COVID-19 on vaikeampi niillä, joiden kilpirauhastilanteessa aktiivisen T3-hormonin määrä on matala.

 https://pubmed.ncbi.nlm.nih.gov/33551316/

Rutiinitutkimuksisa katotaan  TSH ja T4, T¤ on inaktiivi muotojoka aktivoituu kehossa T3-muotoon.  Jos tätä ei tapahdu riittävästi,  tauti on oireinen ja Covid-19 tilanteessa riskitekijä.

 

• 
  
• 
  
• 
  

. 2021 Feb;27(2):101-109.

doi: 10.1016/j.eprac.2021.01.001. Epub 2021 Jan 11.

Sick Euthyroid Syndrome on Presentation of Patients With COVID-19: A Potential Marker for Disease Severity

Yair Schwarz  ¹ , Ruth Percik  ² , Bernice Oberman  ³ , Dana Yaffe  ⁴ , Eyal Zimlichman  ⁵ , Amir Tirosh  ²

Affiliations

• PMID: 33551316
• PMCID: PMC7834506
• DOI: 10.1016/j.eprac.2021.01.001

Free PMC article

Abstract

Objective: Precise risk stratification and triage of coronavirus disease 2019 (COVID-19) patients are essential in the setting of an overwhelming pandemic burden. Clinical observation has shown a somewhat high prevalence of sick euthyroid syndrome among patients with COVID-19. This study aimed to evaluate the predictive value of free triiodothyronine (FT3) at the clinical presentation of COVID-19 for disease severity and death.

Methods: This retrospective cohort study was based on electronic medical records. The study was conducted at Sheba Medical Centre, a tertiary hospital where several acute and chronic wards have been dedicated to the treatment of patients with COVID-19. The primary outcome measure was death during hospitalization; secondary outcomes included hospitalization in intensive care, mechanical ventilation, and length of hospitalization.

Results: Of a total of 577 polymerase chain reaction-positive patients with COVID-19 hospitalized between February 27 and July 30, 2020, 90 had at least 1 measurement of thyroid-stimulating hormone, free thyroxine, and FT3 within 3 days of presentation. After applying strict exclusion criteria, 54 patients were included in the study. Patients in the lowest tertile of FT3 had significantly higher rates of mortality (40%, 5.9%, and 5.9%, P = .008), mechanical ventilation (45%, 29.4%, and 0.0%; P = .007) and intensive care unit admission (55%, 29.4%, and 5.9%, P = .006). In multivariate analyses adjusted for age, Charlson comorbidity index, creatinine, albumin, and white blood cell count. FT3 remained a significant independent predictor of death.

Conclusion: FT3 levels can serve as a prognostic tool for disease severity in the early presentation of COVID-19.

Keywords: COVID-19; FT3; prognostic factors; sick euthyroid syndrome.

Copyright © 2021 AACE. Published by Elsevier Inc. All rights reserved.