Elevated risk of new-onset thyroid disease associated with SARS-Cov-2 infection: a 4.5-year observational study, Mehrotra-Varma et al, 2025

[Kalliope]

Abstract​

Context
Thyroid disease has been reported as a complication associated with acute SARS-CoV-2 infection.

Objective
This study evaluated the long-term risk of incident thyroid dysfunction after COVID-19 in patients without pre-existing thyroid disease.

Methods
Patients without prior thyroid disease were grouped into 15,372 individuals hospitalized with COVID-19, 41,757 non-hospitalized individuals with COVID-19, 343,348 contemporary COVID-negative controls (03/01/2020–08/17/2024), and 171,141 historical controls (01/01/2016–12/31/2019) within the Montefiore Health System. Outcomes included new-onset thyroid disease, hypothyroidism, hyperthyroidism, and other/unspecified thyroid disease, and thyroid-stimulating hormone (TSH), free T3 (FT3), and free T4 (FT4) levels. The primary analysis used Cox regression with inverse-probability weighting (IPW). Sensitivity analyses included multivariable adjustment, 1:1 propensity score matching, and comparisons with historical controls.

Results
Compared to contemporary COVID-negative controls, patients hospitalized for COVID-19 had significantly higher risk of all thyroid disease (IPW-adjusted hazard ratio (HR) = 2.11 [2.03–2.19]), hypothyroidism (HR = 2.02 [1.92–2.12]), hyperthyroidism (HR = 2.31 [2.13–2.50]), and other/unspecified thyroid disease (HR = 2.27 [2.12–2.43]). Non-hospitalized COVID-positive patients also had increased risk of all thyroid disease (HR = 1.40 [1.35–1.46]), hypothyroidism (HR = 1.37 [1.31–1.43]), hyperthyroidism (HR = 1.56 [1.45–1.68]), and other/unspecified thyroid disease (HR = 1.42 [1.34–1.51]). Sensitivity analyses confirmed the main findings. Estimates of risks were attenuated in the non-hospitalized cohort when compared to historical controls.

Conclusions
SARS-CoV-2 infection is associated with an increased risk of all forms of new-onset thyroid disease investigated in both hospitalized and non-hospitalized patients. These findings suggest that enhanced screening for thyroid dysfunction may be warranted among individuals recovering from COVID-19.

https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgaf688/8403187?login=false

 

[Utsikt]

Non-hospitalized COVID-positive patients also had increased risk of all thyroid disease (HR = 1.40 [1.35–1.46]), hypothyroidism (HR = 1.37 [1.31–1.43]), hyperthyroidism (HR = 1.56 [1.45–1.68]), and other/unspecified thyroid disease (HR = 1.42 [1.34–1.51]). Sensitivity analyses confirmed the main findings. Estimates of risks were attenuated in the non-hospitalized cohort when compared to historical controls.

Doesn’t attenuated mean that it was lessened? By how much? It would be nice if the abstract told us if the HR is still >1 in the non-hospitalised cohort.