Hypothyroidism does not lead to worse prognosis in COVID-19: findings from the Brazilian COVID-19 registry

Daniella Nunes Pereira; Leticia Ferreira Gontijo Silveira; Milena Maria Moreira Guimarães; Carísi Anne Polanczyk; Aline Gabrielle Sousa Nunes; André Soares de Moura Costa; Barbara Lopes Farace; Christiane Corrêa Rodrigues Cimini; Cíntia Alcantara de Carvalho; Daniela Ponce; Eliane Würdig Roesch; Euler Roberto Fernandes Manenti; Fernanda Barbosa Lucas; Fernanda d'Athayde Rodrigues; Fernando Anschau; Fernando Graça Aranha; Frederico Bartolazzi; Giovanna Grunewald Vietta; Guilherme Fagundes Nascimento; Helena Duani; Heloisa Reniers Vianna; Henrique Cerqueira Guimarães; Jamille Hemétrio Salles Martins Costa; Joanna d'Arc Lyra Batista; Joice Coutinho de Alvarenga; José Miguel Chatkin; Júlia Drumond Parreiras de Morais; Juliana Machado-Rugolo; Karen Brasil Ruschel; Lílian Santos Pinheiro; Luanna Silva Monteiro Menezes; Luciana Siuves Ferreira Couto; Luciane Kopittke; Luís César de Castro; Luiz Antônio Nasi; Máderson Alvares de Souza Cabral; Maiara Anschau Floriani; Maíra Dias Souza; Marcelo Carneiro; Maria Aparecida Camargos Bicalho; Mariana Frizzo de Godoy; Matheus Carvalho Alves Nogueira; Milton Henriques Guimarães Júnior; Natália da Cunha Severino Sampaio; Neimy Ramos de Oliveira; Pedro Ledic Assaf; Renan Goulart Finger; Roberta Xavier Campos; Rochele Mosmann Menezes; Saionara Cristina Francisco; Samuel Penchel Alvarenga; Silvana Mangeon Mereilles Guimarães; Silvia Ferreira Araújo; Talita Fischer Oliveira; Thulio Henrique Oliveira Diniz; Yuri Carlotto Ramires; Evelin Paola de Almeida Cenci; Thainara Conceição de Oliveira; Alexandre Vargas Schwarzbold; Patricia Klarmann Ziegelmann; Roberta Pozza; Caroline Scherer Carvalho; Magda Carvalho Pires; Milena Soriano Marcolino

doi:10.1016/j.ijid.2022.01.016

Hypothyroidism does not lead to worse prognosis in COVID-19: findings from the Brazilian COVID-19 registry

Int J Infect Dis. 2022 Mar:116:319-327. doi: 10.1016/j.ijid.2022.01.016. Epub 2022 Jan 19.

