The Association of TSH and Thyroid Hormones With Lymphopenia in Bacterial Sepsis and COVID-19
© The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
CONTEXT: Lymphopenia is a key feature of immune dysfunction in patients with bacterial sepsis and coronavirus disease 2019 (COVID-19) and is associated with poor clinical outcomes, but the cause is largely unknown. Severely ill patients may present with thyroid function abnormalities, so-called nonthyroidal illness syndrome, and several studies have linked thyrotropin (thyroid stimulating hormone, TSH) and the thyroid hormones thyroxine (T4) and 3,5,3'-triiodothyronine (T3) to homeostatic regulation and function of lymphocyte populations.
OBJECTIVE: This work aimed to test the hypothesis that abnormal thyroid function correlates with lymphopenia in patients with severe infections.
METHODS: A retrospective analysis of absolute lymphocyte counts, circulating TSH, T4, free T4 (FT4), T3, albumin, and inflammatory biomarkers was performed in 2 independent hospitalized study populations: bacterial sepsis (n = 224) and COVID-19 patients (n = 161). A subgroup analysis was performed in patients with severe lymphopenia and normal lymphocyte counts.
RESULTS: Only T3 significantly correlated (ρ = 0.252) with lymphocyte counts in patients with bacterial sepsis, and lower concentrations were found in severe lymphopenic compared to nonlymphopenic patients (n = 56 per group). Severe lymphopenic COVID-19 patients (n = 17) showed significantly lower plasma concentrations of TSH, T4, FT4, and T3 compared to patients without lymphopenia (n = 18), and demonstrated significantly increased values of the inflammatory markers interleukin-6, C-reactive protein, and ferritin. Remarkably, after 1 week of follow-up, the majority (12 of 15) of COVID-19 patients showed quantitative recovery of their lymphocyte numbers, whereas TSH and thyroid hormones remained mainly disturbed.
CONCLUSION: Abnormal thyroid function correlates with lymphopenia in patients with severe infections, like bacterial sepsis and COVID-19, but future studies need to establish whether a causal relationship is involved.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:106 |
|---|---|
| Enthalten in: |
The Journal of clinical endocrinology and metabolism - 106(2021), 7 vom: 16. Juni, Seite 1994-2009 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Grondman, Inge [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
9002-71-5 |
|---|
| Anmerkungen: |
Date Completed 28.06.2021 Date Revised 28.06.2021 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1210/clinem/dgab148 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM322702240 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM322702240 | ||
| 003 | DE-627 | ||
| 005 | 20231225182611.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1210/clinem/dgab148 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1075.xml |
| 035 | |a (DE-627)NLM322702240 | ||
| 035 | |a (NLM)33713408 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Grondman, Inge |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Association of TSH and Thyroid Hormones With Lymphopenia in Bacterial Sepsis and COVID-19 |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.06.2021 | ||
| 500 | |a Date Revised 28.06.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a CONTEXT: Lymphopenia is a key feature of immune dysfunction in patients with bacterial sepsis and coronavirus disease 2019 (COVID-19) and is associated with poor clinical outcomes, but the cause is largely unknown. Severely ill patients may present with thyroid function abnormalities, so-called nonthyroidal illness syndrome, and several studies have linked thyrotropin (thyroid stimulating hormone, TSH) and the thyroid hormones thyroxine (T4) and 3,5,3'-triiodothyronine (T3) to homeostatic regulation and function of lymphocyte populations | ||
| 520 | |a OBJECTIVE: This work aimed to test the hypothesis that abnormal thyroid function correlates with lymphopenia in patients with severe infections | ||
| 520 | |a METHODS: A retrospective analysis of absolute lymphocyte counts, circulating TSH, T4, free T4 (FT4), T3, albumin, and inflammatory biomarkers was performed in 2 independent hospitalized study populations: bacterial sepsis (n = 224) and COVID-19 patients (n = 161). A subgroup analysis was performed in patients with severe lymphopenia and normal lymphocyte counts | ||
| 520 | |a RESULTS: Only T3 significantly correlated (ρ = 0.252) with lymphocyte counts in patients with bacterial sepsis, and lower concentrations were found in severe lymphopenic compared to nonlymphopenic patients (n = 56 per group). Severe lymphopenic COVID-19 patients (n = 17) showed significantly lower plasma concentrations of TSH, T4, FT4, and T3 compared to patients without lymphopenia (n = 18), and demonstrated significantly increased values of the inflammatory markers interleukin-6, C-reactive protein, and ferritin. Remarkably, after 1 week of follow-up, the majority (12 of 15) of COVID-19 patients showed quantitative recovery of their lymphocyte numbers, whereas TSH and thyroid hormones remained mainly disturbed | ||
| 520 | |a CONCLUSION: Abnormal thyroid function correlates with lymphopenia in patients with severe infections, like bacterial sepsis and COVID-19, but future studies need to establish whether a causal relationship is involved | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a inflammation | |
| 650 | 4 | |a lymphocyte | |
| 650 | 4 | |a metabolism | |
| 650 | 4 | |a sepsis | |
| 650 | 4 | |a thyroid | |
| 650 | 7 | |a Thyroid Hormones |2 NLM | |
| 650 | 7 | |a Thyrotropin |2 NLM | |
| 650 | 7 | |a 9002-71-5 |2 NLM | |
| 700 | 1 | |a de Nooijer, Aline H |e verfasserin |4 aut | |
| 700 | 1 | |a Antonakos, Nikolaos |e verfasserin |4 aut | |
| 700 | 1 | |a Janssen, Nico A F |e verfasserin |4 aut | |
| 700 | 1 | |a Mouktaroudi, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Leventogiannis, Konstantinos |e verfasserin |4 aut | |
| 700 | 1 | |a Medici, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Smit, Jan W A |e verfasserin |4 aut | |
| 700 | 1 | |a van Herwaarden, Antonius E |e verfasserin |4 aut | |
| 700 | 1 | |a Joosten, Leo A B |e verfasserin |4 aut | |
| 700 | 1 | |a van de Veerdonk, Frank L |e verfasserin |4 aut | |
| 700 | 1 | |a Pickkers, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Kox, Matthijs |e verfasserin |4 aut | |
| 700 | 1 | |a Jaeger, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Netea, Mihai G |e verfasserin |4 aut | |
| 700 | 1 | |a Giamarellos-Bourboulis, Evangelos J |e verfasserin |4 aut | |
| 700 | 1 | |a Netea-Maier, Romana T |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Journal of clinical endocrinology and metabolism |d 1945 |g 106(2021), 7 vom: 16. Juni, Seite 1994-2009 |w (DE-627)NLM00001821X |x 1945-7197 |7 nnns |
| 773 | 1 | 8 | |g volume:106 |g year:2021 |g number:7 |g day:16 |g month:06 |g pages:1994-2009 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1210/clinem/dgab148 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 106 |j 2021 |e 7 |b 16 |c 06 |h 1994-2009 | ||