Hasret CENGİZ, Taner DEMİRCİ, Ceyhun VARIM

Hashimoto Tiroiditi ile COVID-19 Enfeksiyonu Gidişatı Arasındaki İlişkinin İncelenmesi

Amaç: Coronavirus enfeksiyonu (COVID-19) dünya çapında bir pandemiye yol açmış ve pek çok sistemi etkilemiştir. Hashimoto Tiroiditi toplumda sık görülen hastalıklardan birisi ve otoimmun tiroid hastalıklarının prototipidir. Tiroid otoimmunitesi ve tiroid fonksiyon bozukluğunun COVID-19 seyrini nasıl etkileyeceği bilinmemektedir.Bu çalışmadaki amaç bu enfeksiyonun Hashimoto Tiroiditi hastalarındaki seyrini göstermektir. Gereç ve Yöntemler: Merkezimizde Nisan-Ekim 2020 tarihleri arasında gelen COVID-19 enfeksiyonu geçirmiş erişkin Hashimoto Tiroiditi hastalarının alındığı tanımlayıcı bir çalışma yapıldı. Hastalığın gidişatını etkileyebilecek ağır komorbid durumları olanlar ve immunmodülatuar ve immunsupresif ilaç kullanan kişiler ve gebeler çalışmaya alınmadı. Bulgular: Total 232 hastada Median (IQR=interquartile) yaş değeri 43 (34-54),Erkek/kadın oranı 21/211 (9.1%/90.9%) idi. Hastalarımızda COVID-19 nedeni ile mortalite kendi yaş gruplarındaki normal toplum ile uyumlu (%1,7,n:4) bulunmuş olup 7 hasta yoğun bakımda tedavi görmüştür. Anti-Tiroglobulin Antikoru (Anti-Tg) ile Beyaz Kan Hücreleri (r=-0.189, p=0.041), Nötrofil (r=-0.191, p=0.040), Nötrofil-Lenfosit Oranı (r=-0.244, p=0.008) ve Ferritin (r=-0.259, p=0.042) ile arasında anlamlı düzeyde negatif korelasyon ilişkisi saptanmıştır. Sonuç: Yoğun bakıma alınan hastalarda Tiroid Stimulan Hormonu (TSH) baskılı olanların oranı biraz yüksek çıkmış fakat vaka sayısı düşük olduğundan anlamlılık kazanmamıştır.Hashimoto Tiroiditi hastalarının çoğu enfeksiyonu hafif geçirmiştir. Tiroid otoimmunitesi COVID-19 enfeksiyonu seyrini etkilemiyor gibi görünmektedir.

Anahtar Kelimeler:

COVID-19, Hashimoto Tiroiditi;, Otoimmun Tiroid Hastalığı

Evaluation of the Relationship Between Hashimoto's Thyroiditis and the Course of COVID-19 Infection

Objectives: Coronavirus infection (COVID-19) has caused a worldwide pandemic and affected many systems. Hashimoto's Thyroiditis is one of the most common diseases in the community and is the prototype of autoimmune thyroid diseases. It is unknown how thyroid autoimmunity and thyroid dysfunction will affect the course of COVID-19. The aim of this study is to show the course of this infection in patients with Hashimoto's Thyroiditis. Materials and Methods: A descriptive study was conducted in which adult patients with Hashimoto's Thyroiditis who received COVID-19 infection from April to October 2020 in our center were recruited retrospectivelly. Those with severe comorbid conditions that may affect the course of the disease,and using immunomodulatory and immunosuppressive drugs, and pregnant women were not included in the study. Results: A total of 232 patients included. Median (IQR=interquartile) age value was 43 (34-54), and the male/female ratio was 21/211 (9.1%/90.9%). In our study, mortality due to COVID-19 in our patients was found to be consistent with the normal population in their age group (1,7%, n:4), and 7 patients were treated in the intensive care unit. A significant negative correlation was found between Anti-Tyroglobuline Antibody (Anti-Tg) and White Blood Cell (WBC) (r=-0.189, p=0.041), Neutrophil (r=-0.191, p=0.040), Neutrophil to Lymphocyte Ratio (NLR) (r=-0.244, p=0.008), Ferritin (r=-0.259, p=0.042). Conclusion: The rate of patients with supressed Thyroid Stimulating Hormone (TSH) in intensive care unit was slightly higher, but since the number of events was low, this finding could not gain significance. Most patients with Hashimoto's Thyroiditis have had a mild infection. Thyroid autoimmunity does not appear to affect the COVID-19 infection’s course.

Keywords:

COVID-19, Hashimoto, Autoimmune Thyroid Disease,

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