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Hu YL, Zhang YJ, Lv XY, Liu RL, Zhong ZH, Fu LJ, Bao MH, Geng LH, Xu HJ, Yu SM, Ding YB. Impact of Omicron Variant Infection on Female Fertility and Laboratory Outcomes: A Self-Controlled Study. Am J Reprod Immunol 2024; 92:e70012. [PMID: 39535337 DOI: 10.1111/aji.70012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/18/2024] [Accepted: 10/16/2024] [Indexed: 11/16/2024] Open
Abstract
PROBLEM Investigating the impact of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection on female fertility and laboratory outcomes in patients undergoing assisted reproductive technology (ART) treatment who were initially uninfected but later became infected. METHODS OF THE STUDY This self-controlled study included 197 patients who underwent repeated oocyte retrieval before and after SARS-CoV-2 infection between March 2021 and April 2023, of which 117 used the same ovarian stimulation protocol within a consistent age range. We evaluated the ovarian reserve, ovarian response, and laboratory outcomes in patients before and after SARS-CoV-2 infection. RESULTS The ovarian reserve (follicle-stimulating hormone [FSH], luteinizing hormone [LH], estrogen [E2], anti-Müllerian hormone [AMH], antral follicle count [AFC]), ovarian response (total Gn dosage, duration of Gn administration, number of follicles ≥14 mm on trigger day, number of retrieved oocytes), and laboratory outcomes (cleavage stage good-quality embryo rate, blastocyst formation rate, and cycle freezing rate) showed no significant differences before and after SARS-CoV-2 infection in 117 patients (p > 0.05). When stratified by age, the ≤ 35 years group showed a higher two pronuclei (2PN) fertilization rate post-infection, while the >35 years group had increased mature metaphase II (MII) oocyte and blastocyst stage good-quality embryo rates. Additionally, upon stratified by the time interval between SARS-CoV-2 infection and ART treatment, in the ≤ 3 months group, there was an increased post-infection MII oocyte rate, 2PN fertilization rate, and blastocyst stage good-quality embryo rate. Meanwhile, no significant differences were found in any indicators when the interval exceeded three months. CONCLUSION Our study suggested that undergoing IVF/ICSI treatment after recovering from COVID-19 may not adversely affect female fertility and laboratory outcomes.
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Affiliation(s)
- Yu-Ling Hu
- The Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, China
| | - Yong-Jia Zhang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Toxicology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xing-Yu Lv
- The Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, China
| | - Rui-Ling Liu
- Department of Toxicology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Zhao-Hui Zhong
- Department of Toxicology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Li-Juan Fu
- Department of Toxicology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
- Department of Pharmacology, Academician Workstation, Changsha Medical University, Changsha, China
| | - Mei-Hua Bao
- Department of Pharmacology, Academician Workstation, Changsha Medical University, Changsha, China
| | - Li-Hong Geng
- The Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, China
| | - Hai-Jiao Xu
- The Reproductive Center, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, China
| | - Shao-Min Yu
- Department of Obstetrics and Gynecology, The People's Hospital of Yubei District of Chongqing, Chongqing, China
| | - Yu-Bin Ding
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Toxicology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Chongqing Medical University, Chongqing, China
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Elliott MR, O'Connor AE, Marshall GD. Inflammatory pathways in patients with post-acute sequelae of COVID-19: The role of the clinical immunologist. Ann Allergy Asthma Immunol 2024; 133:507-515. [PMID: 39179099 PMCID: PMC11575468 DOI: 10.1016/j.anai.2024.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 08/26/2024]
Abstract
As the SARS-CoV-2 pandemic progressed, some survivors noted prolonged symptoms after acute infection, termed post-acute sequelae of COVID-19 (PASC) or "long COVID." PASC is a significant clinical and public health concern that adversely affects patients' quality of life, income, and health care expenses. Moreover, PASC symptoms are highly heterogeneous, the most common being fatigue and cognitive impairment, and they likely reflect a spectrum of clinical phenotypes. The proposed role of persistent inflammation is one of leading pathophysiological theories. This review article addresses these proposed mechanisms of persistent and aberrant inflammation, their clinical evaluation, and theoretical approaches to management. A review of public databases was used to collect literature for the review. The literature supports a prominent role of persistent and aberrant inflammation as a major contributor to the symptoms of PASC. Proposed mechanisms for persistent inflammation include reactivation of latent viruses, viral persistence, loss of immunoregulatory pathways, autoimmune mechanisms, and/or mast cell dysregulation. Persistent inflammation may result in constitutional symptoms such as fatigue, brain fog, body aches, and/or organ-specific dysfunction, such as gastrointestinal dysregulation and myocardial inflammation. There are no approved or even proven therapies for PASC at this time, but some studies have identified therapeutic options that may either reduce the risk for progression to PASC or decrease symptom burden. Laboratory evaluation and therapeutic options are limited and require further investigation to establish their clinical value. A more refined definition of PASC is needed to address the wide variety of clinical presentations, pathophysiology, and therapeutic options.
