J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://www.jofem.org

Original Article

Volume 13, Number 3, August 2023, pages 96-103

Thyroid Gland Dysfunction and COVID-19 Severity: Is There a Correlation?

**Table 1.** Levels and Normal Ranges of T3, T4, and TSH of Hospitalized COVID-19 Patients Stratified by Severity of COVID-19 and Patient Discharge Status
Variables (levels)	A. Severity of COVID-19	P^a
T3, nmol/L (M, (95% CI))	1.23 (1.18 - 1.29)	0.87 (0.79 - 0.95)	< 0.001
T4, pmol/L (M, (95% CI))	15.48 (15.09 - 15.86)	13.95 (12.71 - 15.20)	0.007
TSH, µIU/mL (M, (95% CI))	1.35 (1.17 - 1.53)	0.69 (0.39 - 0.99)	< 0.001
T3 (1.3 - 3.1 nmol/L)	62.9	94.9	< 0.001
T4 (12 - 22 pmol/L)	14.3	25.6	0.068
TSH (0.27 - 4.20 µIU/mL)	10.4	48.8	< 0.001
^aP values were determined using the Mann-Whitney nonparametric test. ^bP values were determined using the Chi-square test. COVID-19: coronavirus disease 2019; T3: triiodothyronine; T4: thyroxine; TSH: thyroid-stimulating hormone; M: mean; CI: confidence interval.
T3, nmol/L (M, (95% CI))	1.26 (1.20 - 1.32)	0.81 (0.75 - 0.87)	< 0.001
T4, pmol/L (M, (95% CI))	15.76 (15.39 - 16.13)	12.65 (11.53 - 13.77)	< 0.001
TSH, µIU/mL (M, (95% CI))	1.36 (1.17 - 155)	0.79 (0.54 - 1.05)	< 0.001

Table 1. Levels and Normal Ranges of T3, T4, and TSH of Hospitalized COVID-19 Patients Stratified by Severity of COVID-19 and Patient Discharge Status

Variables (levels)

A. Severity of COVID-19

P^a

Mild/moderate (n = 374)

Severe/critical (n = 41)

T3, nmol/L (M, (95% CI))

1.23 (1.18 - 1.29)

0.87 (0.79 - 0.95)

< 0.001

T4, pmol/L (M, (95% CI))

15.48 (15.09 - 15.86)

13.95 (12.71 - 15.20)

0.007

TSH, µIU/mL (M, (95% CI))

1.35 (1.17 - 1.53)

0.69 (0.39 - 0.99)

< 0.001

Variables (normal range)

B. Under Normal Range

P^b

Mild/moderate (%)

Severe/critical (%)

T3 (1.3 - 3.1 nmol/L)

62.9

94.9

< 0.001

T4 (12 - 22 pmol/L)

14.3

25.6

0.068

TSH (0.27 - 4.20 µIU/mL)

10.4

48.8

< 0.001

Variables (levels)

C. Patient Discharge Status

P^a

Alive (n = 356)

Dead (n = 59)

^aP values were determined using the Mann-Whitney nonparametric test. ^bP values were determined using the Chi-square test. COVID-19: coronavirus disease 2019; T3: triiodothyronine; T4: thyroxine; TSH: thyroid-stimulating hormone; M: mean; CI: confidence interval.

T3, nmol/L (M, (95% CI))

1.26 (1.20 - 1.32)

0.81 (0.75 - 0.87)

< 0.001

T4, pmol/L (M, (95% CI))

15.76 (15.39 - 16.13)

12.65 (11.53 - 13.77)

< 0.001

TSH, µIU/mL (M, (95% CI))

1.36 (1.17 - 155)

0.79 (0.54 - 1.05)

