Effect of Euthyroid Sick Syndrome Development on Prognosis in COVID-19 Patients.

Thyroid function tests may deteriorate as a result of coronavirus infection. Low free triiodothyronine (FT3) levels are related to a poor prognosis in patients with coronavirus disease 2019 (COVID-19) presenting with euthyroid sick syndrome (ESS). In this study, it was aimed to examine the mortality and other events that developed in the hospital and within the 2-year follow-up in patients who developed ESS. In this retrospective study, 170 patients who were hospitalized as a result of COVID-19 were included. The patients were divided into two groups, as those with ESS and those without (non-ESS), according to the reference range of thyroid-stimulating hormone (TSH), FT3, or free thyroxine (FT4) levels. Secondary events that developed during the hospitalization and/or long-term follow-up (mean 24 months) were analyzed from the hospital registry system. Differences in the demographic, radiologic, clinical, and laboratory statistics were also compared. ESS developed in 97 of a total of 170 patients. Of those, 84 died during hospitalization or within the 2-year follow-up. The FT3 and FT4 hormone levels were significantly lower in the ESS group ( P < 0.001 for both). The COVID-19-associated mortality ratio was significantly higher in the ESS group (P < 0.001). Moreover, the occurrence of acute respiratory distress syndrome and acute renal failure was higher in the ESS group (P < 0.05). The frequency of complications, such as acute myocardial infarction, acute heart failure, and atrial fibrillation, was similar between the groups. The development of ESS with low FT3 levels was associated with disease severity, increased mortality, and risk of complications in COVID-19 patients. The development of ESS is an important prognostic indicator in the course of COVID-19 in long-term follow-up. [ABSTRACT FROM AUTHOR]

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