Authors

Daniella Nunes Pereira¹, Leticia Ferreira Gontijo Silveira², Milena Maria Moreira Guimarães³, Carísi Anne Polanczyk⁴, Aline Gabrielle Sousa Nunes⁵, André Soares de Moura Costa⁶, Barbara Lopes Farace⁷, Christiane Corrêa Rodrigues Cimini⁸, Cíntia Alcantara de Carvalho⁹, Daniela Ponce¹⁰, Eliane Würdig Roesch¹¹, Euler Roberto Fernandes Manenti¹², Fernanda Barbosa Lucas¹³, Fernanda d'Athayde Rodrigues¹⁴, Fernando Anschau¹⁵, Fernando Graça Aranha¹⁶, Frederico Bartolazzi¹⁷, Giovanna Grunewald Vietta¹⁸, Guilherme Fagundes Nascimento¹⁹, Helena Duani²⁰, Heloisa Reniers Vianna²¹, Henrique Cerqueira Guimarães²², Jamille Hemétrio Salles Martins Costa²³, Joanna d'Arc Lyra Batista²⁴, Joice Coutinho de Alvarenga²⁵, José Miguel Chatkin²⁶, Júlia Drumond Parreiras de Morais²⁷, Juliana Machado-Rugolo²⁸, Karen Brasil Ruschel²⁹, Lílian Santos Pinheiro³⁰, Luanna Silva Monteiro Menezes³¹, Luciana Siuves Ferreira Couto³², Luciane Kopittke³³, Luís César de Castro³⁴, Luiz Antônio Nasi³⁵, Máderson Alvares de Souza Cabral³⁶, Maiara Anschau Floriani³⁷, Maíra Dias Souza³⁸, Marcelo Carneiro³⁹, Maria Aparecida Camargos Bicalho⁴⁰, Mariana Frizzo de Godoy⁴¹, Matheus Carvalho Alves Nogueira⁴², Milton Henriques Guimarães Júnior⁴³, Natália da Cunha Severino Sampaio⁴⁴, Neimy Ramos de Oliveira⁴⁵, Pedro Ledic Assaf⁴⁶, Renan Goulart Finger⁴⁷, Roberta Xavier Campos⁴⁸, Rochele Mosmann Menezes⁴⁹, Saionara Cristina Francisco⁵⁰, Samuel Penchel Alvarenga⁵¹, Silvana Mangeon Mereilles Guimarães⁵², Silvia Ferreira Araújo⁵³, Talita Fischer Oliveira⁵⁴, Thulio Henrique Oliveira Diniz⁵⁵, Yuri Carlotto Ramires⁵⁶, Evelin Paola de Almeida Cenci⁵⁷, Thainara Conceição de Oliveira⁵⁸, Alexandre Vargas Schwarzbold⁵⁹, Patricia Klarmann Ziegelmann⁶⁰, Roberta Pozza⁶¹, Caroline Scherer Carvalho⁶², Magda Carvalho Pires⁶³, Milena Soriano Marcolino⁶⁴