< 0.001

**Table 2.** Characteristics of Hospitalized COVID-19 Patients Stratified by Severity of COVID-19
Variables	All patients (n = 415)	Mild/moderate (n = 374)	Severe/critical (n = 41)	P
^aMissing data of 110 patients. ICU: intensive care unit; BMI: body mass index; CVD: cardiovascular disease; M: mean; CI: confidence interval.
Age, years (M, (95% CI))	62.1 (60.5 - 63.7)	62.1 (60.4 - 63.9)	62.0 (58.0 - 66.1)	0.866
Gender (n, %)
Male	230, 55.4	203, 54.3	27, 65.9	0.157
Female	185, 44.6	171, 45.7	14, 34.1
BMI, kg/h² (M, (95% CI))^a	29.6 (29.0 - 30.3)	29.6 (28.9 - 30.3)	29.9 (27.6 - 32.3)	0.745
Ethnicity (n, %)
Jewish	173, 41.7	154, 41.2	19, 46.3	0.253
Druse	134, 32.3	125, 33.4	9, 22.0
Muslim	94, 22.7	84, 22.5	10, 24.4
Cristian	14, 3.3	11, 2.9	3, 7.3
Duration of hospitalization, days (M, (95% CI))	9.2 (8.6 - 9.9)	8.6 (8.0 - 9.3)	14.6 (12.2 - 16.9)	< 0.001
Mortality (n, %)	59, 14.2	39, 10.4	20, 48.8	< 0.001
Hypertension (n, %)	193, 46.8	174, 46.9	19, 46.3	0.946
Diabetes (n, %)	147, 35.7	135, 36.4	12, 29.3	0.366
CVD (n, %)	101, 24.5	89, 24.0	12, 29.3	0.456
Chronic renal failure (n, %)	53, 12.9	51, 13.8	2, 4.9	0.140

Table 2. Characteristics of Hospitalized COVID-19 Patients Stratified by Severity of COVID-19

Variables

All patients (n = 415)

Mild/moderate (n = 374)

Severe/critical (n = 41)

^aMissing data of 110 patients. ICU: intensive care unit; BMI: body mass index; CVD: cardiovascular disease; M: mean; CI: confidence interval.

Age, years (M, (95% CI))

62.1 (60.5 - 63.7)

62.1 (60.4 - 63.9)

62.0 (58.0 - 66.1)

0.866

Gender (n, %)

Male

230, 55.4

203, 54.3

27, 65.9

0.157

Female

185, 44.6

171, 45.7

14, 34.1

BMI, kg/h² (M, (95% CI))^a

29.6 (29.0 - 30.3)

29.6 (28.9 - 30.3)

29.9 (27.6 - 32.3)

0.745

Ethnicity (n, %)

Jewish

173, 41.7

154, 41.2

19, 46.3

0.253

Druse

134, 32.3

125, 33.4

9, 22.0

Muslim

94, 22.7

84, 22.5

10, 24.4

Cristian

14, 3.3

11, 2.9

3, 7.3

Duration of hospitalization, days (M, (95% CI))

9.2 (8.6 - 9.9)

8.6 (8.0 - 9.3)

14.6 (12.2 - 16.9)

< 0.001

Mortality (n, %)

59, 14.2

39, 10.4

20, 48.8

< 0.001

Hypertension (n, %)

193, 46.8

174, 46.9

19, 46.3

0.946

Diabetes (n, %)

147, 35.7

135, 36.4

12, 29.3

0.366

CVD (n, %)

101, 24.5

89, 24.0

12, 29.3

0.456

Chronic renal failure (n, %)

53, 12.9

51, 13.8

2, 4.9

0.140

**Table 3.** Characteristics of Hospitalized COVID-19 Patients Stratified by Patient Mortality
Variables	Alive (n = 356)	Dead (n = 59)	P
^aMissing data of 110 patients. ICU: intensive care unit; BMI: body mass index; CVD: cardiovascular disease; M: mean; CI: confidence interval.
Age, years (M, (95% CI))	60.2 (58.5 - 61.9)	73.6 (70.2 - 77.0)	< 0.001
Gender (n, %)
Male	191, 53.7	39, 66.1	0.075
Female	165, 46.3	20, 33.9
BMI, kg/h² (M, (95% CI))^a	29.7 (28.9 - 30.4)	29.6 (27.9 - 31.3)	0.998
Ethnicity (n, %)
Jewish	151, 42.4	22, 37.3	0.657
Druse	112, 31.5	22, 37.3
Muslim	82, 23.0	12, 20.3
Cristian	11, 3.1	3, 5.1
Duration of hospitalization, days (M, (95% CI))	8.3 (7.6 - 8.9)	15.0 (12.9 - 17.1)	< 0.001
Hypertension (n, %)	158, 44.8	35, 59.3	0.038
Diabetes (n, %)	117, 33.1	30, 50.8	0.009
CVD (n, %)	73, 20.7	28, 47.5	< 0.001
Chronic renal failure (n, %)	41, 11.6	12, 20.3	0.065

