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- Publisher Website: 10.3803/EnM.2021.983
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Article: Insights from a Prospective Follow-up of Thyroid Function and Autoimmunity among COVID-19 Survivors
Title | Insights from a Prospective Follow-up of Thyroid Function and Autoimmunity among COVID-19 Survivors |
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Authors | |
Keywords | COVID-19 Euthyroid sick syndromes SARS-CoV-2 Thyroid function tests Thyroid gland |
Issue Date | 2021 |
Publisher | Korean Endocrine Society. The Journal's web site is located at http://www.enm-kes.org/ |
Citation | Endocrinology and Metabolism, 2021, v. 36 n. 3, p. 582-589 How to Cite? |
Abstract | Abstract Background: The occurrence of Graves' disease and Hashimoto thyroiditis after coronavirus disease 2019 (COVID-19) raised concerns that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger thyroid autoimmunity. We aimed to address the current uncertainties regarding incident thyroid dysfunction and autoimmunity among COVID-19 survivors. Methods: We included consecutive adult COVID-19 patients without known thyroid disorders, who were admitted to Queen Mary Hospital from July 21 to September 21, 2020 and had serum levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine (fT3), and anti-thyroid antibodies measured both on admission and at 3 months. Results: In total, 122 patients were included. Among 20 patients with abnormal thyroid function tests (TFTs) on admission (mostly low fT3), 15 recovered. Among 102 patients with initial normal TFTs, two had new-onset abnormalities that could represent different phases of thyroiditis. Among 104 patients whose anti-thyroid antibody titers were reassessed, we observed increases in anti-thyroid peroxidase (TPO) (P<0.001) and anti-thyroglobulin (P<0.001), but not anti-thyroid stimulating hormone receptor titers (P=0.486). Of 82 patients with negative anti-TPO findings at baseline, 16 had a significant interval increase in anti-TPO titer by >12 U, and four became anti-TPO-positive. Worse baseline clinical severity (P=0.018), elevated C-reactive protein during hospitalization (P=0.033), and higher baseline anti-TPO titer (P=0.005) were associated with a significant increase in anti-TPO titer. Conclusion: Most patients with thyroid dysfunction on admission recovered during convalescence. Abnormal TFTs suggestive of thyroiditis occurred during convalescence, but infrequently. Importantly, our novel observation of an increase in anti-thyroid antibody titers post-COVID-19 warrants further follow-up for incident thyroid dysfunction among COVID-19 survivors. |
Description | Open Access Journal |
Persistent Identifier | http://hdl.handle.net/10722/300935 |
ISSN | 2023 Impact Factor: 3.9 2023 SCImago Journal Rankings: 1.122 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lui, TWD | - |
dc.contributor.author | Lee, CH | - |
dc.contributor.author | Chow, WS | - |
dc.contributor.author | Lee, CHA | - |
dc.contributor.author | Tam, AR | - |
dc.contributor.author | Fong, CHY | - |
dc.contributor.author | Law, CY | - |
dc.contributor.author | Leung, EKH | - |
dc.contributor.author | To, KKW | - |
dc.contributor.author | Tan, KCB | - |
dc.contributor.author | Woo, YC | - |
dc.contributor.author | Lam, CW | - |
dc.contributor.author | Hung, FNI | - |
dc.contributor.author | Lam, KSL | - |
dc.date.accessioned | 2021-07-06T03:12:16Z | - |
dc.date.available | 2021-07-06T03:12:16Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | Endocrinology and Metabolism, 2021, v. 36 n. 3, p. 582-589 | - |
dc.identifier.issn | 2093-596X | - |
dc.identifier.uri | http://hdl.handle.net/10722/300935 | - |
dc.description | Open Access Journal | - |
