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Euthyroid sick syndrome as a prognostic indicator of COVID-19 pulmonary involvement, associated with poorer disease prognosis and increased mortality.

Endocrine Practice 2022 Februrary 22
OBJECTIVE: The prevalence of euthyroid sick syndrome (ESS) and its association with the prognosis of coronavirus disease 2019 (COVID-19) and mortality in patients with lung involvement by COVID-19 have not yet been elucidated.

METHODS: Clinical and laboratory data of COVID-19 patients with or without ESS were collected retrospectively and analyzed on admission. All subjects were admitted to the Department of Internal Diseases and Clinical Pharmacology, Bieganski Hospital between December 2020 and April 2021.

RESULTS: In total, 310 medical records from COVID-19 patients were analyzed retrospectively. Among 215 enrolled patients, 82 cases of ESS were diagnosed. The ESS patients had higher proinflammatory factor levels, longer hospitalization and a higher risk of requiring high flow nasal oxygen therapy or intubation than non-ESS patients. The Kaplan-Meier curve indicated that the patients with ESS had a lower probability for survival when computed tomography (CT) showed =< 50% parenchymal involvement, compared to those without ESS; however, no differences in mortality were noted in those with more than 50% parenchymal involvement . The survival curve showed that ESS was associated with a higher risk of mortality during hospitalization.

CONCLUSION: ESS is closely associated with poorer prognosis, including longer hospitalization, more frequent intubation and transfer to intensive care units (ICU) and a higher mortality rate in COVID-19 patients. ESS is a potential prognostic predictor of survival, regardless of lung involvement by COVID-19.

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