History of hypothyroidism not linked to worse outcomes after COVID-19 hospitalization
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Key takeaways:
- About 8.5% of older adults hospitalized with COVID-19 have a history of hypothyroidism.
- Adults with a history of hypothyroidism have a similar risk for severe COVID-19 outcomes as those without hypothyroidism.
Older adults with a history of hypothyroidism who were hospitalized with COVID-19 had a similar risk for severe outcomes and mortality compared with those without hypothyroidism, according to study data.
“Having a history of hypothyroidism does not substantially impact in-hospital mortality of older patients with COVID-19,” Viviana Bagalà, surgeon in training in the department of medical sciences at the University of Ferrara in Italy, and colleagues wrote in a study published in the Journal of Endocrinological Investigation. “Although not all the study participants had available information on hypothyroidism etiology, the results of our main analysis seemed to be confirmed, especially for those with congenital hypothyroidism. However, further studies with larger sample sizes are needed to explore this issue better.”
Researchers obtained data from GeroCovid Observational study, a multicenter retrospective-prospective study conducted in Italy. Adults aged 60 years or older who were hospitalized for a COVID-19 infection from March to December 2020 were included (n = 1,245; mean age, 78.6 years). History of hypothyroidism before hospitalization was obtained through medical records. Participants were categorized into three groups based on hypothyroidism etiology: congenital hypothyroidism, acquired hypothyroidism or unspecified. COVID-19 severity was determined based on WHO classification at hospital admission. Clinical outcomes analyzed included clinical improvement with hospital discharge, clinical worsening, transfer to other care settings and death.
Of the cohort, 8.5% had a history of hypothyroidism. Of those with hypothyroidism, 20% had congenital hypothyroidism, 24% had an acquired etiology and 30% had no etiology data available.
Adults with a history of hypothyroidism were less likely to have low oxygen saturation (42% vs. 49.5%; P = .03) and anorexia (4.5% vs. 10.5%; P = .01) and more likely to report loss of smell (2.3% vs. 0.7%; P = .01) and muscle aches (9.1% vs. 4.3%; P = .02) than those without hypothyroidism.
Of the full cohort, 28.5% died during hospitalization, 46.4% had a clinical improvement, 22.8% were transferred to another health care setting and 1.5% had clinical worsening. There were no differences in outcomes between adults with a history of hypothyroidism and those without hypothyroidism. In Cox regression models after adjusting for confounders, no associations were observed between the two groups. The results were similar in a secondary analysis evaluating adults by hypothyroidism etiology.
“Future investigations are needed to verify and confirm our findings for the more recent COVID-19 outbreaks, evaluating causes of hypothyroidism and biochemical data on thyroid hormones,” the researchers wrote.
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