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Article: Long COVID in Patients with Mild to Moderate Disease: Do Thyroid Function and Autoimmunity Play a Role?

TitleLong COVID in Patients with Mild to Moderate Disease: Do Thyroid Function and Autoimmunity Play a Role?
Authors
KeywordsPost–acute COVID-19 syndrome
COVID-19
SARS-CoV-2
Thyroid function tests
Autoimmunity
Autoantibodies
Issue Date2021
PublisherElsevier Inc. The Journal's web site is located at https://www.sciencedirect.com/journal/endocrine-practice
Citation
Endocrine Practice, 2021, v. 27 n. 9, p. 894-902 How to Cite?
AbstractObjective: Post-acute sequelae of coronavirus disease 2019 (COVID-19) or long COVID (LC) is an emerging global health issue. Fatigue is a common feature. Whether thyroid function and autoimmunity play a role is uncertain. We aimed to evaluate the prevalence and predictors of LC and the potential role of thyroid function and autoimmunity in LC. Methods: We included consecutive adults without a known thyroid disorder who were admitted to a major COVID-19 center for confirmed COVID-19 from July to December 2020. Thyroid function tests and antithyroid antibodies were measured for all patients on admission and at follow-up. LC was defined by the presence or persistence of symptoms upon follow-up. Results: In total, 204 patients (median age, 55.0 years; 95 men [46.6%]) were reassessed at a median of 89 days (interquartile range, 69-99) after acute COVID-19. Of the 204 patients, 41 (20.1%) had LC. Female sex (adjusted odds ratio, 2.48; P = .018) and severe acute respiratory syndrome coronavirus 2 polymerase chain reaction cycle threshold value of <25 on admission (adjusted odds ratio, 2.84; P = .012) independently predicted the occurrence of LC. Upon follow-up, most abnormal thyroid function tests in acute COVID-19 resolved, and incident thyroid dysfunction was rare. Nonetheless, we observed incident antithyroid peroxidase (anti-TPO) positivity. Although baseline or follow-up thyroid function tests were not associated with the occurrence of LC, among 172 patients with symptomatic acute COVID-19, symptom resolution was more likely in those with positive anti-TPO upon follow-up (P = .043). Conclusion: LC is common among COVID-19 survivors, with females and those with higher viral load in acute COVID-19 particularly being vulnerable. The observation of incident anti-TPO positivity warrants further follow-up for thyroid dysfunction. Whether anti-TPO plays a protective role in LC remains to be elucidated.
Persistent Identifierhttp://hdl.handle.net/10722/301276
ISSN
2021 Impact Factor: 3.701
2020 SCImago Journal Rankings: 0.930
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLui, DTW-
dc.contributor.authorLee, CH-
dc.contributor.authorChow, WS-
dc.contributor.authorLee, ACH-
dc.contributor.authorTam, AR-
dc.contributor.authorPang, P-
dc.contributor.authorHo, TY-
dc.contributor.authorFong, CHY-
dc.contributor.authorLaw, CY-
dc.contributor.authorLeung, EKH-
dc.contributor.authorTo, KKW-
dc.contributor.authorTan, KCB-
dc.contributor.authorWoo, YC-
dc.contributor.authorLam, CW-
dc.contributor.authorHung, IFN-
dc.contributor.authorLam, KSL-
dc.date.accessioned2021-07-27T08:08:44Z-
dc.date.available2021-07-27T08:08:44Z-
dc.date.issued2021-
dc.identifier.citationEndocrine Practice, 2021, v. 27 n. 9, p. 894-902-
dc.identifier.issn1530-891X-
dc.identifier.urihttp://hdl.handle.net/10722/301276-
dc.description.abstractObjective: Post-acute sequelae of coronavirus disease 2019 (COVID-19) or long COVID (LC) is an emerging global health issue. Fatigue is a common feature. Whether thyroid function and autoimmunity play a role is uncertain. We aimed to evaluate the prevalence and predictors of LC and the potential role of thyroid function and autoimmunity in LC. Methods: We included consecutive adults without a known thyroid disorder who were admitted to a major COVID-19 center for confirmed COVID-19 from July to December 2020. Thyroid function tests and antithyroid antibodies were measured for all patients on admission and at follow-up. LC was defined by the presence or persistence of symptoms upon follow-up. Results: In total, 204 patients (median age, 55.0 years; 95 men [46.6%]) were reassessed at a median of 89 days (interquartile range, 69-99) after acute COVID-19. Of the 204 patients, 41 (20.1%) had LC. Female sex (adjusted odds ratio, 2.48; P = .018) and severe acute respiratory syndrome coronavirus 2 polymerase chain reaction cycle threshold value of <25 on admission (adjusted odds ratio, 2.84; P = .012) independently predicted the occurrence of LC. Upon follow-up, most abnormal thyroid function tests in acute COVID-19 resolved, and incident thyroid dysfunction was rare. Nonetheless, we observed incident antithyroid peroxidase (anti-TPO) positivity. Although baseline or follow-up thyroid function tests were not associated with the occurrence of LC, among 172 patients with symptomatic acute COVID-19, symptom resolution was more likely in those with positive anti-TPO upon follow-up (P = .043). Conclusion: LC is common among COVID-19 survivors, with females and those with higher viral load in acute COVID-19 particularly being vulnerable. The observation of incident anti-TPO positivity warrants further follow-up for thyroid dysfunction. Whether anti-TPO plays a protective role in LC remains to be elucidated.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at https://www.sciencedirect.com/journal/endocrine-practice-
dc.relation.ispartofEndocrine Practice-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectPost–acute COVID-19 syndrome-
dc.subjectCOVID-19-
dc.subjectSARS-CoV-2-
dc.subjectThyroid function tests-
dc.subjectAutoimmunity-
dc.subjectAutoantibodies-
dc.titleLong COVID in Patients with Mild to Moderate Disease: Do Thyroid Function and Autoimmunity Play a Role?-
dc.typeArticle-
dc.identifier.emailLui, DTW: dtwlui@hku.hk-
dc.identifier.emailLee, CH: pchlee@hku.hk-
dc.identifier.emailChow, WS: chowws01@hkucc.hku.hk-
dc.identifier.emailLee, ACH: achlee@HKUCC-COM.hku.hk-
dc.identifier.emailPang, P: pollpang@hku.hk-
dc.identifier.emailFong, CHY: kalofong@hku.hk-
dc.identifier.emailTo, KKW: kelvinto@hku.hk-
dc.identifier.emailTan, KCB: kcbtan@hkucc.hku.hk-
dc.identifier.emailWoo, YC: wooyucho@hku.hk-
dc.identifier.emailLam, CW: ching-wanlam@pathology.hku.hk-
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hk-
dc.identifier.emailLam, KSL: ksllam@hku.hk-
dc.identifier.authorityLui, DTW=rp02803-
dc.identifier.authorityLee, CH=rp02043-
dc.identifier.authorityTo, KKW=rp01384-
dc.identifier.authorityTan, KCB=rp00402-
dc.identifier.authorityLam, CW=rp00260-
dc.identifier.authorityHung, IFN=rp00508-
dc.identifier.authorityLam, KSL=rp00343-
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.eprac.2021.06.016-
dc.identifier.pmid34237471-
dc.identifier.pmcidPMC8257401-
dc.identifier.scopuseid_2-s2.0-85113792101-
dc.identifier.hkuros323695-
dc.identifier.volume27-
dc.identifier.issue9-
dc.identifier.spage894-
dc.identifier.epage902-
dc.identifier.isiWOS:000692871600006-
dc.publisher.placeUnited States-

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