scholarly journals Suppression of the hypothalamic-pituitary-thyroid axis is associated with the severity of prognosis in hospitalized patients with COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juan Zheng ◽  
Zhenhai Cui ◽  
Ningjie Shi ◽  
Shenghua Tian ◽  
Ting Chen ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Cardiac Injury ◽  
Endocrine System ◽  
Composite Endpoint ◽  
Organ Damage ◽  
Multiple Organ ◽  
Laboratory Findings ◽  
Normal Thyroid Function ◽  
Hpt Axis

Abstract Background The outbreak of severe acute respiratory syndrome novel coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide. SARS-CoV-2 has been found to cause multiple organ damage; however, little attention has been paid to the damage to the endocrine system caused by this virus, and the subsequent impact on prognosis. This may be the first research on the hypothalamic-pituitary-thyroid (HPT) axis and prognosis in coronavirus disease 2019 (COVID-19). Methods In this retrospective observational study, 235 patients were admitted to the hospital with laboratory-confirmed SARS-CoV-2 infection from 22 January to 17 March 2020. Clinical characteristics, laboratory findings, and treatments were obtained from electronic medical records with standard data collection forms and compared among patients with different thyroid function status. Results Among 235 patients, 17 (7.23%) had subclinical hypothyroidism, 11 (4.68%) severe non-thyroidal illness syndrome (NTIS), and 23 (9.79%) mild to moderate NTIS. Composite endpoint events of each group, including mortality, admission to the ICU, and using IMV were observed. Compared with normal thyroid function, the hazard ratios (HRs) of composite endpoint events for mild to moderate NTIS, severe NTIS, subclinical hypothyroidism were 27.3 (95% confidence interval [CI] 7.07–105.7), 23.1 (95% CI 5.75–92.8), and 4.04 (95% CI 0.69–23.8) respectively. The multivariate-adjusted HRs for acute cardiac injury among patients with NTF, subclinical hypothyroidism, severe NTIS, and mild to moderate NTIS were 1.00, 1.68 (95% CI 0.56–5.05), 4.68 (95% CI 1.76–12.4), and 2.63 (95% CI 1.09–6.36) respectively. Conclusions Our study shows that the suppression of the HPT axis could be a common complication in COVID-19 patients and an indicator of the severity of prognosis. Among the three different types of thyroid dysfunction with COVID-19, mild to moderate NTIS and severe NTIS have a higher risk of severe outcomes compared with subclinical hypothyroidism.

scholarly journals The Spectrum of Cardiovascular Complications in COVID-19- A Comprehensive Literature Review

2020 ◽  
Author(s):  
Raja Shakeel Mushtaque ◽  
Rabia Mushtaque ◽  
Shahbano Baloch ◽  
Aadil Raza ◽  
Haseeb Bhatti ◽  
...  
Keyword(s):  
Literature Review ◽  
Rna Virus ◽  
Treatment Options ◽  
Cardiac Injury ◽  
Organ Damage ◽  
Cardiovascular Complications ◽  
Multiple Organ ◽  
Surface Glycoprotein ◽  
Fulminant Myocarditis ◽  
Organ Systems

A newly identified novel coronavirus named as severe acute respiratory syndrome-related coronavirus2 (SARS‐CoV 2) has given rise to the global pandemic. SARS-CoV2 which causes coronavirus disease 2019 (COVID-19), is a positive-stranded RNA virus with nucleocapsid. It binds to host angiotensin-converting enzyme2 (ACE2) receptor through surface glycoprotein (S protein). These ACE 2 receptors are attached to the cell membranes of many organs. Thus, COVID-19 does not only result in acute respiratory distress syndrome but also affects multiple organ systems, requiring a multidisciplinary approach to manage this disease. COVID-19 can damage the myocardial cells and result in fulminant myocarditis, acute cardiac injury, cardiomyopathy, heart failure, cardiogenic shock, or arrhythmia. COVID-19 seeds harmful immune response through cytokine storm leading to indirect organ damage. In this literature review, the available data is comprehended regarding cardiovascular complications in COVID-19, and the correlation of biomarkers with the disease activity is discussed. This literature review also highlights the important treatment options and outcomes of the individual study.