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Affiliation(s)
- Matthew R Elliott
- The University of Mississippi Medical Center, Department of Internal Medicine, Division of Clinical Immunology, Jackson, Mississippi.
| | - Anna E O'Connor
- The University of Mississippi Medical Center, Department of Internal Medicine, Division of Clinical Immunology, Jackson, Mississippi
| | - Gailen D Marshall
- The University of Mississippi Medical Center, Department of Internal Medicine, Division of Clinical Immunology, Jackson, Mississippi
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Sokołowski G, Studen KB, Opalinska M, Wegrzyn K, Motyka M, Gilis-Januszewska A, Hubalewska-Dydejczyk A. Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series. Intern Emerg Med 2024; 19:1921-1928. [PMID: 38967885 PMCID: PMC11467063 DOI: 10.1007/s11739-024-03690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/18/2024] [Indexed: 07/06/2024]
Abstract
The COVID-19 pandemic was a major challenge for all health care employees, but it was also difficult for patients to gain access to health care services. Myxedema coma (MC) is an extremely rare but potentially fatal endocrine emergency. The aim of the study was to report an increased incidence of life-threatening myxedema coma that occurred in relation to the COVID-19 pandemic. In this paper, we report a cohort of 11 patients with MC who were treated at the University Hospital in Krakow, Poland, in the period from 2015 to 2023. Only 1 case of MC was recorded in the period from 2015 to 2019, and, in the same area, 10 cases of MC were recorded after the start of COVID-19 pandemic until present. Hypothyroidism was diagnosed de novo in 2 (18%) patients; the remaining patients were severely hypothyroid due to therapy non-compliance. Nine patients had primary hypothyroidism, and 2 had central hypothyroidism. Besides longstanding hypothyroidism, an additional precipitating factor for MC was identified in 4 (36%) of the patients. Due to the inaccessibility of parenteral levothyroxine, patients were treated with oral, mostly liquid, form of levothyroxine. The mortality rate in this cohort was 27.2%. In conclusion, the increase of the incidence of MC, which is a life-threatening complication of inadequately treated hypothyroidism, during the COVID-19 pandemic, when resources were limited, and in the post-pandemic era, underlines the importance of adequate communication with patients and of long-term availability of primary care for patients with thyroid disease.
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Affiliation(s)
- Grzegorz Sokołowski
- Chair and Department of Endocrinology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Kraków, Poland
| | - Katica Bajuk Studen
- Faculty of Medicine, Department of Internal Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Nuclear Medicine, University Medical Centre, Ljubljana, Slovenia
| | - Marta Opalinska
- Chair and Department of Endocrinology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Kraków, Poland
| | - Karolina Wegrzyn
- Department of Endocrinology, Oncological Endocrinology, Nuclear Medicine and Internal Medicine, University Hospital, Kraków, Poland
| | - Marcin Motyka
- Department of Endocrinology, Oncological Endocrinology, Nuclear Medicine and Internal Medicine, University Hospital, Kraków, Poland
| | - Aleksandra Gilis-Januszewska
- Chair and Department of Endocrinology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Kraków, Poland
| | - Alicja Hubalewska-Dydejczyk
- Chair and Department of Endocrinology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688, Kraków, Poland.
