THYROTOXICOSIS IN PATIENTS WITH COVID 19: THE THYRCOV STUDY.
OBJECTIVE This study assessed thyroid function in patients affected by the coronavirus disease 19 (COVID 19) based on the hypothesis that the cytokine storm associated with COVID 19 may influence thyroid function and/or the severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) may directly act on thyroid cells, such as previously demonstrated for SARS CoV 1 infection. DESIGN AND METHODS This single center study was retrospective and consisted in evaluating thyroid function tests and serum interleukin 6 (IL 6) values in 287 consecutive patients (193 males, mean age 64.3+ 14.0 years, range: 27 92) hospitalized for COVID 19 in non intensive care units. RESULTS Fifty eight patients (20.2% were found with thyrotoxicosis (overt in 31 cases) 15 (5.2% with hypothyroidism (overt in only 2 cases) 214 (74.6% with normal thyroid function. Serum thyrotropin (TSH) values were inversely correlated with age of patients (rho 0.27; p<0.001) and IL 6 (rho 0.41; p<0.001) In the multivariate logistic regression analysis, thyrotoxicosis resulted to be significantly associated with higher IL 6 (odds ratio 3.25, 95% confidence interval 1.97 5.36; p<0.001) whereas the association with age of patients was lost (p=0.09) CONCLUSIONS This study provides a first evidence that COVID 19 may be associated with high risk of thyrotoxicosis in relationship with systemic immune activation induced by the SARS CoV 2 infection.
European journal of endocrinology