dc.description.abstract | Abstract Background: The occurrence of Graves' disease and Hashimoto thyroiditis after coronavirus disease 2019 (COVID-19) raised concerns that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger thyroid autoimmunity. We aimed to address the current uncertainties regarding incident thyroid dysfunction and autoimmunity among COVID-19 survivors. Methods: We included consecutive adult COVID-19 patients without known thyroid disorders, who were admitted to Queen Mary Hospital from July 21 to September 21, 2020 and had serum levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine (fT3), and anti-thyroid antibodies measured both on admission and at 3 months. Results: In total, 122 patients were included. Among 20 patients with abnormal thyroid function tests (TFTs) on admission (mostly low fT3), 15 recovered. Among 102 patients with initial normal TFTs, two had new-onset abnormalities that could represent different phases of thyroiditis. Among 104 patients whose anti-thyroid antibody titers were reassessed, we observed increases in anti-thyroid peroxidase (TPO) (P<0.001) and anti-thyroglobulin (P<0.001), but not anti-thyroid stimulating hormone receptor titers (P=0.486). Of 82 patients with negative anti-TPO findings at baseline, 16 had a significant interval increase in anti-TPO titer by >12 U, and four became anti-TPO-positive. Worse baseline clinical severity (P=0.018), elevated C-reactive protein during hospitalization (P=0.033), and higher baseline anti-TPO titer (P=0.005) were associated with a significant increase in anti-TPO titer. Conclusion: Most patients with thyroid dysfunction on admission recovered during convalescence. Abnormal TFTs suggestive of thyroiditis occurred during convalescence, but infrequently. Importantly, our novel observation of an increase in anti-thyroid antibody titers post-COVID-19 warrants further follow-up for incident thyroid dysfunction among COVID-19 survivors. | - |
dc.language | eng | - |
dc.publisher | Korean Endocrine Society. The Journal's web site is located at http://www.enm-kes.org/ | - |
dc.relation.ispartof | Endocrinology and Metabolism | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License | - |
dc.subject | COVID-19 | - |
dc.subject | Euthyroid sick syndromes | - |
dc.subject | SARS-CoV-2 | - |
dc.subject | Thyroid function tests | - |
dc.subject | Thyroid gland | - |
dc.title | Insights from a Prospective Follow-up of Thyroid Function and Autoimmunity among COVID-19 Survivors | - |
dc.type | Article | - |
dc.identifier.email | Lui, TWD: dtwlui@hku.hk | - |
dc.identifier.email | Chow, WS: chowws01@HKUCC.hku.hk | - |
dc.identifier.email | Lee, CHA: achlee@hku.hk | - |
dc.identifier.email | To, KKW: kelvinto@hku.hk | - |
dc.identifier.email | Tan, KCB: kcbtan@hku.hk | - |
dc.identifier.email | Woo, YC: wooyucho@hku.hk | - |
dc.identifier.email | Lam, CW: ching-wanlam@pathology.hku.hk | - |
dc.identifier.email | Hung, FNI: ivanhung@hkucc.hku.hk | - |
dc.identifier.email | Lam, KSL: ksllam@hku.hk | - |
dc.identifier.authority | Lui, TWD=rp02803 | - |
dc.identifier.authority | To, KKW=rp01384 | - |
dc.identifier.authority | Tan, KCB=rp00402 | - |
dc.identifier.authority | Lam, CW=rp00260 | - |
dc.identifier.authority | Hung, FNI=rp00508 | - |
dc.identifier.authority | Lam, KSL=rp00343 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.3803/EnM.2021.983 | - |
dc.identifier.pmid | 34107601 | - |
dc.identifier.pmcid | PMC8258341 | - |
dc.identifier.scopus | eid_2-s2.0-85109488562 | - |
dc.identifier.hkuros | 323095 | - |
dc.identifier.volume | 36 | - |
dc.identifier.issue | 3 | - |
dc.identifier.spage | 582 | - |
dc.identifier.epage | 589 | - |
dc.identifier.isi | WOS:000668158300013 | - |
dc.publisher.place | South Korea | - |