Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)

[helvella]

Having today written on another post, lamenting the ignoring of thyroid issues, I find this paper which shows commendable inquisitiveness and interesting observations.

Although the population investigated was small, I find the difference in TSH between the fallers and the non-fallers very interesting.

We have seen all too many times that TSH of anything up to 10 seems totally ignorable once you reach the status of old or elderly. Have they even looked at falls as a symptom of hypothyroidism?

Med Sci Monit. 2022 May 27;28:e936547.

doi: 10.12659/MSM.936547.

Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)

Marcin Mikos 1 , Błażej Szydło 2 , Ivan Szergyuk 3 , Maria Helena Santos de Oliveira 4 , Michał Kuboń 2 , Grzegorz Juszczyk 5 , Brandon Michael Henry 6

Affiliations

• PMID: 35619331

• DOI: 10.12659/MSM.936547

Abstract

BACKGROUND During the current Coronavirus Disease 2019 (COVID-19) pandemic, falls have been identified as a potential presenting symptom in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, data on factors increasing fall risk in this patient population are limited. This study aimed to examine the factors that may predispose hospitalized COVID-19 disease patients to falls. MATERIAL AND METHODS In this retrospective observational study, hospitalized COVID-19 disease patients were examined for fall incidence, as well as demographics, comorbidities, and clinical and laboratory data. Patients were stratified according to their fall status and their characteristics were compared using Fisher's exact test or Mann-Whitney U test. A total of 312 hospitalized COVID-19 disease patients were enrolled (median age, 75 years; males, 51.3%), of whom 11 (3.5%) fell. RESULTS There was a greater prevalence of falls among patients who experienced arrhythmias than those that did not (28.6% vs 1.7%; P<0.001). Additionally, a significantly greater proportion of those that were discharged to the internal ward and to the intensive care unit fell (10.3% and 10.0%, respectively) compared to those that were discharged home (1.6%, P=0.008). Thyroid-stimulating hormone (TSH) was significantly elevated in patients who fell (5.3 vs 0.97 µIU/mL, P=0.013), while alanine aminotransferase (ALT) was significantly lower in those who fell (17.1 vs 33.5 IU/L, P=0.041). CONCLUSIONS Arrhythmias may be an important predisposing factor for falls in COVID-19 disease patients and fall prevention programs should prioritize interventions directed at this vulnerable patient population

Full paper freely accessible from here:

medscimonit.com/abstract/in...

Note: Although the context is of Covid, the interest should be considered across all who could be considered ill enough to need hospital treatment. I really don't think there is much, if anything, that is specific to Covid.

[nellie237]

Mmmn, Almost landing flat on my face was the 'symptom' that took me to the GP at 48yrs, and prompt dx with TSH of 8.6 & FT4 11 (10-21). If I had been in my 70's is a very scary thought.

I've just looked at the Thyroid UK symptoms list, and although there are many things which could contribute to 'falling', it is not listed. It probably should be.

I was losing consciousness for nano-seconds.......I wasn't getting dizzy but just blacking out. I wasn't anaemic, and it resolved completely on starting Levo, even though I was under-medicated for the 1st couple of years.

[TSH110]

If hypothyroidism affects coordination and spatial awareness then it seems obvious to me to lead to more likelihood of falls. It is known to cause syncope too. A relative with undiagnosed thyroid disorder fell many times prior to diagnosis. I mysteriously passed out whilst cycling and smashed so much crockery by accident it was ridiculous. I got so bad I walked into people because I could not judge where I was in space or in relation to others it was awful. Then there’s the muscle weakness….small wonder falls were more prevalent in those with a higher TSH.

Thanks for posting. It’s good it’s being demonstrated to be the case and At much lower values than a TSH of 10 which some would have us believe is perfectly ok and even suggest 20 to be acceptable for the elderly. It’s clearly complete rubbish and costly not to treat with thyroid hormone therapy leading to all those falls/broken hips etc

[helvella Administrator Thyroid UK in reply to TSH110]

Your and nellie237 responses are both spot on.

[tattybogle]

it would be also interesting to see some figures for TSH in "people who got hit by a car while trying to cross the road"