Endocrine Abstracts

Introduction

Adequate supply of zinc, selenium, and vitamin D is essential for resistance to other viral infections, immune function, and reduced inflammation. Low levels of micronutrients are associated with adverse clinical outcomes during viral infections. Vitamin D improves the physical barrier against the virus and stimulates the production of antimicrobial peptides. It can prevent cytokine storms by reducing the production of inflammatory cytokines. Selenium enhances the function of cytotoxic effector cells. Furthermore, selenium is important for maintaining T cell maturation and function, as well as for producing T cell-dependent antibodies. Our goal was to determine the effects of selenium, zinc, and vitamin D supplementation on recovery from COVID-19 in patients with pre-existing Hashimoto’s thyroiditis.

Methods

A cohort observational study was conducted. Adult patients with pre-existing Hashimoto’s thyroiditis admitted to the “Dr. Al-Tawil” outpatient clinic with COVID-19 from March 15 to December 31, 2020 were included. Of the 356 Hashimoto’s patients who had COVID-19 infection, 270 (75.8%) took supplements and 86 (24.2%) did not.

Results

Most Hashimoto’s patients (93%) who had COVID-19 were euthyroid. The study showed that Hashimoto’s patients (24.2%) who did not take selenium, zinc and vitamin D increased their risk of adverse outcomes from COVID-19 infection. In those who did not take supplements, 28% required hospitalization. There were no deaths. After adjusting for age, gender, BMI, smoking status, we found an association between the absence of supplements and the risk of hospitalization, and invasive mechanical ventilation. Patients with Hashimoto’s thyroiditis who had COVID-19 infection and who had previously taken supplements such as selenium, zinc, and vitamin D had milder clinical outcomes, or no symptoms compared to those who did not receive supplements who had a moderate or severe outcome (P <0.05).

Conclusions

For the treatment of people with Hashimoto’s thyroiditis who become infected with COVID-19, the addition of selenium, zinc, and vitamin D3 could be beneficial. Randomized controlled trials and large population studies should be performed to evaluate these recommendations.

Keywords

COVID-19, Hashimoto thyroiditis, micronutrients, selenium, zinc, vitamin D