RT Journal Article
T1 Free triiodothyronine levels and age influences the metabolic profile and COVID-19 severity parameters in euthyroid and levothyroxine-treated patients
A1 Amich, Inés
A1 Anguita Mandly, Eduardo Luis
A1 Escribano Serrat, Silvia
A1 Álvarez, Cristina
A1 García, Verónica
A1 Bello, Rocío
A1 Peña Pedrosa, José Alberto
A1 Torrejón, María José
A1 Martín Sánchez, Francisco Javier
A1 Alemany, Susana
AB Metabolic reprogramming is required to fight infections and thyroid hormones are key regulators of metabolism. We have analyzed in hospitalized COVID-19 patients: 40 euthyroid and 39 levothyroxine (LT4)-treated patients in the ward and 29 euthyroid and 9 LT4-treated patients in the intensive care unit (ICU), the baseline characteristics, laboratory data, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), the FT3/FT4 ratio, 11 antiviral cytokines and 74 metabolomic parameters. No evidence for significant differences between euthyroid and LT4-treated patients were found in the biochemical, metabolomic and cytokines parameters analyzed. Only TSH (p=0.009) and ferritin (p=0.031) showed significant differences between euthyroid and LT4-treated patients in the ward, and TSH (p=0.044) and FT4 (p=0.012) in the ICU. Accordingly, severity and mortality were similar in euthyroid and LT4-treated patients. On the other hand, FT3 was negatively related to age (p=0.012), independently of sex and body mass index in hospitalized COVID-19 patients. Patients with low FT3 and older age showed a worse prognosis and higher levels of the COVID-19 severity markers IL-6 and IL-10 than patients with high FT3. IL-6 negatively correlated with FT3 (p=0.023) independently of age, body mass index and sex, whereas IL-10 positively associated with age (p=0.035) independently of FT3, body mass index and sex. A metabolomic cluster of 6 parameters defined low FT3 ward patients. Two parameters, esterified cholesterol (p=4.1x10-4) and small HDL particles (p=6.0x10-5) correlated with FT3 independently of age, body mass index and sex, whereas 3-hydroxybutyrate (p=0.010), acetone (p=0.076), creatinine (p=0.017) and high-density-lipoprotein (HDL) diameter (p=8.3x10-3) were associated to FT3 and also to age, with p-values of 0.030, 0.026, 0.017 and 8.3x10-3, respectively. In conclusion, no significant differences in FT3, cytokines, and metabolomic profile, or in severity and outcome of COVID-19, were found during hospitalization between euthyroid patients and hypothyroid patients treated with LT4. In addition, FT3 and age negatively correlate in COVID-19 patients and parameters that predict poor prognosis were associated with low FT3, and/or with age. A metabolomic cluster indicative of a high ketogenic profile defines non-critical hospitalized patients with low FT3 levels.
PB Frontiers Media
SN 1664-2392
YR 2022
FD 2022-11-09
LK https://hdl.handle.net/20.500.14352/95469
UL https://hdl.handle.net/20.500.14352/95469
LA eng
NO Amich I, Anguita E, Escribano-Serrat S, Alvarez C, Rodríguez-Muñoz D, García V, Bello R, Peña-Pedrosa JA, Martínez-Micaelo N, Amigó N, Ortiz P, Torrejón MJ, Boscá L, Martín-Sánchez J, Aranda A, Alemany S. Free triiodothyronine levels and age influences the metabolic profile and COVID-19 severity parameters in euthyroid and levothyroxine-treated patients. Front Endocrinol (Lausanne). 2022 Nov 9;13:1025032.
NO Fundación Hay Esperanza
NO Ministerio de Ciencia e Innovación
NO Comunidad de Madrid
NO CSIC
NO Generalitat de Cataluña
DS Docta Complutense
RD 9 abr 2025