No association between hypothyroidism, poor COVID-19 outcomes
Analysis of more than 3,000 COVID-19-positive adults in New York City showed no association between a history of hypothyroidism and risks for COVID-19 hospitalization, mechanical ventilation or death, according to study data.
“This study investigates whether pre-existing hypothyroidism worsens outcomes for patients with COVID-19. The study found that hypothyroidism does not increase risk of adverse outcomes from COVID-19 infection,” Maaike van Gerwen, MD, PhD, assistant professor in the department of otolaryngology – head and neck surgery at Icahn School of Medicine at Mount Sinai; and Catherine F. Sinclair MD, FRACS, FACS, associate professor in the department of otolaryngology – head and neck surgery at Icahn School of Medicine at Mount Sinai and director of the division of head and neck surgery at Mount Sinai West Hospital in New York, told Healio. “The clinical implications of the findings are that patients with hypothyroidism need not fear that the hypothyroidism puts them at increased risk of worse outcomes if infected by COVID-19.”
Van Gerwen, Sinclair and colleagues’ findings were published in Frontiers in Endocrinology.
Researchers conducted a retrospective review of electronic medical records from 3,703 hospitalized and ambulatory COVID-19 patients in a large New York City health system between March 1 and April 1. Individuals were identified as having hypothyroidism if the term was significantly mentioned in their medical record or if it was found in clinical notes in combination with thyroid hormone therapy prior to their COVID-19 diagnosis. Data were collected on hospital admission, invasive mechanical ventilation and all-cause mortality through May 13.
Of the total study population, 6.8% had hypothyroidism, and 8.8% of those with hypothyroidism had Hashimoto’s disease. In those with hypothyroidism and COVID-19, 68.1% needed hospitalization.
After adjusting for age, sex, ethnicity, BMI, smoking status and number of comorbidities, no association was found between hypothyroidism and risks for hospitalization, invasive mechanical ventilation or death. Propensity score matching between individuals with and without hypothyroidism revealed no statistical difference in the risk for hospitalization or death between the two groups.
“This study provided clinical evidence confirming the recommendations made by the American Thyroid Association that well-managed hypothyroidism is not associated with increased infection risk,” van Gerwen and Sinclair said. “However, patients with poorly controlled hypothyroidism were not specifically investigated in this study, and there is some evidence that susceptibility to infection might increase this subclass of patients with hypothyroidism.”
Individuals with thyroid disease should continue taking their medications to reduce the risk for thyroid dysregulation that could lead to a more severe COVID-19 outcome, the researchers wrote.
For more information:
Maaike van Gerwen, MD, PhD, can be reached at firstname.lastname@example.org.
Catherine F. Sinclair MD, FRACS, FACS, can be reached at email@example.com.