tetano
Editor, Senior Moderator
Clin Endocrinol (Oxf)
. 2022 Feb 18.
doi: 10.1111/cen.14699. Online ahead of print.
Association of Hypothyroidism with Outcomes in Hospitalized Adults with COVID-19: Results from the International SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry
Marija Bogojevic[SUP] 1 [/SUP], Vikas Bansal[SUP] 1 [/SUP], Vishwanath Pattan[SUP] 2 [/SUP], Romil Singh[SUP] 3 [/SUP], Aysun Tekin[SUP] 3 [/SUP], Mayank Sharma[SUP] 3 [/SUP], Abigail T La Nou[SUP] 4 [/SUP], Allison M LeMahieu[SUP] 5 [/SUP], Andrew C Hanson[SUP] 5 [/SUP], Phillip J Schulte[SUP] 5 [/SUP], Neha Deo[SUP] 6 [/SUP], Shahraz Qamar[SUP] 7 [/SUP], Simon Zec[SUP] 1 [/SUP], Diana J Valencia Morales[SUP] 1 [/SUP], Nicholas Perkins[SUP] 8 [/SUP], Margit Kaufman[SUP] 9 [/SUP], Joshua L Denson[SUP] 10 [/SUP], Roman Melamed[SUP] 11 [/SUP], Valerie M Banner-Goodspeed[SUP] 12 [/SUP], Amy B Christie[SUP] 13 [/SUP], Yasir Tarabichi[SUP] 14 [/SUP], Smith Heavner[SUP] 15 [/SUP], Vishakha K Kumar[SUP] 16 [/SUP], Allan J Walkey[SUP] 17 [/SUP], Ognjen Gajic[SUP] 1 [/SUP], Sumit Bhagra[SUP] 18 [/SUP], Rahul Kashyap[SUP] 3 [/SUP], Amos Lal[SUP] 1 [/SUP], Juan Pablo Domecq[SUP] 19 [/SUP], Society of Critical Care Medicine (SCCM) Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
Affiliations
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is associated with high rates of morbidity and mortality. Primary Hypothyroidism is a common comorbid condition, but little is known about its association with COVID-19 severity and outcomes. This study aims to identify the frequency of Hypothyroidism in hospitalized patients with COVID-19 as well as describe the differences in outcomes between patients with and without pre-existing Hypothyroidism using an observational, multinational registry.
Methods: We enrolled patients 18 years or older, with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection between March 2020, and February 2021. The primary outcomes were 1) the disease severity defined as per the World Health Organization scale for clinical improvement, which is an ordinal outcome corresponding with the highest severity level recorded during a patient's index COVID-19 hospitalization, 2) in-hospital mortality, and 3) hospital free days. Secondary outcomes were the rate of Intensive Care Unit (ICU) admission and ICU mortality.
Results: Among the 20,366 adult patients included in the study, pre-existing Hypothyroidism was identified in 1,616 (7.9%). The median age for the Hypothyroidism group was 70 (IQR 59-80) years, and 65% were female and 67% were White. The most common comorbidities were Hypertension (68%), Diabetes (42%), Dyslipidemia (37%), and Obesity (28%). After adjusting for age, Body Mass Index (BMI), sex, admission date in the quarter year since March 2020, race, smoking history, and other comorbid conditions (Coronary Artery Disease, Hypertension, Diabetes, and Dyslipidemia), pre-existing Hypothyroidism was not associated with higher odds of severe disease using the WHO disease severity index (OR 1.02,95% CI 0.92-1.13, p=0.69), in-hospital mortality (OR 1.03, 95% CI 0.92-1.15, p= 0.58) or differences in hospital free days (estimated difference 0.01 days, 95% CI -0.45, 0.47, p=0.97). Pre-existing Hypothyroidism was not associated with ICU admission or ICU mortality in unadjusted as well as in adjusted analysis.
Conclusions: In an international registry Hypothyroidism was identified in around 1 of every 12 adult hospitalized patients with COVID-19. Pre-existing Hypothyroidism in hospitalized patients with COVID-19 was not associated with higher disease severity or increased risk of mortality or ICU admissions. However, more research on the possible effects of COVID-19 on the thyroid gland and its function is needed in the future. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; COVID-19 Disease Severity; Hypothyroidism; Mortality.