Abstract P125: Interaction Effects of Diabetes and Subclinical Hypothyroidism on Heart Rate Variability. The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Rosangela Hoshi ◽  
Itamar S Santos ◽  
Eduardo Dantas ◽  
Rodrigo Andreao ◽  
Bruce Duncan ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Longitudinal Study ◽  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Interaction Effects ◽  
Heart Rate Variability Parameter ◽  
Adult Health ◽  
Normal Thyroid ◽  
Normal Thyroid Function

Background: Diabetes and subclinical hypothyroidism are frequently coexisting conditions. The separated effects of each one on the cardiovascular system and cardio autonomic function are known. However, it has not been investigated yet whether the presence of both diseases has a joint influence on the cardiac autonomic system. As the autonomic nervous system is involved in cardiovascular, endocrine, and metabolic control, the association of diabetes and subclinical hypothyroidism might have combined effects, leading to cardio autonomic impairment and rising cardiovascular risk. Aim: To analyze the interaction effects of diabetes and subclinical hypothyroidism on Heart Rate Variability parameters among adults. using the participants enrolled at the baseline data of t Methods: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a cohort of 15015 men and women aged 35 to 74 years-old recruited in 2008-10. Participants were categorized into four groups: non-diabetes with normal thyroid function (controls), non-diabetes with subclinical hypothyroidism; diabetes with normal thyroid function; and diabetes with subclinical hypothyroidism. Heart Rate Variability analyses were performed in time and frequency domains: Standard Deviation of NN interval (SDNN); Root of the Mean of the Sum of the Squares of Differences between adjacent NN intervals (RMSSD, Low-Frequency (LF) and High-Frequency (HF) on 5-minute time series collected in the supine position. For each Heart Rate Variability parameter, we divided the sample into quartile groups, using the fourth quartile as reference. We analyzed the associations with the highest quartile group for each Heart Rate Variability parameter using additive and multiplicative terms in logistic models. Results: Point Odds Ratio, and 95% Confidence Intervals (95%CI) estimates for the first quartiles of all Heart Rate Variability measures were higher for subjects with the combination of both, “diabetes plus subclinical hypothyroidism” than for people with only the diagnosis of diabetes: SDNN: 2.61 (95%CI = 1.13 to 6.05) vs. 1.52 (95%CI =1.25 to 1.85); RMSSD: 2.70 (95%CI =1.18 to 6.18) vs. 1.48 (95%CI =1.21 to 1.80); LF: 2.82 (95%CI =1.05 to 7.56) vs. 1.73 (95%CI =1.40 to 2.13); HF: 3.07 (95%CI =1.21 to 7.75) vs. 1.41 (95%CI =1.16 to 1.71). Nonetheless, no significant multiplicative interaction terms between diabetes and subclinical hypothyroidism were found for the association with HRV variables. Conclusion: There is a potential joint impact on Heart Rate Variability showed by additive effects between diabetes and subclinical hypothyroidism.

scholarly journals High Prevalence of Anti Thyroid Antibodies in an Albanian Cohort of Patients

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A830-A831
Author(s):  
Dorina Minxuri ◽  
Anila Mitre ◽  
Silva Bino ◽  
Ina Toska ◽  
Ina Mulla
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Thyroid Disorders ◽  
Thyroid Antibodies ◽  
Positive Group ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Significant Difference ◽  
High Prevalence

