Adults hospitalized with COVID-19 have lower thyroglobulin levels with glucocorticoid use
Click Here to Manage Email Alerts
Key takeaways:
- Thyroglobulin levels did not differ by thyroid function status among adults hospitalized with COVID-19.
- Adults treated with glucocorticoids had lower thyroglobulin levels.
Thyroglobulin levels differed by glucocorticoid use, but not by thyroid function, among a cohort of adults hospitalized for COVID-19, according to findings published in Frontiers in Endocrinology.
“The thyroid function in COVID-19 is complex and sometimes confusing. COVID-19-related nonthyroidal illness, subacute thyroiditis and thyrotoxicosis quickly gained the attention of researchers,” Agata Berlinska, MD, a PhD student and research assistant in the department of endocrinology and internal medicine, faculty of medicine at the Medical University of Gdansk in Poland, and colleagues wrote. “Thyroid function tests undergo distinct and very often transient changes in COVID-19-positive patients. In our material, the concentration of thyroglobulin did not differ between the patients with normal and abnormal thyroid function tests; however, it differed significantly depending on the use of glucocorticoids and tended to decrease over time.”
Researchers conducted an observational study of 174 adults hospitalized for COVID-19 at 7th Navy Hospital in Gdansk, Poland, from Feb. 14 to Dec. 1, 2021. Blood samples were collected in the morning of days 1, 4 and 10 of hospitalization. Thyroid function testing measured thyrotropin, total thyroxine, free T4, free triiodothyronine, reverse T3, thyroglobulin, anti-thyroglobulin antibodies and C-reactive protein. Data on demographics, anthropometric measurements, concomitant diseases and medication use were collected. Researchers also analyzed associations among 93 adults who received glucocorticoids during observation and 81 adults who did not receive glucocorticoids.
Of the cohort, 160 had thyroglobulin levels measured at day 1, 147 had measurements performed at day 4 and 102 has measurements taken at day 10. Anti-thyroglobulin antibodies were present in 6.9% of the cohort.
Thyroglobulin levels decreased during hospitalization. A decrease in thyroglobulin levels over time was observed among adults receiving glucocorticoids, but not among those who did not take glucocorticoids. Adults in the glucocorticoid group had lower thyroglobulin levels at day 4 (26.9 ng/mL vs. 40.3 ng/mL; P = .033) and day 10 (21.7 ng/mL vs. 34.2 ng/mL; P = .001) compared with adults who did not take glucocorticoids.
Thyroglobulin levels were similar between adults with normal thyroid function and those with abnormal thyroid function at all time points. No thyroid function parameters were correlated with thyroglobulin levels when adults were split into glucocorticoid subgroups. When the full cohort was analyzed, there was a positive correlation between thyroglobulin and free T3 (r = 0.215; P = .03), thyroglobulin and T4 (r = 0.196; P = .048), and thyroglobulin and C-reactive protein at day 10 (r = 0.225; P = .027).
“We found that 19 patients had elevated thyroglobulin levels at least once during observation, but a thyroid function test pattern suggestive of thyrotoxicosis was not common in this group,” the researchers wrote.
Researchers also analyzed thyroglobulin levels among adults who met a predefined endpoint of death, mechanical ventilation, noninvasive ventilation or high-flow nasal oxygenation, vasopressor use or hospitalization for at least 10 days. No differences in thyroglobulin were observed between adults who met one of those endpoints and adults who did not. There were also no differences observed for any of the endpoints when they were analyzed individually.
Collapse
Read more about
Click Here to Manage Email Alerts