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Horm Metab Res 2023; 55(01): 25-30
DOI: 10.1055/a-1971-8781
Original Article: Endocrine Care

The Clinical Characteristics and Outcomes of COVID-19 Patients with Pre-Existing Thyroid Dysfunction: A Nationwide Study

Mustafa Sahin
1   Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Ibrahim Demirci
2   University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Cem Haymana
2   University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Ilker Tasci
3   University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
,
Rıfat Emral
1   Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Erman Cakal
4   University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Ugur unluturk
5   Hacettepe University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Ilhan Satman
6   Istanbul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Istanbul, Turkey
,
Tevfik Demir
7   Dokuz Eylul University, Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Naim Ata
8   Department of Strategy Development, Ministry of Health, Ankara, Turkey
,
Derun Ertugrul
9   University of Health Sciences, Faculty of Medicine, Kecioren Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Aysegul Atmaca
10   Ondokuz Mayis University, Faculty of Medicine, Department of Endocrinology and Metabolism, Samsun, Turkey
,
Serpil Salman
11   Medica Clinic, Department of Endocrinology and Metabolism, Istanbul, Turkey
,
Ibrahim Sahin
12   Inonu University, Faculty of Medicine, Department of Endocrinology and Metabolism, Malatya, Turkey
,
Selcuk Dagdelen
4   University of Health Sciences, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
,
Osman Celik
13   Public Hospitals General Directorate, Republic of Turkey, Ministry of Health, Ankara, Turkey
,
Murat Caglayan
14   Ankara Provincial Health Directorate, Ankara, Turkey
,
Alper Sonmez
2   University of Health Sciences, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey
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Abstract

To which extent the pre-existing hypothyroidism or hyperthyroidism has an impact on coronavirus infection 2019 (COVID-19) outcomes remains unclear. The objective of this study was to evaluate COVID-19 morbidity and mortality in patients with pre-existing thyroid dysfunction. A retrospective cohort of patients with a polymerase chain reaction (PCR)-confirmed COVID-19 infection (n=14 966) from March 11 to May 30, 2020, was established using the database of the Turkish Ministry of Health. We compared the morbidity and mortality rates of COVID-19 patients with pre-existing hypothyroidism (n=8813) and hyperthyroidism (n=1822) to those patients with normal thyroid function (n=4331). Univariate and multivariate regression analyses were performed to identify the factors associated with mortality. Mortality rates were higher in patients with hyperthyroidism (7.7%) and hypothyroidism (4.4%) than those with normal thyroid function (3.4%) (p<0.001 and p=0.008, respectively). Pre-existing hyperthyroidism was significantly associated with an increased risk of mortality (OR 1.54; 95% CI, 1.02–2.33; p=0.042) along with advanced age, male gender, lymphopenia and chronic kidney disease (p<0.001 for all). Although a potential trend was noted, the association between pre-existing hypothyroidism and mortality was not significant (OR 1.36; 95% CI, 0.99–1.86; p=0.055). In conclusion, this study showed an association between pre-existing hyperthyroidism with higher COVID-19 mortality. A potential trend towards increased mortality was also observed for hypothyroidism. The risk was more pronounced in patients with hyperthyroidism.

Key words

thyroid dysfunction - hyperthyroidism - TSH - COVID-19 - mortality - ICU admission

Supplementary Material



Publication History

Received: 11 May 2022

Accepted after revision: 03 November 2022

Accepted Manuscript online:
03 November 2022

Article published online:
09 December 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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