儿童SARS-CoV-2感染与甲状腺功能障碍

K. Kozak, H. Pavlyshyn, I. Avramenko, O. Dyvonyak, O. O. Shevchuk, K. Hlushko
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引用次数: 1

摘要

儿童中与SARS-CoV-2感染相关的甲状腺功能障碍问题尚不清楚。因此,本研究旨在揭示甲状腺功能障碍与COVID-19严重程度之间的相互关系,并确定筛查儿童甲状腺疾病的最佳临界值。共有90名年龄在1个月至17岁之间的儿童参与了这项研究。已知甲状腺疾病的患者未被纳入研究。对所有参与者进行甲状腺检查,包括:游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)和抗甲状腺过氧化物酶(ATPO)抗体。采用统计学软件Statistica 13.0进行统计分析。研究发现,14.10%的SARS-CoV-2感染儿童在重症COVID-19合并多系统炎症综合征患者中(33.33%)出现甲状腺功能正常综合征(ESS)的比例高于轻症病程(6.67%)和中度疾病严重程度(8.89%)(P < 0.05)。FT3与红细胞沉降率(ESR)呈显著相关(rs = -0.22;P < 0.05);FT3与c反应蛋白(CRP) (rs = -0.33;P < 0.05);FT3和降钙素原(rs = -0.43;P < 0.05)。下一个测定ESS的临界值为:ESR 18.5 mm/h (AUC 0.803);CRP 11.5 mg/l (AUC 0.763);铁蛋白84.8 ng/ml (AUC 0.733)。结果提示儿科医师应重视新冠肺炎对儿童内分泌的干扰。关键词:COVID-19,儿童甲状腺机能亢进综合征,炎症标志物
本文章由计算机程序翻译,如有差异,请以英文原文为准。
SARS-CoV-2 infection and thyroid dysfunction in children
The problem of thyroid dysfunction related to SARS-CoV-2 infection remains unclear in children. Therefore, the study aimed to reveal the interrelationship between thyroid dysfunction and COVID-19 severity­ as well as to determine optimal cut-off values for screening for thyroid disorders in children. A total number of 90 children aged from 1 month to 17 years were involved in the study. Patients with known thyroid disease were not recruited for the research. A thyroid panel was assessed for all participants that included: free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH) and anti-thyroid peroxidase (ATPO) antibodies. Statistical analysis was done using the computer software Statistica 13.0. Research has revealed euthyroid sick syndrome (ESS) in 14.10% of SARS-CoV-2 infected children more often among patients with severe COVID-19 and multisystem inflammatory syndrome (33.33%) compared to mild COVID-19 course (6.67%) and moderate disease severity (8.89%) (P < 0.05). Significant correlation relationships were revealed for next values – FT3 and erythrocyte sedimentation rate (ESR) (rs = -0.22; P < 0.05); FT3 and C-reactive protein (CRP) (rs = -0.33; P < 0.05); FT3 and procalcitonin (rs = -0.43; P < 0.05). The next cut-off values for ESS determination were revealed: ESR 18.5 mm/h (AUC 0.803); CRP 11.5 mg/l (AUC 0.763); ferritin 84.8 ng/ml (AUC 0.733). Results suggest that pediatricians should pay attention to the endocrine disruptions by COVID-19 in children. Keywords: COVID-19, euthyroid sick syndrome in children, inflammatory markers
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