Covid and the thyroid

[diogenes]

This paper discusses the action of COVID on thyroid expression. Downloadable.

Front. Endocrinol., 07 October 2020

| doi.org/10.3389/fendo.2020....

Euthyroid Sick Syndrome in Patients With COVID-19

Runmei Zou, Chenfang Wu, Siye Zhang, Guyi Wang, Quan Zhang, Bo Yu, Ying Wu, Haiyun Dong, Guobao Wu, Shangjie Wu and Yanjun Zhong

[TSH110]

Very interesting, thanks for posting. I wonder if it has any implications for vaccination.

[tattybogle]

Interesting , thankyou .

Nothing intelligent to add, but i'm glad i don't have to figure out what's causing what from that lot.

It still doesn't seem possible to say whether ESS is a helpful response and a sign of a body having a worse problem dealing with covid , or whether it's unhelpful and those with it do worse.

Has anybody tried chucking T4 /T3 into covid/ ESS patients when they get to hospital and seeing if it improves outcomes ?

[jimh111]

Thanks. There have been some similar studies and also studies that showed thyrotoxicosis. In a few studies like this one T3 (total T3 in this study) was quite low whereas TSH and T4 are just a little lower suggesting that TSH in this group has low bioactivity and in particular deiodinase or thyroidal T3 secretion is substantially reduced. I've been lobbying for a study of TSH structure in such patients as it gives a unique opportunity to study how different TSH isoforms affect the thyroid and deiodinase.

[Kitten44 in reply to jimh111]

That would be great. With the known information to date, what is the take home, lay person's, message for thyroid patients if we ever get covid? Would doses need adjusting? Is a "thyroid storm" likely? Or what should we look out for, do to minimise problems?

[jimh111 in reply to Kitten44]

Short answer is don't know. These studies have looked at people without thyroid disease and we might expect similar results in thyroid patients except those without a functioning thyoid will not get subaccute thyroiditis.

[helvella Administrator Thyroid UK]

Another recent (not yet reviewed) paper:

Conclusion This pilot study from Pakistan demonstrates that changes in serum TSH and TT3 levels may be important manifestations of the courses of COVID-19 pneumonia.

Thyroid Function Analysis in COVID-19: A Retrospective Study from a Single Center

View ORCID ProfileJahanzeb Malik, Asmara Malik, Muhammad Javaid, Tayyaba Zahid, Uzma Ishaq, Muhammad Shoaib

doi: doi.org/10.1101/2021.02.09....

This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

[jimh111]

Thanks. Another study to add to our confusion! Some studies report Non-thyroidal Illness (NTI) with low TSH, T3. Other studies report subaccute thyroditis with elevated T3 levels. Treatment of COVID-19 can include the use of steroids which could affect thyroid function. The Day1 assays in this study were done before treatment was initiated. It seems that COVID-19 has different effects in different people and perhaps different locales.

[humanbean]

From the paper :

"the lymphocyte count was apparently lower in ESS patients than in non-ESS patients"

I can't work out how this can occur. I thought people who were sick would generally have higher levels of lymphocytes because lymphocytes help the body to defend itself against disease. So is Covid-19 attacking the immune system directly? Or is it only attacking the immune system in people with Covid where the thyroid has become a target?

thoughtco.com/lymphocytes-d...

From the above link :

Lymphocytes are a type of white blood cell generated by the immune system to defend the body against cancerous cells, pathogens, and foreign matter. Lymphocytes circulate in blood and lymph fluid and are found in body tissues including the spleen, thymus, bone marrow, lymph nodes, tonsils, and liver. Lymphocytes provide a means for immunity against antigens. This is accomplished through two types of immune responses: humoral immunity and cell mediated immunity. Humoral immunity focuses on identifying antigens prior to cell infection, while cell mediated immunity focuses on the active destruction of infected or cancerous cells.

[diogenes Remembering in reply to humanbean]

In News/Medical Life Sciences it states:

Pre-existing lymphocytopenia was associated with COVID-19 fatality

Bivariate analysis pointed to an association between pre-existing lymphocytopenia (defined as an ALC of 0.9x109 /L) and COVID-19- related death.

Furthermore, logistic regression analysis adjusting for patient age and the number of ALCs obtained indicated that patients who had pre-existing lymphocytopenia were 1.4 times more likely to die from COVID-19 than those who did not.

[tattybogle in reply to diogenes]

Pre-existing lymphocytopenia was associated with COVID-19 fatality

Oh .. that's unfortunate.

I was looking at low lymphocytes a while ago as i discovered i'd had below range lymphocytes for years when i had extremely high TPOab and wondered if there was a connection and found this:-

ncbi.nlm.nih.gov/pmc/articl....

"Effect of Thyroid Dysfunctions on blood cell count and Red Blood Cell Indice"

Iranian Journal of Pediatric Hematology and Oncology

2013 3 (2) 73 -77

......which is completely over my head , but anyone who understands blood and may find it interesting . ( humanbean ?)

"With regard to lymphocytes, T3 is as a precursor substance for normal B cell formation in bone marrow through its mediation of pro-B cell proliferation. Therefore, thyroid disorders can induce different effects on various blood cell lineages (7-10)."