Title Retrospective comparison of thyroid hormone levels in patients following a SARS-CoV-2 (COVID-19) infection
Title (croatian) Retrospektivna usporedba razine hormona štitnjače u bolesnika nakon infekcije SARS-CoV-2 (COVID-19)
Author Hanna Heitmann
Mentor Sigrun Renate Merger (mentor)
Committee member Johannes Brachmann (predsjednik povjerenstva)
Committee member Georg Gerhard Grabenbauer (član povjerenstva)
Committee member Ivana Pavlinac Dodig (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2024-07-11, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Basic Medical Sciences Human Physiology
Abstract Objectives: The objective of this study was to collect regional data of Upper Franconia and observe the association between thyroid parameters thyroid-stimulating-hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4) and an infection with SARS- CoV- 2. It was set to investigate the prevalence of patients with abnormal thyroid parameters (outside the range of reference), the association of COVID-19 infection on thyroid gland secretion based on laboratory parameters of routine clinical data and a possible increased vulnerability of persons with a history of Hashimoto's thyroiditis and Graves' disease to infection with COVID-19.
Patients and methods: For this retrospective observational study, routine clinical data of patients admitted to the REGIOMED Hospital Coburg, Upper Franconia region in Bavaria, Germany (single-site) were included and subsequently analyzed. The admissions were in between the official pandemic declaration of WHO on 11th March and ended with the declaration of German government on 07th April 2023 ending the pandemic. Data was collected from anonymized sources. A total of 10 450 cases were included of which 195 were also diagnosed with Hashimoto´s thyroiditis. Furthermore, 93 were included based on their ICD code in the group for Grave´s disease. The statistical analysis was carried out with RStudio.
Results: The first and foremost finding of this study indicates that the prevalence of a TSH value below the reference was significantly lower in the group with an active COVID infection in comparison to the non-COVID group. Other laboratory parameters fT3 and fT4 did not change in a mild course of an infection. Secondly, reduced deiodinase activity was seen to be caused by the CoV-19 infection and not by autoimmune activity in the setting of Hashimoto´s thyroiditis. Furthermore, neither Hashimoto´s thyroiditis nor Graves´ disease were seen to be associated with severely altered thyroid levels during a CoV-19 infection.
Conclusion: A mild infection with COVID-19 increases the risk of a lower TSH value but no altered thyroid function was seen in these patients. Following the pandemic several studies in the realm of the thyroid gland have been conducted but found widely heterogenic and also conflicting results have been found. Furthermore, a second significant finding of this study described reduced levels of SPINA GD with a subsequently a lowered deiodinase activity. This finding was indicated to be caused by the CoV-19 infection and not by an autoimmune activity in the setting of Hashimoto´s thyroiditis. Targeted prospective studies need to follow to evaluate on associations found in our study.
Abstract (croatian) Ciljevi: Cilj ovog istraživanja bio je prikupiti regionalne podatke Gornje Frankonije i promatrati povezanost između parametara štitnjače koji stimuliraju štitnjaču (TSH), slobodnog trijodtironina (fT3), slobodnog tiroksina (fT4) i infekcije SARS-CoV-2. Postavljeno je istraživanje prevalencije bolesnika s abnormalnim parametrima štitnjače (izvan raspona referencije), povezanost infekcije COVID-19 na izlučivanje štitnjače na temelju laboratorijskih parametara rutinskih kliničkih podataka i moguće povećane ranjivosti osoba s poviješću Hashimotovog tiroiditisa i Gravesove bolesti na infekciju COVID-19.
Pacijenti i metode: Za ovu retrospektivnu opservacijsku studiju uključeni su rutinski klinički podaci pacijenata primljenih u bolnicu REGIOMED Hospital Coburg, regija Gornja Frankonija u Bavarskoj, Njemačka. Priznanja su provedena između službenom pandemijskom deklaracijom izjave WHO-a o pandemiji 11. ožujka, te završilo je izjavom njemačke vlade 07. travnja 2023. o okončanju pandemije. Podaci su prikupljeni iz anonimiziranih izvora. Uključeno je ukupno 10.450 slučajeva, od kojih je kod 195 također dijagnosticiran Hashimotov tiroiditis. Osim toga, 93 su uključena u skupinu za Gravesovu bolest na temelju njihovog ICD koda. Statistička analiza provedena je sa RStudio.
Rezultati: Prvi i najvažniji rezultat ove studije pokazuje da je prevalencija TSH ispod referentnih vrijednosti bila značajno niža u skupini s aktivnom COVID infekcijom u usporedbi s nema-COVID skupinom. Ostali laboratorijski parametri fT3 i fT4 nisu se promijenili u blagom tijeku infekcije. Drugo, utvrđeno je da je smanjena aktivnost deiodinaze uzrokovana infekcijom CoV-19, a nema autoimunom aktivnošću u kontekstu Hashimotovog tiroiditisa. Osim toga, nije utvrđeno da ni Hashimotov tiroiditis ni Gravesova bolest nisu povezani s ozbiljno promijenjenom razinom štitnjače tijekom infekcije CoV-19.
Zaključak: Blaga infekcija COVID-19 povećava rizik niže vrijednosti TSH, ali u tih bolesnika nije uočena promijenjena funkcija štitnjače. Nakon pandemije provedeno je nekoliko studija na području štitne žlijezde, ali su dale vrlo heterogene i kontradiktorne rezultati. Osim toga, drugi značajan rezultat ove studije opisao je smanjenu razinu SPINA-GD s naknadno smanjenom aktivnošću deiodinaze. Ovaj nalaz uzrokovan je infekcijom CoV-19, a nema autoimunom aktivnošću u kontekstu Hashimotovog tiroiditisa. Ciljane prospektivne studije moraju slijediti kako bi se procijenile asocijacije pronađene u našoj studiji.
Keywords
SARS-CoV-2
COVID-19
Thyroid gland
Hypothyroidism
Hyperthyroidism
Hashimoto Disease
Graves Disease
Autoimmunity
SPINA GD
Keywords (croatian)
SARS-CoV-2
COVID-19
štitna žlijezda
hipotireoza
hipertireoza
Hashimotova bolest
gušavost
autoimunost
SPINA GD
Language english
URN:NBN urn:nbn:hr:171:893151
Study programme Title: Medical Studies in English Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access Embargo expiration date: 2024-07-11
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Created on 2024-07-05 08:32:24