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Syal R, Kaur J, Siddiqui M, Amatul-Raheem H, Suarez C, Bojanki NLSVA, Kapadia SD, Yennam AK, Kunchala K, Metry S, Ruma U. Long-Term Impacts of COVID-19 on Thyroid Health: Insights From Clinical Studies. Cureus 2024; 16:e71469. [PMID: 39544551 PMCID: PMC11560388 DOI: 10.7759/cureus.71469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2024] [Indexed: 11/17/2024] Open
Abstract
BACKGROUND COVID-19 emerged in December 2019 and rapidly became a global pandemic. It has since been associated with the progression of various endocrine disorders, including thyroid disease. The long-term effects of this interplay have yet to be explored. This review explores the relationship between COVID-19 and thyroid diseases, emphasizing thyroid gland function and the clinical implications for managing thyroid disorders in infected individuals. OBJECTIVES This narrative review intends to provide insight into the scope of research that future clinical studies may aim to address regarding the long-term effects of COVID-19 infection on thyroid health. METHODS Keywords including "thyroid disease", "COVID-19", and "long-term" were used to search PubMed and Google Scholar for updated and relevant clinical research. RESULTS COVID-19 affects the thyroid gland multifacetedly and includes direct viral invasion, immune-mediated damage, and hypothalamic-pituitary-thyroid axis disruption. Approximately 15% of COVID-19 patients experience thyroid dysfunction, which can present as thyrotoxicosis, hypothyroidism, or non-thyroidal illness syndrome (NTI). Noteworthy findings include inflammatory thyroiditis. Long-term effects, including those observed in children, include persistent hypothyroidism and exacerbated pre-existing thyroid-autoimmune conditions. Management of thyroid disorders in COVID-19 patients requires consideration: anti-thyroid drug (ATD) therapy used to treat hyperthyroidism in COVID-19 patients may need adjustment to prevent immunosuppression. Radioactive iodine (ROI) alternatives and interleukin-6 (IL-6) receptor antagonists could offer potential benefits and should be further explored. CONCLUSION Longitudinal follow-ups post-COVID-19 for patients with new and pre-existing thyroid disorders can improve disease outcomes. In addition, pathophysiological research on thyroid dysfunction in COVID-19 may help develop strategies to prevent and alleviate thyroid gland abnormalities post-COVID-19.
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Affiliation(s)
- Ria Syal
- Department of Biology, University of Waterloo, Cambridge, CAN
| | - Jasmeet Kaur
- Department of Medicine, Sapienza University of Rome, Rome, ITA
| | - Maheen Siddiqui
- Department of Cardiac Sciences, SINA-Health, Education and Welfare Trust, Karachi, PAK
| | | | - Cristhian Suarez
- Department of Medicine, Universidad San Francisco de Quito, Quito, ECU
| | | | - Sagar D Kapadia
- Department of Emergency Medicine, Jio World Center, Mumbai, IND
| | | | - Keerthi Kunchala
- Department of Internal Medicine, Sri Venkateswara Medical College, Tirupati, IND
| | - Sherien Metry
- Department of Medicine, Medical University of Assiut, Asyut, EGY
| | - Umme Ruma
- Department of Medicine, Rajeev Gandhi University of Health Sciences, Bengaluru, IND
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5
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Shen Y, Zhang Y, Xu YY, Li X, Wu J, Pei H, Wang L, Zhu T. Causal associations between severe COVID-19 and diseases of seven organs: a proteome-wide mendelian randomization study. Front Genet 2024; 15:1421824. [PMID: 39192889 PMCID: PMC11347274 DOI: 10.3389/fgene.2024.1421824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/29/2024] [Indexed: 08/29/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic poses an enormous threat to public health worldwide. Many retrospective studies and case reports to date have shown associations between severe COVID-19 and diseases of multi-organs. However, the research on the causal mechanisms behind this phenomenon is neither extensive nor comprehensive. We conducted a proteome-wide Mendelian randomization (MR) study using summary statistics from a Genome-Wide Association Studies (GWAS) of severe COVID-19 and diseases related to seven organs: lung, spleen, liver, heart, kidney, testis, and thyroid, based on the European ancestry. The primary analytical method used is the radial inverse variance-weighted (radial IVW) method, supplemented with the inverse variance-weighted (IVW), weighted-median (WM), MR-Egger methods. Our findings have confirmed the association between severe COVID-19 and multiple organ-related diseases, such as Hypothyroidism, strict autoimmune (HTCBSA), Thyroid disorders (TD), and Graves' disease (GD). And we have also identified certain proteins that are associated with organ-related diseases, such as Superoxide Dismutase 2 (SOD2) and TEK Receptor Tyrosine Kinase (TEK), which are also considered potential drug targets. Phenotype scanning and sensitivity analyses were implemented to consolidate the results for Mendelian randomization. This study provides a compelling foundation for investigating COVID-19 caused diseases in future studies.
