Euthyroid sick syndrome in severe sars-cov-2 disease

Ifigenia Kostoglou-Athanassiou; Lambros Athanassiou; Eleni Ziambara; Alexandra Konstantinou; Sofia Nikolakopoulou; Charilaos Samaras; Panagiotis Athanassiou

doi:10.1530/endoabs.99.EP147

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Endocrine Abstracts (2024) 99 EP147 | DOI: 10.1530/endoabs.99.EP147

ECE2024 Eposter Presentations Thyroid (198 abstracts)

Euthyroid sick syndrome in severe sars-cov-2 disease

Ifigenia Kostoglou-Athanassiou ¹ , Lambros Athanassiou ² , Eleni Ziambara ³ , Alexandra Konstantinou ³ , Sofia Nikolakopoulou ³ , Charilaos Samaras ³ & Panagiotis Athanassiou ⁴

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¹Asclepeion Hospital, Voula, Department of Endocrinology, Athens, Greece; ²Asclepeion Hospital, Voula, Department of Rheumatology, Athens, Greece; ³Asclepeion Hospital, Voula, 1st Department of Medicine, Athens, Greece; ⁴St. Paul’s Hospital, Department of Rheumatology, Thessaloniki, Greece

Euthyroid sick syndrome also known as nonthyroidal illness syndrome is the reaction of the thyroid gland to severe disease. The SARS-CoV-2 virus affects the thyroid gland and may cause subacute thyroiditis, autoimmune Hashimoto’s thyroiditis, Graves’ disease, exacerbation of Graves’ disease and a form of silent thyroiditis. The aim was to study thyroid hormone levels and identify the presence of euthyroid sick syndrome in the context of severe SARS-CoV-2 disease. A group of 108 patients (68 male and 40 female) who were hospitalized for severe SARS-CoV-2 disease were studied. In these patients the levels of TSH, FT₄ and FT₃ were measured. TSH levels were measured in serum by the ARCHITECT TSH immunoassay (Abbott Park IL, USA). FT4 levels were analyzed in the serum of the patients via the ARCHITECT FT4 microparticle chemiluminescent immunoassay (Abbott Park IL, USA). FT3 was measured in serum using the ARCHITECT FT3 microparticle chemiluminescent immunoassay (Abbott Park IL, USA). TSH levels were 1.25±01.19 μIU/ml (mean±SEM), FT₄ levels 9.31±0.5 ng/dl and FT₃ levels 3.5±0.09 pg/ml . In 42 patients the presence of euthyroid sick syndrome was identified. The presence of euthyroid sick syndrome was related to the outcome of SARS-CoV-2 disease. The SARS-CoV-2 virus affects the thyroid gland and may cause autoimmune and autoinflammatory disease such as subacute thyroiditis, autoimmune Hashimoto’s thyroiditis, a form of silent thyroiditis and exacerbation of Graves’ disease. In patients with severe COVID-19 disease the presence of euthyroid sick syndrome was identified. In other reports the presence and severity of euthyroid sick syndrome was related to disease severity and disease outcome in COVID-19 patients.