The prevalence of thyroid disorders in COVID-19 patients: a systematic review and meta-analysis.

Sadra Ashrafi, Hossein Hatami, Razieh Bidhendi-Yarandi, Mohammad Hossein Panahi

Journal: BMC endocrine disorders 2024;24(1):5

PMID: 38166835

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Plain Language Summary

COVID-19, caused by the SARS-CoV-2 virus, has had widespread impacts on various organ systems, including the endocrine system. Emerging evidence suggests that COVID-19 may affect thyroid function, leading to thyroid disorders. The primary aim of this study was to evaluate the prevalence of thyroid disorders among COVID-19 patients and to identify any associated factors. This research was a systematic review and meta-analysis, incorporating data from multiple observational studies and clinical reports on thyroid function in COVID-19 patients. Results showed a 26% prevalence of non-thyroidal illness syndrome and a 10% prevalence of thyrotoxicosis [clinical state associated with excess thyroid hormone activity]. Authors concluded that clinicians should monitor thyroid function in COVID-19 patients, particularly those with severe illness, and provide appropriate treatment.

Abstract

OBJECTIVES

To conduct a systematic review and meta-analysis to evaluate the prevalence of thyroid disorders in COVID-19 patients.

DATA SOURCES

Scopus, PubMed, ISI Web of Science, and Google Scholar databases were used in this review. We also consider the results of grey literature.

STUDY SELECTIONS

Cohort, cross-sectional, and case-control studies were included.

DATA EXTRACTION AND SYNTHESIS

The required data were extracted by the first author of the article and reviewed by the second author. The Pooled prevalence of outcomes of interest was applied using the meta-prop method with a pooled estimate after Freeman-Tukey Double Arcsine Transformation to stabilize the variances.

OUTCOMES AND MEASURED

The different thyroid disorders were the main outcomes of this study. The diseases include non-thyroidal illness syndrome, thyrotoxicosis, hypothyroidism, isolated elevated free T4, and isolated low free T4.

RESULTS

Eight articles were included in our meta-analysis(Total participants: 1654). The pooled prevalence of events hypothyroidism, isolated elevated FT4, isolated low FT4, NTIS, and thyrotoxicosis were estimated (Pooled P = 3%, 95% CI:2-5%, I2: 78%), (Pooled P = 2%, 95% CI: 0-4%, I2: 66%), (Pooled P = 1%, 95% CI: 0-1%, I2: 0%), (Pooled P = 26%, 95% CI: 10-42%, I2: 98%), and (Pooled P = 10%, 95% CI: 4-16%, I2: 89%), respectively.

CONCLUSION

Thyroid dysfunction is common in COVID-19 patients, with a high prevalence of non-thyroidal illness syndrome (NTIS) and thyrotoxicosis. Our meta-analysis found a 26% prevalence of NTIS and a 10% prevalence of thyrotoxicosis.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022312601.

Address: Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Department of Public Health, School of Public Health & Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.; Safety Promotion and Injury Prevention Research Center, Research Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [email protected].; Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran. [email protected].

DOI: 10.1186/s12902-023-01534-9