thyrotoxicosis in COVID-19 infection: medscape... - Thyroid UK

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thyrotoxicosis in COVID-19 infection

Eddie83 profile image
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medscape.com/viewarticle/93...

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Eddie83 profile image
Eddie83
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helvella profile image
helvellaAdministrator

Afraid that link reports the page does not exist. :-(

RedApple profile image
RedAppleAdministrator

Eddie83 Is this the article you're referring us to?

medscape.com/viewarticle/93...

Evidence Mounts for COVID-19 Effects on Thyroid Gland Rates of thyrotoxicosis are significantly higher among patients who are critically ill with COVID-19 than among patients who are critically ill but who do not not have COVID-19, suggesting an atypical form of thyroiditis related to the novel coronavirus infection, according to new research.

Eddie83 profile image
Eddie83 in reply toRedApple

yes

jimh111 profile image
jimh111

Ful paper here thelancet.com/journals/land... . It's important to also look at the supplementary material.

This study defines thyrotoxicosis as TSH < 0.28 and / or fT4 > 21.9. This means that if a patient has a low TSH and perhaps low fT3 and fT4 they would be wrongly classified as thyrotoxic.

They also measured fT3, fT4 if TSH < 0.45 or TSH > 3.5. Consequently they would miss hypo or hyper thyroid patients with abnormal fT3, fT4 and normal TSH. In particular they would miss patients with low T3 syndrome.

This and other studies have found subacute thyroiditis in some COVID-19 patients. They have elevated fT4 and low or normal fT3 andTSH. This seems to resolve within about a week as described in this similar paper healthunlocked.com/thyroidu... . Again this second study did not measure fT3, fT4 if TSH was normal and so would miss cases of low T3 syndrome.

It seems that a small proportion of COVID-19 patients have subacute thyroiditis or short duration and elevated fT4.

Lora7again profile image
Lora7again in reply tojimh111

That is interesting because I think I had covid back in January which lasted 7 weeks and I ended up being sent to A & E. I had a chest x-ray and this showed inflammation so I was given a course of steroids. I then had a thyroid blood test after I had recovered and it showed my TSH to be 0.38 and my T4 22.7 so top of the range. I really do not understand why they are not doing mass testing to see who has antibodies because they have had covid. I have already filled in 2 questionaires about this and they ask if I would be willing to have an antibody test and I have told them twice that I would. I have heard nothing for weeks now so I don't think they will giving me this test now.

jimh111 profile image
jimh111 in reply toLora7again

As I understand it antibody tests are not reliable and in addition some patients don't even develop antibodies. I believe they are only using antibody tests for monitoring progress of the virus at the moment. i.e. as a statistical tool.

Lora7again profile image
Lora7again in reply tojimh111

They are using blood plasma of patients who have had covid to treat patients with the disease.

nhsbt.nhs.uk/how-you-can-he...

jimh111 profile image
jimh111 in reply toLora7again

It's going to get beyond my knowledge in this area but I assume they use plasma from patients with high antibody levels. When testing for previous infection they will have to set a cut-off point and perhaps this is not definitive for deciding whether or not a patient has had COVID-19.

All I'm fairly sure of is that some infected patients do not produce antibodies and the NHS tells us the tests have not been shown to be reliable.

Lora7again profile image
Lora7again in reply tojimh111

I wish they would do more research about this because I have never stopped going out from day one. I have no choice because my Dad and his wife are self isolating because they have health issues. They have asked me to continue to do their shopping because they won't feel safe until a vaccine is found.

jimh111 profile image
jimh111 in reply toLora7again

It's really difficult. A lot of research is being done but the challenge is so great. They don't even know if someone who has had COVID-19 can catch it again, like catching colds. We don't know if there will ever be a vaccine. The good news is treatment is improving rapidly, mortality rates are falling. We just have to be sensible and careful whilst trying not to become too concerned or let it have too much impact on our lives.

Angel_of_the_North profile image
Angel_of_the_North in reply toLora7again

I would try not to worry, as sunshine and fresh air (going out) improve your immune system and stress depletes it (worrying). This virus has killed fewer people than the flu and is just a mild disease in most people, so carry on helping your relatives who are more likely to get it badly than you are.

Angel_of_the_North profile image
Angel_of_the_North in reply tojimh111

It seems that T-cells have more to do with immunity to that virus than regular antibodies and although it is possible to measure what T-cells do, it is apparently expensive and not so easy. I suspect the antibody tests are as reliable as the rt PCR tests for the virus (ie not very).

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