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Affiliation(s)
- Yunhan Shen
- College of Mathematics and Computer Science, Zhejiang A&F University, Hangzhou, China
| | - Yi Zhang
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Ye-yang Xu
- Songyang County People’s Hospital, Lishui, Zhejiang, China
| | - Xinyi Li
- College of Mathematics and Computer Science, Zhejiang A&F University, Hangzhou, China
| | - Jiachen Wu
- College of Mathematics and Computer Science, Zhejiang A&F University, Hangzhou, China
| | - Hao Pei
- MobiDrop (Zhejiang) Co., Ltd., Tongxiang, Zhejiang, China
| | - Linyan Wang
- Zhejiang Provincial Key Laboratory of Ophthalmology, Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Zhejiang University, Hangzhou, Zhejiang, China
| | - Tiansheng Zhu
- College of Mathematics and Computer Science, Zhejiang A&F University, Hangzhou, China
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Chavez-Flores V, Sharobiem A, Kim S, Kang M, Kim TY. New-Onset Paroxysmal Atrial Fibrillation in a Healthy Male With Post-COVID-19 Painless Thyroiditis: A Case Report. Cureus 2024; 16:e66288. [PMID: 39238761 PMCID: PMC11376423 DOI: 10.7759/cureus.66288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 09/07/2024] Open
Abstract
Painless thyroiditis is a variant of thyroiditis without the typical neck pain and is otherwise similar to subacute thyroiditis, which is a known post-viral condition and has been associated with coronavirus disease 2019 (COVID-19) infections. While it is usually self-limiting, it can lead to thyrotoxicosis that can predispose individuals to cardiac dysrhythmias, including atrial fibrillation. There has been a clear association between COVID-19 and subacute thyroiditis with a few case reports describing atrial fibrillation. We present a case of a healthy patient with new-onset atrial fibrillation secondary to painless thyroiditis. This report highlights the rare entity of painless thyroiditis leading to atrial fibrillation with rapid ventricular response in a patient who recently recovered from COVID-19. Physicians should consider the potential association of painless thyroiditis in patients with new-onset atrial fibrillation who recently recovered from COVID-19.
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Affiliation(s)
| | - Andro Sharobiem
- Internal Medicine, HCA Healthcare, Riverside Community Hospital, Riverside, USA
| | - Steven Kim
- Emergency Medicine, HCA Healthcare, Riverside Community Hospital, Riverside, USA
| | - Michael Kang
- Emergency Medicine, HCA Healthcare, Riverside Community Hospital, Riverside, USA
| | - Tommy Y Kim
- Emergency Medicine, HCA Healthcare, Riverside Community Hospital, Riverside, USA
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Lui DTW, Xiong X, Cheung CL, Lai FTT, Li X, Wan EYF, Chui CSL, Chan EWY, Cheng FWT, Li L, Chung MSH, Lee CH, Woo YC, Tan KCB, Wong CKH, Wong ICK. Risk of Incident Thyroid Dysfunction in the Post-Acute Phase of COVID-19: A Population-Based Cohort Study in Hong Kong. Endocr Pract 2024; 30:528-536. [PMID: 38552902 DOI: 10.1016/j.eprac.2024.03.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE The evidence of thyroid dysfunction in the post-acute phase of SARS-CoV-2 infection is limited. This study aimed to evaluate the risk of incident thyroid dysfunction in the post-acute phase of COVID-19. METHODS This retrospective, propensity-score matched, population-based study included COVID-19 patients and non-COVID-19 individuals between January 2020 and March 2022, identified from the electronic medical records of the Hong Kong Hospital Authority. The cohort was followed up until the occurrence of outcomes, death, or 31 January 2023, whichever came first. Patients with COVID-19 were 1:1 matched to controls based on various variables. The primary outcome was a composite of thyroid dysfunction (hyperthyroidism, hypothyroidism, initiation of antithyroid drug or levothyroxine, and thyroiditis). Cox regression was employed to evaluate the risk of incident thyroid dysfunction during the post-acute phase. RESULTS A total of 84 034 COVID-19 survivors and 84 034 matched controls were identified. Upon a median follow-up of 303 days, there was no significant increase in the risk of diagnosed thyroid dysfunction in the post-acute phase of COVID-19 (hazard ratio [HR] 1.058, 95% confidence interval 0.979-1.144, P = .154). Regarding the secondary outcomes, patients with COVID-19 did not have increased risk of hyperthyroidism (HR 1.061, P = .345), hypothyroidism (HR 1.062, P = .255), initiation of antithyroid drug (HR 1.302, P = .070), initiation of levothyroxine (HR 1.086, P = .426), or thyroiditis (P = .252). Subgroup and sensitivity analyses were largely consistent with the main analyses. CONCLUSION Our population-based cohort study provided important reassuring data that COVID-19 was unlikely to be associated with persistent effects on thyroid function.