Abstract Introduction: Albania is classified as iodine deficient region and endemic goiter in this country has been a concern for public health. A salt iodization program has been implemented in Albania since 2008. Most of regions still remain with a mild or moderate iodine deficiency there are no studies on prevalence of thyroid autoimmune disorders. The purpose of this study was to assess thyroid function and the presence of thyroid antibodies in subjects that were not previously diagnosed or treated for thyroid disorders. Methods: This is a cross-sectional study performed in a cohort of patients in Albania during a 2 year period (january 2018-january 2020). We assessed the prevalence of thyroid function disorders and presence of thyroid antibodies in 5047 subjects (81% females and 19% males). Individuals previously diagnosed or treated for thyroid disease were excluded from the study. TSH, Free T4, total T3, Anti TPO(thyroid peroxidase) and anti TG (thyroglobulin) were measured with electrochemiluminescence method with Cobas 6000 Roche Diagnostics. We calculated the frequency of thyroid antibodies and the abnormal thyroid function. Statistical analysis was performed to see if there was a difference between individuals with positive antibodies and those negative for antibodies. Results: 91 % (4596) of subjects resulted euthyroid. We found a low prevalence of overt thyroid dysfunction (hyperthyroidism 0.48% and hypothyroidism 1.69%). The rates of subclinical hypothyroidism and hyperthyroidism were 5.5% and 1.4% respectively. The prevalence of positive thyroid antibodies, at least one of them was 28% in females and 14% in males (2:1 ratio). 97.3 % of subjects who testet negative for antibodies had normal thyroid function compared to 73.5% in antibodies positive group. There was a significant difference for subclinical hypothyroidism and other thyroid disorders between antibodies positive group and antibodies negative group (p value <0.0000119% of individuals(from 5047 examined) had normal thyroid function and resulted positive for anti TPO or anti TG. Conclusions: Undiagnosed biochemical thyroid dysfunctions were common in subjects living in a mild to moderate iodine-deficient area especially subclinical hypothyroidism. TSH level correlated well with the presence of antibodies resulting in significant difference in thyroid function between 2 groups. We found a high prevalence (19%) of thyroid antibodies in euthyroid subjects. TPO antibodies in euthyroid subjects can be used to identify subjects with increased risk for hypothyroidism such as women who are pregnant (to predict first trimester or postpartum thyroid dysfunction), patients with other autoimmune diseases, subjects on drugs like amiodarone or relatives of patients with autoimmune thyroid diseases.

scholarly journals Multiple Organ Dysfunction Reduces In-Hospital Survival in COVID-19 Patients

2020 ◽  
Vol 5 (09) ◽  
pp. 389-394
Author(s):  
Najiba Abdulrazzaq ◽  
Kashif Bin Naeem ◽  
Abdalla Alhajiri ◽  
Ayman Chkhis ◽  
Vinod Choondal ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Organ Dysfunction ◽  
Distress Syndrome ◽  
Cardiac Injury ◽  
Kidney Injury ◽  
Organ Damage ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Hospital Survival ◽  
Multiple Organs

Background: Although primarily a respiratory illness, COVID-19 involves multiple organs when the disease is severe or critical. Hence, we conducted this study to evaluate the incidence of multiple organ dysfunction in COVID-19 patients and its implications on survival. Methods: A retrospective analysis of laboratory-confirmed COVID-19 patients presenting to our center in Dubai, UAE between April 2020 and July 2020. Data was collected from the electronic medical records and analyzed to evaluate multiple organ damage observed during hospital admission. Findings: Five-hundred patients were studied. Overall mean age was 49.5 years (range 13-94), 76% males, 33% diabetics, 31% hypertensives. 97/500 (19.4%) had evidence of single organ damage; 37/500 (7.4%) had two organ damage; and 105/500 (21%) had more than two organ damage. Acute respiratory distress syndrome was the most prevalent organ damage,153/500 (30.6%); followed by acute cardiac injury, 120/500 (24%); acute kidney injury 107/500 (21.4%); acute liver injury 96/500 (19.2%); septic shock 93/500 (18.6%); disseminated intravascular coagulation 27/500 (5.4%), and heart failure 17/500 (3.4%). We found that in-hospital survival reduced as the number of organs involved increased; only 20% patients survived who had more than 2 organ damage. Also, the chances of survival reduced considerably once other organs were involved in addition to the acute respiratory distress syndrome (91.6% survival in ARDS alone vs. 28.6% survival in ARDS with acute kidney injury vs. 10.4% survival in ARDS with shock/acute cardiac injury/acute kidney injury). Conclusion: Multiple organ dysfunction is common in COVID-19 as 21% had evidence of more than two organ damage in our study. The survival in COVID-19 reduces significantly once multiple organs are involved. Early monitoring and recognition of multiple organ dysfunction is necessary to prevent adverse outcomes and improve survival.

