Hypothyroidism does not lead to worse prognosis in COVID-19: findings from the Brazilian COVID-19 registry
Author:
Pereira Daniella NunesORCID, Gontijo Silveira Leticia FerreiraORCID, Moreira Guimarães Milena MariaORCID, Polanczyk Carísi AnneORCID, Sousa Nunes Aline GabrielleORCID, de Moura Costa André SoaresORCID, Farace Barbara LopesORCID, Rodrigues Cimini Christiane CorrêaORCID, de Carvalho Cíntia AlcantaraORCID, Ponce DanielaORCID, Roesch Eliane WürdigORCID, Fernandes Manenti Euler RobertoORCID, Lucas Fernanda Barbosa, Rodrigues Fernanda d’AthaydeORCID, Anschau FernandoORCID, Aranha Fernando GraçaORCID, Bartolazzi FredericoORCID, Vietta Giovanna GrunewaldORCID, Nascimento Guilherme FagundesORCID, Duani HelenaORCID, Vianna Heloisa ReniersORCID, Guimarães Henrique CerqueiraORCID, Martins Costa Jamille Hemétrio SallesORCID, Lyra Batista Joanna d’ArcORCID, de Alvarenga Joice CoutinhoORCID, Chatkin José MiguelORCID, de Morais Júlia Drumond Parreiras, Machado-Rugolo JulianaORCID, Ruschel Karen BrasilORCID, Pinheiro Lílian SantosORCID, Monteiro Menezes Luanna SilvaORCID, Ferreira Couto Luciana SiuvesORCID, Kopittke LucianeORCID, de Castro Luís CésarORCID, Nasi Luiz AntônioORCID, de Souza Cabral Máderson AlvaresORCID, Floriani Maiara AnschauORCID, Souza Maíra DiasORCID, Carneiro MarceloORCID, Camargos Bicalho Maria AparecidaORCID, de Godoy Mariana FrizzoORCID, Alves Nogueira Matheus CarvalhoORCID, Guimarães Júnior Milton HenriquesORCID, Severino Sampaio Natália da CunhaORCID, de Oliveira Neimy RamosORCID, Assaf Pedro LedicORCID, Finger Renan GoulartORCID, Campos Roberta XavierORCID, Menezes Rochele MosmannORCID, Francisco Saionara CristinaORCID, Alvarenga Samuel PenchelORCID, Mereilles Guimarães Silvana Mangeon, Araújo Silvia FerreiraORCID, Oliveira Talita FischerORCID, Oliveira Diniz Thulio HenriqueORCID, Ramires Yuri CarlottoORCID, de Almeida Cenci Evelin PaolaORCID, de Oliveira Thainara ConceiçãoORCID, Schwarzbold Alexandre VargasORCID, Ziegelmann Patricia KlarmannORCID, Pozza RobertaORCID, Pires Magda CarvalhoORCID, Marcolino Milena SorianoORCID
Abstract
AbstractBackgroundIt is not clear whether previous thyroid diseases influence the course and outcomes of COVID-19. The study aims to compare clinical characteristics and outcomes of COVID-19 patients with and without hypothyroidism.MethodsThe study is a part of a multicentric cohort of patients with confirmed COVID-19 diagnosis, including data collected from 37 hospitals. Matching for age, sex, number of comorbidities and hospital was performed to select the patients without hypothyroidism for the paired analysis.ResultsFrom 7,762 COVID-19 patients, 526 had previously diagnosed hypothyroidism (50%) and 526 were selected as matched controls. The median age was 70 (interquartile range 59.0-80.0) years-old and 68.3% were females. The prevalence of underlying comorbidities were similar between groups, except for coronary and chronic kidney diseases, that had a higher prevalence in the hypothyroidism group (9.7% vs. 5.7%, p=0.015 and 9.9% vs. 4.8%, p=0.001, respectively). At hospital presentation, patients with hypothyroidism had a lower frequency of respiratory rate > 24 breaths per minute (36.1% vs 42.0%; p=0.050) and need of mechanical ventilation (4.0% vs 7.4%; p=0.016). D-dimer levels were slightly lower in hypothyroid patients (2.3 times higher than the reference value vs 2.9 times higher; p=0.037). In-hospital management was similar between groups, but hospital length-of-stay (8 vs 9 days; p=0.029) and mechanical ventilation requirement (25.4% vs. 33.1%; p=0.006) were lower for patients with hypothyroidism. There was a trend of lower in-hospital mortality in patients with hypothyroidism (22.1% vs. 27.0%; p=0.062).ConclusionIn this large Brazilian COVID-19 Registry, patients with hypothyroidism had a lower requirement of mechanical ventilation, and showed a trend of lower in-hospital mortality. Therefore, hypothyroidism does not seem to be associated with a worse prognosis, and should not be considered among the comorbidities that indicate a risk factor for COVID-19 severity.
Publisher
Cold Spring Harbor Laboratory
|
|