Table 3. Characteristics of Hospitalized COVID-19 Patients Stratified by Patient Mortality

Variables

Alive (n = 356)

Dead (n = 59)

^aMissing data of 110 patients. ICU: intensive care unit; BMI: body mass index; CVD: cardiovascular disease; M: mean; CI: confidence interval.

Age, years (M, (95% CI))

60.2 (58.5 - 61.9)

73.6 (70.2 - 77.0)

< 0.001

Gender (n, %)

Male

191, 53.7

39, 66.1

0.075

Female

165, 46.3

20, 33.9

BMI, kg/h² (M, (95% CI))^a

29.7 (28.9 - 30.4)

29.6 (27.9 - 31.3)

0.998

Ethnicity (n, %)

Jewish

151, 42.4

22, 37.3

0.657

Druse

112, 31.5

22, 37.3

Muslim

82, 23.0

12, 20.3

Cristian

11, 3.1

3, 5.1

Duration of hospitalization, days (M, (95% CI))

8.3 (7.6 - 8.9)

15.0 (12.9 - 17.1)

< 0.001

Hypertension (n, %)

158, 44.8

35, 59.3

0.038

Diabetes (n, %)

117, 33.1

30, 50.8

0.009

CVD (n, %)

73, 20.7

28, 47.5

< 0.001

Chronic renal failure (n, %)

41, 11.6

12, 20.3

0.065

**Table 4.** Multivariate Logistic Regression Models to Predict Mortality Among COVID-19 Patients With Adjustment for Age and Gender
Variables	Values	N	OR	95% CI	P
COVID-19: coronavirus disease 2019; T3: triiodothyronine; T4: thyroxine; TSH: thyroid-stimulating hormone; OR: odds ratio; CI: confidence interval; Ref.: reference.
T3	nmol/L		0.07	0.01 - 0.42	0.004
T4	Normal range (12 - 22 pmol/L)	352	Ref.
	Below of normal range	63	3.08	1.18 - 8.08	0.022
TSH	Normal range (0.27 - 4.20 µIU/mL)	356	Ref.
	Below of normal range	59	6.08	2.54 - 14.54	< 0.001
Duration of hospital stay	Days		1.12	1.06 - 1.18	< 0.001
Age	Years		1.07	1.05 - 1.16	0.004
Gender	Female	185	Ref.
	Male	230	1.74	0.73 - 4.13	0.211

Table 4. Multivariate Logistic Regression Models to Predict Mortality Among COVID-19 Patients With Adjustment for Age and Gender

Variables

Values

95% CI

COVID-19: coronavirus disease 2019; T3: triiodothyronine; T4: thyroxine; TSH: thyroid-stimulating hormone; OR: odds ratio; CI: confidence interval; Ref.: reference.

nmol/L

0.07

0.01 - 0.42

0.004

Normal range (12 - 22 pmol/L)

352

Ref.

Below of normal range

3.08

1.18 - 8.08

0.022

TSH

Normal range (0.27 - 4.20 µIU/mL)

356

Ref.

Below of normal range

6.08

2.54 - 14.54

< 0.001

Duration of hospital stay

Days

1.12

1.06 - 1.18

< 0.001

Age

Years

1.07

1.05 - 1.16

0.004

Gender

Female

185

Ref.

Male

230

1.74

0.73 - 4.13

0.211