Development of new predictive equations for basal metabolic rate in Iranian healthy adults: negligible effect of sex

2020 ◽  
pp. 1-10
Author(s):  
Bahareh Nikooyeh ◽  
Nastaran Shariatzadeh ◽  
Ali Kalayi ◽  
Maliheh Zahedirad ◽  
Tirang R. Neyestani
Keyword(s):  
Metabolic Rate ◽  
Thyroid Function ◽  
Basal Metabolic Rate ◽  
Age Groups ◽  
Thyroid Function Tests ◽  
Anthropometric Measures ◽  
Predictive Equations ◽  
Normal Thyroid Function ◽  
Asian People ◽  
Predictive Formulas

Abstract. Some studies have reported inaccuracy of predicting basal metabolic rate (BMR) by using common equations for Asian people. Thus, this study was undertaken to develop new predictive equations for the Iranian community and also to compare their accuracy with the commonly used formulas. Anthropometric measures and thyroid function were evaluated for 267 healthy subjects (18–60 y). Indirect calorimetry (InCal) was performed only for those participants with normal thyroid function tests (n = 252). Comparison of predicted RMR (both kcal/d and kcal.kg.wt−1.d−1) using current predictive formulas and measured RMR revealed that Harris-Benedict and FAO/WHO/UNU significantly over-estimated and Mifflin-St. Jeor significantly under-estimated RMR as compared to InCal measurements. In stepwise regression analysis for developing new equations, the highest r2 (=0.89) was from a model comprising sex, height and weight. However, further analyses revealed that unlike the subjects under 30 y, the association between age and the measured RMR in subjects 30 y and plus was negative (r = −0.241, p = 0.001). As a result, two separate equations were developed for these two age groups. Over 80 percent of variations were covered by the new equations. In conclusion, there were statistical significant under- and over-estimation of RMR using common predictive equations in our subjects. Using the new equations, the accuracy of the calculated RMR increased remarkably.

Radioiodine treatment of feline hyperthyroidism in Germany

2002 ◽  
Vol 41 (06) ◽  
pp. 245-251 ◽  
Author(s):  
M. Knietsch ◽  
T. Spillmann ◽  
E.-G. Grünbaum ◽  
R. Bauer ◽  
M. Puille
Keyword(s):  
Radiation Exposure ◽  
Radiation Protection ◽  
Thyroid Function ◽  
Radioiodine Therapy ◽  
Whole Body ◽  
Radioiodine Treatment ◽  
Normal Thyroid ◽  
Normal Thyroid Function ◽  
Body Activity ◽  
Thyroid Uptake

SummaryAim: Establishment of radioiodine treatment of feline hyperthyroidism in veterinary routine in accordance with German radiation protection regulations. Patients and methods: 35 cats with proven hyperthyroidism were treated with 131I in a special ward. Thyroid uptake and effective halflife were determined using gammacamera dosimetry. Patients were released when measured whole body activity was below the limit defined in the German “Strahlenschutzverordnung”. Results: 17/20 cats treated with 150 MBq radioiodine and 15/15 cats treated with 250 MBq had normal thyroid function after therapy, normal values for FT3 and FT4 were reached after two and normal TSH levels after three weeks. In 14 cats normal thyroid function was confirmed by controls 3-6 months later. Thyroidal iodine uptake was 24 ± 10%, effective halflife 2.5 ± 0.7 days. Whole body activity <1 MBq was reached 13 ± 4 days after application of 131I. Radiation exposure of cat owners was estimated as 1.97 Sv/MBq for adults. Conclusion: Radioiodine therapy of feline hyper-thyroidism is highly effective and safe. It can easily be performed in accordance with German radiation protection regulations, although this requires hospitalisation for approximately two weeks. Practical considerations on radiation exposure of cat owners do not justify this long interval. Regulations for the veterinary use of radioactive substances similar to existing regulations for medical use in humans are higly desirable.

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