ArticleClinical endocrinology2021
Role of non-thyroidal illness syndrome in predicting adverse outcomes in COVID-19 patients predominantly of mild-to-moderate severity.
Article in Clinical endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- The prevalence of thyroid disorders in COVID-19 patients: a systematic review and meta-analysis.BMC endocrine disorders · 2024Pooled it
- Thyroid diseases are associated with coronavirus disease 2019 infection.Frontiers in endocrinology · 2022Pooled it
- Association of thyroid dysfunction and COVID-19: A systematic review and meta-analysis.Frontiers in endocrinology · 2022Pooled it
- The Association Between COVID-19 and Thyroxine Levels: A Meta-Analysis.Frontiers in endocrinology · 2021Pooled it
- Non-thyroidal illness (euthyroid sick) syndrome: Laboratory aspects and clinical significance in critically ill patients and other diseases - A narrative review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Review
- Dissecting biomarker networks linking COVID-19 inflammatory drivers, disease severity and thyroid adaptive responses.Scientific reports · 2025Article
- [Abnormal thyroid markers in critically ill patients-harmless irritation or a real problem?]Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Thr92Ala-DIO2 heterozygosity is associated with skeletal muscle mass and myosteatosis in patients with COVID-19.European thyroid journal · 2024Article
- Association between thyroid function and prognosis of severe COVID-19 among patients with SARS-CoV-2 infection: a retrospective cohort study in China.Frontiers in endocrinology · 2024Article
- Thyroid Autoimmunity and SARS-CoV-2 Infection.Journal of clinical medicine · 2023Review
- Review
- Thyroid disturbances after COVID-19 and the effect of vaccination in children: a prospective tri-center registry analysis.European journal of pediatrics · 2023Article
- A prospective follow-up on thyroid function, thyroid autoimmunity and long COVID among 250 COVID-19 survivors.Endocrine · 2023Article
- Analysis of clinical features and 7-year all-cause mortality in older male patients with non-thyroidal illness syndrome on general wards.European geriatric medicine · 2023Observational
- A Literature Review on SARS-CoV-2 and Other Viruses in Thyroid Disorders: Environmental Triggers or No-Guilty Bystanders?International journal of environmental research and public health · 2023Review
- Transient low T3 syndrome in patients with COVID-19: a new window for prediction of disease severity.Frontiers in endocrinology · 2023Article
- Article
- Development of a prediction score (ThyroCOVID) for identifying abnormal thyroid function in COVID-19 patients.Journal of endocrinological investigation · 2022Article
- Thyroid autoimmunity and SARS-CoV-2 infection: Report of a large Italian series.Autoimmunity reviews · 2022Review
- Thyroid-Stimulating Hormone Predicts Total Cholesterol and Low-Density Lipoprotein Cholesterol Reduction during the Acute Phase of COVID-19.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
14 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveExisting studies reported the potential prognostic role of non-thyroidal illness syndrome (NTIS), characterized by low triiodothyronine (T3) with normal/low thyroid-stimulating hormone (TSH), mainly in severe COVID-19. None considered the significant impact of SARS-CoV-2 viral load on adverse outcomes. We aimed to clarify the prognostic role of NTIS among predominantly mild-to-moderate COVID-19 patients.
designA prospective study of COVID-19 patients. PATIENTS AND MEASUREMENTS: Consecutive adults admitted to Queen Mary Hospital for confirmed COVID-19 from July to December 2020 were prospectively recruited. SARS-CoV-2 viral load was represented by cycle threshold (Ct) values from real-time reverse transcription-polymerase chain reaction of the respiratory specimen on admission. Serum TSH, free thyroxine and free T3 were measured on admission. The outcome was deterioration in clinical severity, defined as worsening in ≥1 category of clinical severity according to the Chinese National Health Commission guideline.
resultsWe recruited 367 patients. At baseline, 75.2% had mild disease, and 27 patients (7.4%) had NTIS. Fifty-three patients (14.4%) had clinical deterioration. Patients with NTIS were older, had more comorbidities, worse symptomatology, higher SARS-CoV-2 viral loads and worse profiles of inflammatory and tissue injury markers. They were more likely to have clinical deterioration (p < .001). In multivariable stepwise logistic regression analysis, NTIS independently predicted clinical deterioration (adjusted odds ratio 3.19, p = .017), in addition to Ct value <25 (p < .001), elevated C-reactive protein (p = .004), age >50 years (p = .011) and elevated creatine kinase (p = .017).
conclusionsNon-thyroidal illness syndrome was not uncommon even in mild-to-moderate COVID-19 patients. NTIS on admission could predict clinical deterioration in COVID-19, independent of SARS-CoV-2 viral load, age and markers of inflammation and tissue injury.
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