.9% (52/84) patients presented with thyroid function abnormalities and the proportion of thyroid dysfunction was higher in severe cases than mild/moderate cases.…”

Section: Covid-19 and Endocrine Activitymentioning

confidence: 99%

Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19

et al. 2022

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Coronavirus disease 2019 or COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a significant threat to the health of human beings. While wearing mask, maintaining social distance and performing self-quarantine can reduce virus spreading passively, vaccination actively enhances immune defense against COVID-19. However, mutations of SARS-CoV-2 and presence of asymptomatic carriers frustrate the effort of completely conquering COVID-19. A strategy that can reduce the susceptibility and thus prevent COVID-19 while blocking viral invasion and pathogenesis independent of viral antigen stability is highly desirable. In the pathogenesis of COVID-19, endocrine disorders have been implicated. Correspondingly, many hormones have been identified to possess therapeutic potential of treating COVID-19, such as estrogen, melatonin, corticosteroids, thyroid hormone and oxytocin. Among them, oxytocin has the potential of both treatment and prevention of COVID-19. This is based on oxytocin promotion of immune-metabolic homeostasis, suppression of inflammation and pre-existing comorbidities, acceleration of damage repair, and reduction of individuals’ susceptibility to pathogen infection. Oxytocin may specifically inactivate SARS-COV-2 spike protein and block viral entry into cells via angiotensin-converting enzyme 2 by suppressing serine protease and increasing interferon levels and number of T-lymphocytes. In addition, oxytocin can promote parasympathetic outflow and the secretion of body fluids that could dilute and even inactivate SARS-CoV-2 on the surface of cornea, oral cavity and gastrointestinal tract. What we need to do now is clinical trials. Such trials should fully balance the advantages and disadvantages of oxytocin application, consider the time- and dose-dependency of oxytocin effects, optimize the dosage form and administration approach, combine oxytocin with inhibitors of SARS-CoV-2 replication, apply specific passive immunization, and timely utilize efficient vaccines. Meanwhile, blocking COVID-19 transmission chain and developing other efficient anti-SARS-CoV-2 drugs are also important. In addition, relative to the complex issues with drug applications over a long term, oxytocin can be mobilized through many physiological stimuli, and thus used as a general prevention measure. In this review, we explore the potential of oxytocin for treatment and prevention of COVID-19 and perhaps other similar pathogens.

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“…[ 18 ] Approximately 15% of adults with COVID-19 infection have abnormal thyroid function, and circulating triiodothyronine levels are associated with adverse COVID-19 outcomes. [ 19 , 20 ] Therefore, physicians should be aware of the possibility of thyroid dysfunction in patients with COVID-19. In the present case, his condition was stable following treatment with amiodarone, and levothyroxine replacement.…”

Section: Discussionmentioning

confidence: 99%

Primary hypothyroidism with an episode of ventricular tachycardia in a patient with COVID-19

et al. 2022

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Rationale: Coronavirus disease 2019 (COVID-19) is a systemic disease with major clinical manifestations in the respiratory system. However, thyroid involvement has also been reported. We present a case of hypothyroidism with ventricular tachycardia following diagnosis with COVID-19.Patient concerns: A 77-year-old man was admitted to the isolation ward due to COVID-19. After respiratory support and medical treatment, the patient was successfully weaned off the ventilator. However, an episode of short-run ventricular tachycardia was detected, and primary hypothyroidism was also diagnosed.Diagnosis: Ventricular tachycardia was detected by electrocardiography.Interventions: Intravenous amiodarone administration and oral levothyroxine replacement.Outcomes: No arrhythmia detected following treatment.Lessons: Awareness of the association between hypothyroidism and COVID-19 is important in preventing possible complications.Abbreviations: ACE-2 = angiotensin-converting enzyme-2, CK = creatine kinase, COVID-19 = coronavirus disease 2019, SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.

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Thyroid Hormone Profile and Its Prognostic Impact on the Coronavirus Disease 2019 in Korean Patients

Cited by 25 publications

References 34 publications

The Association Between FT3 With the Outcome and Inflammation/Coagulopathy/Fibrinolysis of COVID-19

The Association Between FT3 With the Outcome and Inflammation/Coagulopathy/Fibrinolysis of COVID-19

Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19

Primary hypothyroidism with an episode of ventricular tachycardia in a patient with COVID-19

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