ECE2022 Eposter Presentations Thyroid (219 abstracts)
1St. Queen Jadwiga Clinical District Hospital No.2 Rzeszów, Department of Internal Medicine, Nephrology and Endocrinology, Poland; 2Medical College of Rzeszów University, Poland
Introduction: The incidence and mortality rate for COVID-19 differ in different regions, but the risk of in-hospital death is high in all countries. It is very important to identify patients at risk of death at the beginning of hospitalization. The disease often leads to NTIS (nonthyroidal illness syndrome), which can be the result of the cytokines storm [1]. The inflammatory parameters and the level of FT3 appear to be obvious leading risk of death.
Objective: The study aimed to investigate the serum levels of thyroid hormones and selected inflammatory biomarkers in adult COVID-19 patients and to determine whether they predict the risk of death.
Methods: We retrospectively analyzed the lab results of patients hospitalized in our clinic from October 2020 to January 2021 with confirmed SARS-CoV-2 infection (n=393). Patients with a history of thyroid disease, patients treated with thyroid drugs and those who have recently received iodinated contrast were excluded. All of them were initially in stage II of the course of the disease [2]. The STATISTICA 13.1 statistical program was used to perform the tests and P values < 0.05 were considered statistically significant.
Results: Fifty-three (13,49%) adult patients were enrolled in the study. The median age was 72±12,2 years, 26 patients (49%) were men. NTIS was detected in 64% of all patients and low FT3 serum levels showed strong correlation with disease severity and mortality prognosis in COVID-19. The results are shown in Table 1.
Nonsurvivors (n=14) | Survivors (n=39) | ||||||
median | Min. | Max. | median | Min. | Max. | P | |
FT3, [pg/ml] | 1,8 | 1,2 | 2,5 | 2,2 | 1,3 | 3,4 | P=0,01 |
FT4, [ng/ml] | 1,1 | 0,6 | 1,5 | 1,3 | 0,6 | 1,8 | P=0,05 |
Interleukin 6, [pg/ml] | 41,9 | 4,8 | 620 | 15 | 2,7 | 559 | P=0,05 |
Ferritin, [ng/ml] | 221.25 | 22 | 994 | 570 | 12 | 16000 | P=0.01 |
WBC, [10&unix2079;/l] | 10.9 | 7.78 | 195 | 6.75 | 1.01 | 25.97 | P=0.002 |
Neutrophils, [cells/µl] | 7860 | 752 | 15050 | 5120 | 897 | 23770 | P=0.04 |
Conclusions: 1. Low serum FT3 concentrations predict clinical deterioration and higher mortality in COVID-19 patients. 2. The levels of Il-6, WBC, ferritin, neutrophils are prognostic markers of in-hospital mortality in patients with COVID-19.
References: 1. Llamas M et al. Low free-T3 serum levels and prognosis of COVID-19: systematic review and meta-analysis. Clin Chem Lab Med. 2021 Aug 10. 2. Siddiqi HK et al. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. J Heart Lung Transplant. 2020; 39: 405-407.