DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20211228

COVID-19 patients with hypothyroidism: a retrospective cohort study from a dedicated COVID hospital of Mumbai, India

Chinmay N. Gokhale, Smita S. Chavhan, Balkrishna B. Adsul, Maharudra A. Kumbhar, Kirti V. Kinge, Prasad T. Dhikale, Aniket R. Ingale

Abstract


Background: India was one of the leaders in terms of COVID-19 cases across year 2020. Hypothyroidism is one of the common morbidities that may influence prognosis of infectious diseases. However, some previously published literature had suggested that hypothyroidism may not be affecting outcomes of COVID-19 disease. Objective of this study was to analyze the outcomes of COVID-19 patients with pre-existing hypothyroidism and further suggesting determinants of worse outcomes

Methods: This retrospective cohort study was carried out at one of largest Dedicated COVID-19 Hospital in Mumbai, India. Of the 16306 patients that got admitted at this hospital in year 2020, all those having hypothyroidism were included. Bivariate analysis was performed using Chi-square test and Multivariate analysis was performed using multiple logistic regression.

Results: A total of 251 patients were having pre-existing hypothyroidism (1.54%). More females had hypothyroidism (73.7%) while death rate was more in males (26.3%). ICU admissions (27.5%) and death proportions (18.3%) were significantly more in hypothyroidism. Diabetes and hypertension were common concomitant Co-morbidities and odds ratios for death for diabetes group, hypertension group and diabetes+hypertension group were 4.9, 8.1 and 4.4 respectively in comparison to those having exclusive hypothyroidism.

Conclusions: This study deals with an important topic of co-existing Hypothyroidism in COVID-19 patients and we can conclude that patients with Hypothyroidism must be considered to be at risk of severe outcomes. Furthermore, age, male gender and presence of concomitant Co-morbidities increase the risk of worse outcome.


Keywords


Hypothyroidism, COVID19, COVID-19 outcome

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References


WHO Director-General's opening remarks at the media briefing on COVID-19 11 March 2020. Available at https://www.who.int/director-general/ speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-COVID-19---11-march-2020. Accessed on 24 December 2020.

WHO Coronavirus Disease (COVID-19) Dashboard. Available at https://www.COVID19.who.int. Accessed on 24 December 2020.

Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of underlying diseases in hospitalized patients with COVID-19: A systematic review and meta-analysis. Archives Academic Emergency Med. 2020;8(1):e35.

Gerwen M, Alsen M, Little C, Barlow J, Naymagon L, Tremblay D, et al. Outcomes of patients with Hypothyroidism and COVID-19: a retrospective cohort study. Front Endocrinol. 2020;11:565.

Thyroid disease and Coronavirus. British Thyroid Foundation. Available at https://www.btf-thyroid.org/news/thyroid-disease-and-coronavirus-COVID-19. Accessed on 15 January 2021.

Scappaticcio L, Pitoia F, Esposito K, Piccardo A, Trimboli P. Impact of COVID19 on thyroid gland: An update. Rev Endocr Metab Disord. 2020;5:76-9.

Hariyanto TI, Kurniawan A. Thyroid disease is associated with severe coronavirus disease 2019 (COVID-19) infection. diabetes and metabolic syndrome: Clinical Res Reviews. 2020;14:e1429-e30.

Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab. 2013;17(4):647-52.

Zhang Y, Lin F, Tu W, Zhang J, Choudhry AA, Ahmed O. Thyroid dysfunction may be associated with poor outcomes in patients with COVID-19. Molecular and cellular Endocrinology. 2021;521:111097.

Daraei M, Hasibi M, Abdollahi H, Hazaveh MM, Zebaradst J, Hajinoori M, et al. Possible role of hypothyroidism in the prognosis of COVID-19. Internal Med J. 2020;50:1410-2.

Almiral A, Kostov B, Heredia M, Rotlan S, Aymar E, Corrales M, et al. Prognostic factors in Spanish COVID-19 patients: a case series from Barcelona. PLOS One. 2021;0237960.

Almazeedi S, Youha S, Jamal M, Haddad M, Muhaini A, Ghimlas F. Characteristics, risk factors and outcomes among the first consecutive 1096 patients diagnosed with COVID-19 in Kuwait. E Clinical Med. 2020;24:100448.

Mithal A, Dharmalingam M, Tewari N. Are patients with primary hypothyroidism in India receivingappropriate thyroxine replacement? An observational study. Indian J Endocrinol Metab. 2014;18(1):83-8.

Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Fong CHY, et al. Thyroid dysfunction in relation to immune profile, disease status and outcome in 191 patients with COVID-19. J Clin Endocrinol Metab. 2020;3:813.

Khoo B, Tan T, Clarke SA, Mills EG, Patel B, Modi M, et al. Thyroid function before, during, and after COVID-19. J Clin Endocrinol Metab. 2020;20(20):1-9.