Affiliations

¹ Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena, 190, Belo Horizonte, Brazil. Electronic address: [email protected].
² Endocrinology Unit, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil. Electronic address: [email protected].
³ Endocrinology Unit, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil. Electronic address: [email protected].
⁴ Internal Medicine Department. Universidade Federal do Rio Grande do Sul. Coordinator of the Institute for Health Technology Assessment (IATS/CNPq). Rua Ramiro Barcelos, 2359. Prédio 21 | Sala 507, Porto Alegre, Brazil. Electronic address: [email protected].
⁵ Hospital Unimed-BH. Av do Contorno, 3097, Belo Horizonte, Brazil. Electronic address: [email protected].
⁶ Hospitais da Rede Mater Dei, Belo Horizonte, Brazil. Electronic address: [email protected].
⁷ Hospital Risoleta Tolentino Neves. Rua das Gabirobas, 01, Belo Horizonte, Brazil. Electronic address: [email protected].
⁸ Hospital Santa Rosália, Teófilo Otoni, Brazil. Electronic address: [email protected].
⁹ Hospital João XXIII. Av. Professor Alfredo Balena, 400, Belo Horizonte, Brazil. Electronic address: [email protected].
¹⁰ Hospital das Clínicas da Faculdade de Medicina de Botucatu. Botucatu, Brazil. Electronic address: [email protected].
¹¹ Hospital de Clínicas de Porto Alegre. Av. Ramiro Barcellos, 2350, Porto Alegre, Brazil. Electronic address: [email protected].
¹² Hospital Mãe de Deus, Porto Alegre, Brazil. Electronic address: [email protected].
¹³ Hospital Santo Antônio, Curvelo, Brazil. Electronic address: [email protected].
¹⁴ Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Av. Ramiro Barcellos, 2350, Porto Alegre, Brazil. Electronic address: [email protected].
¹⁵ Graduation Program on Evaluation and Production of Technologies for the Brazilian National Health System, Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor. Av. Francisco Trein, 326, Porto Alegre, Brazil. Electronic address: [email protected].
¹⁶ Hospital SOS Cárdio, Florianópolis, Brazil. Electronic address: [email protected].
¹⁷ Hospital Santo Antônio, Curvelo, Brazil. Electronic address: [email protected].
¹⁸ Hospital SOS Cárdio, Florianópolis, Brazil. Electronic address: [email protected].
¹⁹ Hospital Unimed-BH. Av do Contorno, 3097, Belo Horizonte, Brazil. Electronic address: [email protected].
²⁰ Internal Medicine Department. University Hospital, Universidade Federal de Minas Gerais. Av. Prof Alfredo Balena, 110, Belo Horizonte, Brazil. Electronic address: [email protected].
²¹ Hospital Universitário Ciências Médicas, Belo Horizonte, Brazil. Electronic address: [email protected].
²² Hospital Risoleta Tolentino Neves. Rua das Gabirobas, 01, Belo Horizonte, Brazil. Electronic address: [email protected].
²³ Hospital Márcio Cunha, Ipatinga, Brazil. Electronic address: [email protected].
²⁴ Hospital Regional do Oeste, Chapecó, Santa Catarina, Brazil. Electronic address: [email protected].
²⁵ Hospital João XXIII. Av. Professor Alfredo Balena, 400, Belo Horizonte, Brazil. Electronic address: [email protected].
²⁶ Pneumology Department, Medical School, Universidade Católica do Rio Grande do Sul (RGS), Porto Alegre, Brazil. Hospital São Lucas PUCRS, Porto Alegre, Brazil. Electronic address: [email protected].
²⁷ Hospital Universitário Ciências Médicas, Belo Horizonte, Brazil. Electronic address: [email protected].
²⁸ Hospital das Clínicas da Faculdade de Medicina de Botucatu. Botucatu, Brazil. Electronic address: [email protected].
²⁹ Hospital Mãe de Deus, Hospital Universitário de Canoas, Universidade Federal do Rio Grande do Sul e Instituto de Avaliação de Tecnologia em Saúde (IATS/CNPQ), Porto Alegre, Brasil. Electronic address: [email protected].
³⁰ Universidade Federal dos Vales do Jequitinhonha e Mucuri. R. Cruzeiro, 1, Teófilo Otoni, Brazil. Electronic address: [email protected].
³¹ Hospital Luxemburgo, Belo Horizonte, Brazil. Electronic address: [email protected].
³² Hospital Luxemburgo, Belo Horizonte, Brazil. Electronic address: [email protected].
³³ Hospital Nossa Senhora da Conceição. Av. Francisco Trein, 326, Porto Alegre, Brazil. Electronic address: [email protected].
³⁴ Hospital Bruno Born. Av. Benjamin Constant, 881, Lajeado, Brazil. Electronic address: [email protected].
³⁵ Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil. Electronic address: [email protected].
³⁶ Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena, 190, Belo Horizonte, Brazil. Electronic address: [email protected].
³⁷ Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil. Electronic address: [email protected].
³⁸ Hospital Metropolitano Odilon Behrens, Belo Horizonte, Brazil. Electronic address: [email protected].
³⁹ Hospital Santa Cruz, Santa Cruz do Sul, Brazil. Electronic address: [email protected].
⁴⁰ Hospital Julia Kubitschek. Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil. Electronic address: [email protected].
⁴¹ Hospital São Lucas PUCRS, Porto Alegre, Brazil. Electronic address: [email protected].
⁴² Hospitais da Rede Mater Dei, Belo Horizonte, Brazil. Electronic address: [email protected].
⁴³ Hospital Márcio Cunha, Ipatinga, Brazil. Electronic address: [email protected].
⁴⁴ Hospital Eduardo de Menezes. R. Dr. Cristiano Rezende, 2213, Belo Horizonte, Brazil. Electronic address: [email protected].
⁴⁵ Hospital Eduardo de Menezes. R. Dr. Cristiano Rezende, 2213, Belo Horizonte, Brazil. Electronic address: [email protected].
⁴⁶ Hospital Metropolitano Doutor Célio de Castro. Rua Dona Luiza, 311, Belo Horizonte, Brazil. Electronic address: [email protected].
⁴⁷ Hospital Regional do Oeste, Chapecó, Santa Catarina, Brazil. Electronic address: [email protected].
⁴⁸ Hospital Julia Kubitschek. Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil. Electronic address: [email protected].
⁴⁹ Hospital Santa Cruz, Santa Cruz do Sul, Brazil. Electronic address: [email protected].
⁵⁰ Hospital Metropolitano Doutor Célio de Castro. Rua Dona Luiza, 311, Belo Horizonte, Brazil. Electronic address: [email protected].
⁵¹ Hospital São João de Deus, Divinópolis, Brazil. Electronic address: [email protected].
⁵² Hospital Semper. Alameda Ezequiel Dias, 389, Belo Horizonte, Brazil. Electronic address: [email protected].
⁵³ Hospital Semper. Alameda Ezequiel Dias, 389, Belo Horizonte, Brazil. Electronic address: [email protected].
⁵⁴ Hospital Metropolitano Odilon Behrens, Belo Horizonte, Brazil. Electronic address: [email protected].
⁵⁵ Hospital São João de Deus, Divinópolis, Brazil. Electronic address: [email protected].
⁵⁶ Hospital Bruno Born. Av. Benjamin Constant, 881, Lajeado, Brazil. Electronic address: [email protected].
⁵⁷ Hospital Universitário Canoas, Canoas, Rio Grande do Sul, Brazil. Electronic address: [email protected].
⁵⁸ Hospital Universitário Canoas, Canoas, Rio Grande do Sul, Brazil. Electronic address: [email protected].
⁵⁹ Hospital Universitário de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil. Electronic address: [email protected].
⁶⁰ Hospital Tacchini, Bento Gonçalves, Brazil. Electronic address: [email protected].
⁶¹ Hospital Tacchini, Bento Gonçalves, Brazil. Electronic address: [email protected].
⁶² Hospital Universitário de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil. Electronic address: [email protected].
⁶³ Department of Statistics, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos, 6627, ICEx, sala 4071, Belo Horizonte, Brazil. Electronic address: [email protected].
⁶⁴ Department of Internal Medicine, Medical School; and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena 190 sala 246, Belo Horizonte, Brazil; Institute for Health Technology Assessment (IATS/ CNPq). Rua Ramiro Barcelos, 2359. Prédio 21 | Sala 507, Porto Alegre, Brazil. Electronic address: [email protected].

