Consequent measurements were analyzed with the Wilcoxon test. et al. [8]334 COVID-19, 122 control86.6%Not determined5.4%5.7%TSH related to CRP and Setrobuvir (ANA-598) cortisoland KruskalCWallis tests. Consequent measurements were analyzed with the Wilcoxon test. The cross tables of categorical variables were analyzed with chi-square and Fisher’s exact tests. The correlation between numerical variables was tested with Spearman’s correlation test. The uni- and multivariate binary logistic regression analyses were performed and odds ratios were reported. L2 (Euclidean) cluster analysis was performed with Setrobuvir (ANA-598) random start points, where 0.05 was considered statistically significant. All analyses were executed by using Stata Setrobuvir (ANA-598) 15.1 software Setrobuvir (ANA-598) (Stata Corp, Texas 77845 USA). 3. Results Baseline characteristics of patients are shown in Table 2. Median basal lymphocyte percent of the patients was 18.7% (3.3C51.6%; IQR: 15), ferritin was 165? 0.001), length of hospitalization (rho?=?0.69, 0.001), neutrophil count (rho?=?0.28, 0.001), ferritin (rho?=?0.27, 0.001), LDH (rho?=?0.29, 0.001), hs-CRP (rho?=?0.39, 0.001), d-dimer (rho?=?0.36, 0.001), procalcitonin (rho?=?0.36, 0.001), and FT4 (rho?=?0.2, 0.001), FT3 (rho?=?-0.34, 0.001), and TSH (rho?=?-0.21, 0.001). Also, moderate ESS patients had higher WHO score (score?=?6) when compared to mild ESS patients (score?=?5) ( 0.001). 3.1. Comparison Rabbit Polyclonal to HBP1 of Laboratory Parameters and Outcomes of Euthyroid and Noneuthyroid Patients Euthyroid patients were younger ( 0.001) and mostly female ( 0.001), and the rate of oxygen demand ( 0.001), ICU admission ( 0.001), LDH (230?U/L vs. 284?U/L, 0.001), procalcitonin (0.07? 0.001), and d-dimer (0.48?mg/L vs. 0.79?mg/L, 0.001) levels of the euthyroid group were significantly low, and lymphocyte percent (23.7% vs. 17.3%, 0.001). More patients in the moderate ESS group needed oxygen ( 0.001). The mortality of the patients with ESS was significantly higher than that of the euthyroid patients (value 0.001) and their length of hospitalization was longer ( 0.001). D-dimer, procalcitonin, hs-CRP, LDH, ferritin, and neutrophil counts were significantly higher in the ICU group together with low lymphocyte percent (Table 4). Nine patients had died. They were also older in age (valuevalue 0.001 and value 0.001, pseudo- 0.001), and decreasing TSH (OR?=?0.57, 95% CI?=?0.34C0.95, 0.001, pseudo- 0.001). The patients in high-risk cluster had a higher median FT4 value (median?=?1.04?ng/dL; IQR?=?0.33) ( 0.001) compared to patients in low-risk cluster (median?=?0.93?ng/dL; IQR?=?0.2). The patients in high-risk cluster had a lower median TSH value (median?=?0.62?mIU/L; IQR?=?0.59) compared to patients in low-risk cluster (median?=?1.89?mIU/L; IQR?=?1.37) ( 0.001) while for 69 patients, the current FT4 levels were significantly higher ( 0.001). 32 patients had follow-up TSH levels and there was a statistically significant increase ( 0.001), higher median FT4 ( 0.001) had significantly higher risk for mortality ( em n /em ?=?8; 7.48% vs em n /em ?=?1; 1.11%; em p /em =0.039). We also compared these two risk clusters for ICU admission rate, and high risk cluster included 25 of 31 patients admitted to ICU (23.3% vs. 6.67%, em p /em =0.001). We believe that risk clusters established for our study according to thyroid functions are valuable for the prediction of ICU admission risk and mortality. COVID-19-induced thyroid dysfunction might be due to a primary thyroid injury (thyrotoxicosis; atypical thyroiditis), a secondary injury at hypothalamic or pituitary level, or both of them [28]. In Setrobuvir (ANA-598) this study, three patients were assigned as secondary hypothyroidism confirmed by low FSH and LH levels and low sex hormones. One of these patients had died. When the strength of our study is considered, it is one of the largest patient groups in the literature with all thyroid function tests, thyroid antibodies, previous thyroid, and pituitary function tests which were evaluated individually in a double-blinded manner by two investigators together with clinical outcomes. But our study also has several limitations. A control group was not enrolled, and follow-up thyroid function tests and antibodies were planned, but patients have refused to come to the hospital because of the pandemic. There are a lot of conflicts about COVID-19 and thyroid. What we want to say is that if you are a euthyroid, you will be lucky. In this study, the length of hospitalization, the rate of oxygen demand, and ICU admission rate were lower in the euthyroid patients. Moreover, none of the euthyroid patients died. Furthermore, the worst scenario might be to fall into high-risk group. Hence, the prognosis of patients who are in high-risk cluster with low FT3 (median?=?2.34?ng/L; IQR?=?0.86), a high median FT4 value (median?=?1.04?ng/dL; IQR?=?0.33), and a low median TSH value (median?=?0.62?mIU/L; IQR?=?0.59) are poor and mortality is increased. We believe that COVID-19 will have effects on the thyroid gland, especially in respect to autoimmunity, and the pituitary gland. Long term studies with follow-up measurements should be planned. Acknowledgments The authors are thankful to all the medical staff working in Marmara University or college Pendik E&R Hospital pandemic clinics. Data Availability Data used to support the findings of this study are.
