The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective study
BackgroundSince the comprehensive lifting of coronavirus disease 2019 (COVID-19) pandemic control measures in mainland China in December 2022, the population has experienced widespread infection with COVID-19. COVID-19 affects multiple systems, including the endocrine system, particularly the thyroi...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2025.1597083/full |
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| author | Lujia Xu Jianbo Zhang Jianbo Zhang Riping Cong Yujian Zhang Xuenan Song Wei Wang Yingli Diao Haijiao Liu Kuanxiao Tang |
| author_facet | Lujia Xu Jianbo Zhang Jianbo Zhang Riping Cong Yujian Zhang Xuenan Song Wei Wang Yingli Diao Haijiao Liu Kuanxiao Tang |
| author_sort | Lujia Xu |
| collection | DOAJ |
| description | BackgroundSince the comprehensive lifting of coronavirus disease 2019 (COVID-19) pandemic control measures in mainland China in December 2022, the population has experienced widespread infection with COVID-19. COVID-19 affects multiple systems, including the endocrine system, particularly the thyroid. Graves’ disease, a common autoimmune disorder, may be complicated by COVID-19 infection. Therefore, investigating changes in thyroid function and psychological status in patients with Graves’ disease (GDC) and COVID-19 coinfection holds significant clinical importance.MethodsThis study enrolled 110 hyperthyroid patients with COVID-19 coinfection, including 90 GDC patients meeting inclusion criteria. They were prospectively followed for one year at three time points: pre-COVID-19, 3 months, and 1 year post-infection. Patients were categorized by COVID-19 duration: G1 (≤5 days), G2 (6–8 days), and G3 (≥9 days). Follow-up included assessments of COVID-19 and GD symptoms, laboratory tests, psychological evaluations, treatment efficacy, COVID-19 management, and antithyroid medication adjustments. Statistical analyses (rank-sum tests, t-tests, multivariate logistic regression) explored COVID-19-GD associations and changes in thyroid function and psychological status in GDC patients.ResultsMultivariate logistic regression analysis, after covariate adjustment, identified the number of COVID-19 symptoms as an independent risk factor for hyperthyroidism in GDC patients, and COVID-19 duration as an independent risk factor for poor psychological status. At 3 months post-infection, the G3 group showed an increased FT3/FT4 ratio and decreased FT4 levels. Significant intergroup differences were observed in FT4 and TSH changes from pre-infection levels, with the G3 group having the highest anxiety and depression scores. Antithyroid medication and psychological interventions were adjusted based on thyroid function and psychological scores. At 1 year post-infection, TSH levels in the G1 and G3 groups increased compared to 3 months, while psychological scores decreased. The G3 group had significantly higher TSH levels than pre-infection, with significant intergroup differences in FT3 and FT4 levels.ConclusionPost-COVID-19 infection, GDC patients may experience hyperthyroidism and psychological distress, which improve with tailored ATD adjustments and psychological interventions. The FT3/FT4 ratio guides (antithyroid drugs) ATDs optimization, while psychological intervention effectively mitigates anxiety and depression in GDC patients. |
| format | Article |
| id | doaj-art-60ba00fcd1d2467d8c9e047854625f7f |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj-art-60ba00fcd1d2467d8c9e047854625f7f2025-08-20T03:27:58ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-07-011610.3389/fendo.2025.15970831597083The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective studyLujia Xu0Jianbo Zhang1Jianbo Zhang2Riping Cong3Yujian Zhang4Xuenan Song5Wei Wang6Yingli Diao7Haijiao Liu8Kuanxiao Tang9Department of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of Emergency and Chest Pain Center, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaDepartment of Internal Medicine, Jinan Hospital, Jinan, Shandong, ChinaDepartment of General Practice, Qilu Hospital of Shandong University, Jinan, Shandong, ChinaBackgroundSince the comprehensive lifting of coronavirus disease 2019 (COVID-19) pandemic control measures in mainland China in December 2022, the population has experienced widespread infection with COVID-19. COVID-19 affects multiple systems, including the endocrine system, particularly the thyroid. Graves’ disease, a common autoimmune disorder, may be complicated by COVID-19 infection. Therefore, investigating changes in thyroid function and psychological status in patients with Graves’ disease (GDC) and COVID-19 coinfection holds significant clinical importance.MethodsThis study enrolled 110 hyperthyroid patients with COVID-19 coinfection, including 90 GDC patients meeting inclusion criteria. They were prospectively followed for one year at three time points: pre-COVID-19, 3 months, and 1 year post-infection. Patients were categorized by COVID-19 duration: G1 (≤5 days), G2 (6–8 days), and G3 (≥9 days). Follow-up included assessments of COVID-19 and GD symptoms, laboratory tests, psychological evaluations, treatment efficacy, COVID-19 management, and antithyroid medication adjustments. Statistical analyses (rank-sum tests, t-tests, multivariate logistic regression) explored COVID-19-GD associations and changes in thyroid function and psychological status in GDC patients.ResultsMultivariate logistic regression analysis, after covariate adjustment, identified the number of COVID-19 symptoms as an independent risk factor for hyperthyroidism in GDC patients, and COVID-19 duration as an independent risk factor for poor psychological status. At 3 months post-infection, the G3 group showed an increased FT3/FT4 ratio and decreased FT4 levels. Significant intergroup differences were observed in FT4 and TSH changes from pre-infection levels, with the G3 group having the highest anxiety and depression scores. Antithyroid medication and psychological interventions were adjusted based on thyroid function and psychological scores. At 1 year post-infection, TSH levels in the G1 and G3 groups increased compared to 3 months, while psychological scores decreased. The G3 group had significantly higher TSH levels than pre-infection, with significant intergroup differences in FT3 and FT4 levels.ConclusionPost-COVID-19 infection, GDC patients may experience hyperthyroidism and psychological distress, which improve with tailored ATD adjustments and psychological interventions. The FT3/FT4 ratio guides (antithyroid drugs) ATDs optimization, while psychological intervention effectively mitigates anxiety and depression in GDC patients.https://www.frontiersin.org/articles/10.3389/fendo.2025.1597083/fullCOVID-19Graves’ diseasethyroid functionpsychological statemedical intervention |
| spellingShingle | Lujia Xu Jianbo Zhang Jianbo Zhang Riping Cong Yujian Zhang Xuenan Song Wei Wang Yingli Diao Haijiao Liu Kuanxiao Tang The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective study Frontiers in Endocrinology COVID-19 Graves’ disease thyroid function psychological state medical intervention |
| title | The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective study |
| title_full | The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective study |
| title_fullStr | The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective study |
| title_full_unstemmed | The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective study |
| title_short | The impact of COVID-19 on thyroid function and psychological state of Graves’ disease: a one-year prospective study |
| title_sort | impact of covid 19 on thyroid function and psychological state of graves disease a one year prospective study |
| topic | COVID-19 Graves’ disease thyroid function psychological state medical intervention |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2025.1597083/full |
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