Effects of SARS-CoV-2 infection on hypothyroidism and subclinical hypothyroidism: a meta-analysis.

Jiaqi Wei, Fenghua Zhang

Journal: Frontiers in endocrinology 2023;14():1291774

PMID: 38111709

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Plain Language Summary

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has raised concerns about its impact on various health conditions, including thyroid disorders. Hypothyroidism and subclinical hypothyroidism are common endocrine disorders that may be influenced by viral infections. The primary aim of this study was to systematically review and analyse the effects of SARS-CoV-2 infection on the prevalence and severity of hypothyroidism and subclinical hypothyroidism. This research is a meta-analysis, synthesising data from multiple observational studies that examined the relationship between SARS-CoV-2 infection and thyroid function, specifically focusing on hypothyroidism and subclinical hypothyroidism. Results showed that although SARS-CoV-2 infection itself may not directly induce hypothyroidism, the severity of COVID-19 may contribute to thyroid dysfunction. Specifically, thyroid stimulating hormone and FT3 levels were significantly lower in individuals with severe COVID-19 than those with mild COVID-19. Authors concluded that further studies are needed to explore the findings of their study in order to understand the potential mechanisms of thyroid dysfunction in the outcome of COVID-19.

Abstract

BACKGROUND

In recent years, the outbreak of COVID-19 caused by SARS-CoV-2 has been witnessed globally. However, the impact of SARS-CoV-2 infection on thyroid dysfunction and subclinical thyroid dysfunction remains unclear. Therefore, this meta-analysis aimed to assess the effects of SARS-CoV-2 infection on thyroid dysfunction and its relationship with the severity of COVID-19.

METHODS

We systematically searched databases including PubMed, Willey Library, Embase, Web of Science, CNKI, Wanfang, and VIP. We focused on randomized controlled trials, case-control studies, and cohort studies published between December 2019 and August 2023, examining the association between SARS-CoV-2 infection and hypothyroidism, with a specific emphasis on the severity of the infection. The quality of the research was assessed using the Newcastle-Ottawa Scale (NOS), while statistical analysis was conducted using the meta and metafor packages in R 4.2.1 software.

RESULTS

For the meta-analysis, a total of eight articles were identified based on strict inclusion and exclusion criteria. For the association between SARS-CoV-2 infection and hypothyroidism, three studies (266 samples) comparing TSH levels of COVID-19 and control groups showed no difference in TSH levels [SMD=-0.04,95%CI(-1.22,1.15),]. Additionally, two studies examining TT3 (a sample of 176 cases) and two studies examining TT4 (a sample of 176 cases) also showed no difference in TT3 and TT4 between the COVID-19 group and the control group, respectively. However, when evaluating the severity of COVID-19, six studies (565 samples) showed that TSH in the severe group was significantly lower than in the mild group [SMD = -0.55, 95% CI (-0.96, -0.14)], while FT3 was also lower in the severe group [SMD = -0.96, 95% CI (-1.24, -0.67)]. No noticeable differences were observed between the severe and mild groups in their TT3, FT4, and TT4 levels.

CONCLUSION

SARS-CoV-2 infection may have detrimental effects on thyroid function in individuals with severe symptoms. More research is needed to confirm and explore this relationship.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023486042.

Address: College of Medical Technology, Shanghai University of Medicine & Health Sciences, Shanghai, China.; Department of Laboratory Medicine, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China.

DOI: 10.3389/fendo.2023.1291774