![]() In this study, we assessed the thyroid function in patients with COVID-19 and analyzed the related factors to determine the potential value of ESS in predicting the disease severity. Previous studies suggested that thyroid hormone levels, especially low serum levels of free T3 (FT3), are usually associated with the disease severity and deterioration prognosis in critical illness ( 11, 12). ESS is the physiologic adaptation and pathologic response to acute disease, occurring in the fasting state in healthy individuals, as well as in the context of infection, trauma, myocardial infarction, and malignancy ( 10). ![]() ESS is characterized by a decreased level of serum T3 and/or thyroxine (T4) without an increased secretion of thyroid-stimulating hormone (TSH) ( 9). During acute illness, changes in the serum levels of thyroid hormones have been depicted which represent a condition known as euthyroid sick syndrome (ESS). A study composed of 48 SARS patients found that 93.7% patients had a low serum level of triiodothyronine (T3) ( 8). An identity match of more than 85% has been identified between SARS-CoV-2 and a bat SARS-like CoV genome published previously ( 7). Whether the thyroid gland is affected by SARS-CoV-2 remains unclear. The thyroid gland is a neuroendocrine organ which plays an important role in regulating immunity and metabolism. The etiological agent of COVID-19 has been confirmed as a novel coronavirus, initially named 2019-nCov but now known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ( 5).ĬOVID-19 can impair almost any structure in the human body from the brain to the toes, including lungs, liver, heart, kidney, brain, gut, etc. As of August 28, over 24,000,000 cases and 800,000 deaths have been identified worldwide ( 4). It has spread widely around the world and been declared a pandemic by the World Health Organization (WHO) on March 11, 2020. It was first reported in Wuhan, China, in December 2019 ( 1– 3). The areas under the curve (AUCs) for predicting the severe disease were and for FT3 and CRP, respectively.Ĭonclusion: ESS was significantly associated with the disease severity and inflammatory parameters in COVID-19 patients.Ĭoronavirus Disease 2019 (COVID-19) is an infectious disease which causes severe respiratory illness. The regression analysis showed that ESS was significantly associated with the disease severity of COVID-19 (HR = 2.515, 95% CI: 1.050–6.026, P = 0.039). The levels of erythrocyte sedimentation rate and C-reactive protein, and the positive rate of procalcitonin were significantly higher, whereas the lymphocyte count was apparently lower in ESS patients than in non-ESS patients. ESS patients had higher proportions of fever, shortness of breath, hypertension, diabetes, and severe events than those of non-ESS patients. Results: Forty-one (27.52%) cases of COVID-19 patients diagnosed with ESS. Subsequently, a receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performances of FT3 and C-reactive protein (CRP) in the disease severity. Kaplan-Meier curve and cox regression model were utilized to determine the correlation between ESS and the endpoints. Methods: Clinical and laboratory data of COVID-19 patients with or without ESS in Changsha, China, were collected and analyzed on admission. In this study, the thyroid function of COVID-19 patients was assessed and factors associated with outcomes were analyzed to determine the potential predictive value of ESS. Euthyroid sick syndrome (ESS) is usually associated with the disease severity and deterioration prognosis in critical illness. ![]() However, it is not clear whether the thyroid gland is impaired in COVID-19 patients. 4Department of Respiratory, The Second Xiangya Hospital, Central South University, Changsha, Chinaīackground: Coronavirus disease 2019 (COVID-19) has been shown to affect almost every organ throughout the body.3Critical Care Medicine, The First Hospital of Changsha, Changsha, China.2Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.1Children’s Medical Center, The Second Xiangya Hospital, Central South University, Changsha, China. ![]() Runmei Zou 1† Chenfang Wu 2† Siye Zhang 2 Guyi Wang 2 Quan Zhang 3 Bo Yu 2 Ying Wu 2 Haiyun Dong 2 Guobao Wu 2 Shangjie Wu 4 Yanjun Zhong 2* ![]()
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