. 2022 Feb 18.
doi: 10.1111/cen.14699. Online ahead of print.
Association of Hypothyroidism with Outcomes in Hospitalized Adults with COVID-19: Results from the International SCCM Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry
Marija Bogojevic[SUP] 1 [/SUP], Vikas Bansal[SUP] 1 [/SUP], Vishwanath Pattan[SUP] 2 [/SUP], Romil Singh[SUP] 3 [/SUP], Aysun Tekin[SUP] 3 [/SUP], Mayank Sharma[SUP] 3 [/SUP], Abigail T La Nou[SUP] 4 [/SUP], Allison M LeMahieu[SUP] 5 [/SUP], Andrew C Hanson[SUP] 5 [/SUP], Phillip J Schulte[SUP] 5 [/SUP], Neha Deo[SUP] 6 [/SUP], Shahraz Qamar[SUP] 7 [/SUP], Simon Zec[SUP] 1 [/SUP], Diana J Valencia Morales[SUP] 1 [/SUP], Nicholas Perkins[SUP] 8 [/SUP], Margit Kaufman[SUP] 9 [/SUP], Joshua L Denson[SUP] 10 [/SUP], Roman Melamed[SUP] 11 [/SUP], Valerie M Banner-Goodspeed[SUP] 12 [/SUP], Amy B Christie[SUP] 13 [/SUP], Yasir Tarabichi[SUP] 14 [/SUP], Smith Heavner[SUP] 15 [/SUP], Vishakha K Kumar[SUP] 16 [/SUP], Allan J Walkey[SUP] 17 [/SUP], Ognjen Gajic[SUP] 1 [/SUP], Sumit Bhagra[SUP] 18 [/SUP], Rahul Kashyap[SUP] 3 [/SUP], Amos Lal[SUP] 1 [/SUP], Juan Pablo Domecq[SUP] 19 [/SUP], Society of Critical Care Medicine (SCCM) Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group
Affiliations
- PMID: 35180316
- DOI: 10.1111/cen.14699
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is associated with high rates of morbidity and mortality. Primary Hypothyroidism is a common comorbid condition, but little is known about its association with COVID-19 severity and outcomes. This study aims to identify the frequency of Hypothyroidism in hospitalized patients with COVID-19 as well as describe the differences in outcomes between patients with and without pre-existing Hypothyroidism using an observational, multinational registry.
Methods: We enrolled patients 18 years or older, with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection between March 2020, and February 2021. The primary outcomes were 1) the disease severity defined as per the World Health Organization scale for clinical improvement, which is an ordinal outcome corresponding with the highest severity level recorded during a patient's index COVID-19 hospitalization, 2) in-hospital mortality, and 3) hospital free days. Secondary outcomes were the rate of Intensive Care Unit (ICU) admission and ICU mortality.
Results: Among the 20,366 adult patients included in the study, pre-existing Hypothyroidism was identified in 1,616 (7.9%). The median age for the Hypothyroidism group was 70 (IQR 59-80) years, and 65% were female and 67% were White. The most common comorbidities were Hypertension (68%), Diabetes (42%), Dyslipidemia (37%), and Obesity (28%). After adjusting for age, Body Mass Index (BMI), sex, admission date in the quarter year since March 2020, race, smoking history, and other comorbid conditions (Coronary Artery Disease, Hypertension, Diabetes, and Dyslipidemia), pre-existing Hypothyroidism was not associated with higher odds of severe disease using the WHO disease severity index (OR 1.02,95% CI 0.92-1.13, p=0.69), in-hospital mortality (OR 1.03, 95% CI 0.92-1.15, p= 0.58) or differences in hospital free days (estimated difference 0.01 days, 95% CI -0.45, 0.47, p=0.97). Pre-existing Hypothyroidism was not associated with ICU admission or ICU mortality in unadjusted as well as in adjusted analysis.
Conclusions: In an international registry Hypothyroidism was identified in around 1 of every 12 adult hospitalized patients with COVID-19. Pre-existing Hypothyroidism in hospitalized patients with COVID-19 was not associated with higher disease severity or increased risk of mortality or ICU admissions. However, more research on the possible effects of COVID-19 on the thyroid gland and its function is needed in the future. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; COVID-19 Disease Severity; Hypothyroidism; Mortality.