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Affiliation(s)
- David Tak Wai Lui
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xi Xiong
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Advanced Data Analytics for Medical Science (ADAMS) Limited, Hong Kong SAR, China
| | - Francisco Tsz Tsun Lai
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Advanced Data Analytics for Medical Science (ADAMS) Limited, Hong Kong SAR, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xue Li
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Advanced Data Analytics for Medical Science (ADAMS) Limited, Hong Kong SAR, China
| | - Eric Yuk Fai Wan
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Advanced Data Analytics for Medical Science (ADAMS) Limited, Hong Kong SAR, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Celine Sze Ling Chui
- Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Advanced Data Analytics for Medical Science (ADAMS) Limited, Hong Kong SAR, China; School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Esther Wai Yin Chan
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Department of Pharmacy, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China; The University of Hong Kong Shenzhen Institute of Research and Innovation, Shenzhen, China
| | - Franco Wing Tak Cheng
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Lanlan Li
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Matthew Shing Hin Chung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Chi Ho Lee
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yu Cho Woo
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kathryn Choon Beng Tan
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Carlos King Ho Wong
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Department of Infectious Disease Epidemiology & Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Ian Chi Kei Wong
- Department of Pharmacology and Pharmacy, Centre for Safe Medication Practice and Research, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China; Advanced Data Analytics for Medical Science (ADAMS) Limited, Hong Kong SAR, China; Aston Pharmacy School, Aston University, Birmingham, United Kingdom.
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Balasubramaniam S, Suresh Kumar A, Pandian P, Raviganesh PK, Perumpallipatty Kumarasamy S, Raju BP, Selvaraj B, Srinivasan AK, Balaji S, Ramasubramanian S. Thyroid Density in CT Imaging as a Potential Marker of Lung Involvement in COVID-19: A Retrospective Analysis. Cureus 2024; 16:e59699. [PMID: 38841002 PMCID: PMC11150337 DOI: 10.7759/cureus.59699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2024] [Indexed: 06/07/2024] Open
Abstract
Background The SARS-CoV-2 pandemic has underscored the multifaceted impact of the virus on human health, extending beyond the respiratory system to involve other organ systems, including the endocrine system. Emerging evidence suggests a notable interaction between COVID-19 and thyroid function, characterized by alterations in thyroid hormone levels and structural changes within the gland. This study aims to explore the association between thyroid density on CT imaging and lung involvement in patients with COVID-19, potentially offering new insights into the systemic effects of the virus. Methodology A retrospective cross-sectional analysis was conducted on 1,066 patients with COVID-19 who underwent chest CT scans without contrast at Government Medical College, Omandurar Government Estate, Chennai, which was designated as the COVID-19 care center from April to June 2021. Thyroid density and lung involvement were quantitatively assessed, and their correlation was analyzed using descriptive and inferential statistics, including the Kruskal-Wallis H test and Shapiro-Wilk test for normality. Results The study population predominantly exhibited normal thyroid density (749, 70.3%), followed by altered (212, 19.9%), nodular (104, 9.8%), and a single instance (0.1%) of absent thyroid density. Despite variability in lung involvement across different thyroid density categories, statistical analysis revealed no significant association between thyroid density and the extent of lung involvement in patients with COVID-19. Conclusions This study found no significant correlation between thyroid density and lung involvement in patients with COVID-19, suggesting that thyroid density on CT imaging may not serve as a reliable marker for lung involvement in this population. Further research is warranted to explore the complex interactions between COVID-19 and thyroid function, as well as the potential implications for patient management and prognosis.
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Affiliation(s)
| | - Aparna Suresh Kumar
- Internal Medicine, Government Medical College, Omandurar Government Estate, Chennai, IND
| | - Pravin Pandian
- Radiodiagnosis, Government Stanley Medical College and Hospital, Chennai, IND
| | | | - Sowmiya Perumpallipatty Kumarasamy
- Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
- Radiodiagnosis, Government Stanley Medical College and Hospital, Chennai, IND
| | - Bharathi Priya Raju
- Radiodiagnosis, Government Stanley Medical College and Hospital, Chennai, IND
| | - Balaji Selvaraj
- Radiodiagnosis, Government Medical College, Omandurar Government Estate, Chennai, IND
| | | | - Sangeetha Balaji
- Radiodiagnosis, Government Medical College, Omandurar Government Estate, Chennai, IND
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