Elevated risk of new-onset thyroid disease associated with SARS-CoV-2 infection: a 4.5-year observational study.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 41433356.
- Also identified by DOI 10.1210/clinem/dgaf688.
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Abstract
Thyroid disease has been reported as a complication associated with acute SARS-CoV-2 infection. This study evaluated the long-term risk of incident thyroid dysfunction after COVID-19 in patients without pre-existing thyroid disease. 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. 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. 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.