Marija Bogojevic, MD,
Resident Physician
Montefiore New Rochelle Hospital, Minnesota, United States
Disclosure information not submitted.
Vikas Bansal, MPH, MBBS
Research Fellow
Mayo Clinic
Rochester, Minnesota
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Romil Singh, MD
Resident
n/a
Rochester, Minnesota, United States
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Mayank Sharma, MBBS
Research Fellow
n/a, Minnesota, United States
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Abigail La Nou, MD
Medical Doctor
Mayo Clinic Health System in Eau Claire, United States
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Allison LeMahieu, BS, MS
Biostatistician
Mayo Clinic
Rochester, Minnesota, United States
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Andrew Hanson, MS
Biostatistician
Mayo Clinic
Rochester, Minnesota, United States
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Phillip Schulte, MD
Senior Associate Consultant II
n/a
Rochester, Minnesota, United States
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Neha Deo, BS
Medical Student
Mayo Clinic Alix School of Medicine
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Simon Zec, MD (he/him/his)
Research Fellow, Pulmonary and Critical Care Medicine
Mayo Clinic
Rochester, Minnesota, United States
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Vishakha Kumar, MD, MBA
Society of Critical Care Medicine
Mount Prospect, Illinois
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Allan Walkey, MD (he/him/his)
Professor of Medicine
Boston University
Boston, Massachusetts, United States
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Ognjen Gajic, MD
Professor
Mayo Clinic
Rochester, Minnesota, United States
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Sumit Bhagra, MD
Consultant Endocrinology
Mayo Clinic Health System Austin
Austin, Minnesota, United States
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Vishwanath Pattan, MD
Attending Physician
Wyoming Medical Center
Casper, Wyoming, United States
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Juan Pablo Domecq Garces, MD
Assistant Professor of Medicine
Mayo Clinic College of Medicine
North Mankato, Minnesota, United States
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Rahul Kashyap, MD, MBA,
Medical Director Research
Wellspan Health-York Hospital
York, Pennsylvania
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Title: Association of Hypothyroidism with COVID-19 outcomes: Results from the SCCM Discovery VIRUS Registry
Introduction:
Coronavirus diseases (COVID-19) is associated with high rates of morbidity and mortality and worse outcomes have been reported for various comorbidities. Primary hypothyroidism is a common comorbid condition. Little is known about its association with COVID-19 severity and outcome. This study aims to describe the differences in disease severity and COVID-19 related outcomes between patients with and without pre-existing Hypothyroidism in a prospective, observational, multinational registry.
Methods:
We enrolled patients 18 years or older, with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection between March 2020, and May 2021. The primary outcomes were 1) the disease severity defined as per the World Health Organization scale for clinical improvement, which is an ordinal outcome corresponding with the highest severity level recorded during a patient’s index COVID-19 hospitalization, in-hospital mortality, and hospital free days
Results:
Among the 20,366 adult patients included in the study, pre-existing hypothyroidism was identified in 1616 (7.9%). The median age for the hypothyroidism group was 70.0 (IQR 59.0-80.0) years and 1048 (65%) were female and 17% were Black. The most common comorbidities were hypertension (68%), Diabetes (42%), Dyslipidemia (37%), and Obesity (28%). The unadjusted odds ratio for severe COVID-19 patients with hypothyroidism was 1.18 (95% CI 1.08, 1.31; p-value < 0.001), for hospital mortality was 1.23 (95% CI 1.09-1.39, p-value < 0.001) and differences in hospital-free days was -0.88 (95% CI 1-1.53--0.23, p-value 0.008). After adjusting for age, BMI, sex, time since the pandemic, race, smoking history, and other comorbid conditions, pre-existing hypothyroidism was not associated with higher odds of severe disease (OR 1.02,95% CI 0.92-1.13, p=0.69), in-hospital mortality (OR 1.03, 95% CI 0.92-1.15, p= 0.58) or differences in hospital free days (estimated difference 0.01 days, 95% CI -0.45, 0.47, p=0.97). Pre-existing hypothyroidism was not associated with ICU admission or ICU mortality in unadjusted as well as in adjusted analysis.
Conclusions:
Primary hypothyroidism is identified in around 1 of every 10 adult patients hospitalized with COVID-19 and was not associated with worse outcomes after adjusting for relevant confounders.