Abstract

Background: It is not clear whether previous thyroid diseases influence the course and outcomes of COVID-19.

Methods: The study is a part of a multicentric cohort of patients with confirmed COVID-19 diagnosis from 37 hospitals. Matching for age, sex, number of comorbidities, and hospital was performed for the paired analysis.

Results: Of 7,762 patients with COVID-19, 526 had previously diagnosed hypothyroidism and 526 were matched controls. The median age was 70 years, and 68.3% were females. The prevalence of comorbidities was similar, except for coronary and chronic kidney diseases that were higher in the hypothyroidism group (p=0.015 and p=0.001). D-dimer levels were lower in patients with hypothyroid (p=0.037). In-hospital management was similar, but hospital length-of-stay (p=0.029) and mechanical ventilation requirement (p=0.006) were lower for patients with hypothyroidism. There was a trend of lower in-hospital mortality in patients with hypothyroidism (22.1% vs 27.0%; p=0.062).

Conclusion: Patients with hypothyroidism had a lower requirement of mechanical ventilation and showed a trend of lower in-hospital mortality. Therefore, hypothyroidism does not seem to be associated with a worse prognosis.

Keywords: COVID-19; Epidemiology; Hypothyroidism; Mortality; Prognosis.

MeSH terms

Aged
COVID-19 Testing
COVID-19*
Female
Hospital Mortality
Humans
Hypothyroidism* / complications
Hypothyroidism* / epidemiology
Prognosis
Registries
SARS-CoV-2