Main Article Content
Background. Hypothyroidism requires treatment with levothyroxine (L-T4) to keep patients euthyroid. The rate of hospital admissions for chronic conditions decreased during COVID-19 era. We aimed to observe whether hospital admissions of the patients with hypothyroidism decreased during COVID-19 compared to the same time period in 2019. We also aimed to find out the rate of treatment compliance in subjects with hypothyroidism during pandemic era. Materials and methods. This cross-sectional study was performed on patients who applied to Internal Medicine Department of Abant Izzet Baysal University Hospital, and who received L-T4 replacement therapy due to hypothyroidism. 108 hypothyroidism patients were included in the study with their consent forms. The patients were divided into 2 groups according to the treatment compliance; either as compliant or incompliant patients. Results. The last TSH level of compliant group was significantly lower than incompliant group (p < 0.001). The last fT4 level of the compliant group was significantly higher than that of the incompliant group (p = 0.04). The median of the LT-4 treatment used irregularly was 35 (10–90) days in incompliant group and was 0 (0–0) days in compliant group (p < 0.001). The number of irregularly L-T4 used days was significantly positively correlated with last TSH value (r = 0.564, p < 0.001), and negatively correlated with last FT4 value (r = –0.492, p < 0.001). Mean corpuscular volume (MCV) of the compliant and incompliant groups were 85 (69.1–97.5) fL and 89 (66–96.6) fL, respectively (p = 0.03). Retrospective nature and relatively small study population are two main limitations of our study. Conclusions. Compliance to treatment is very important to achieve euthyroid hormone levels in patients with hypothyroidism during COVID-19 pandemic. Elevated MCV levels could predict incompliance to treatment in hypothyroidism.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
Garber JR, Cobin RH, Gharib H, et al; American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012 Nov-Dec;18(6):988-1028. doi:10.4158/EP12280.GL.
Ingoe L, Phipps N, Armstrong G, Rajagopal A, Kamali F, Razvi S. Prevalence of treated hypothyroidism in the community: Analysis from general practices in North-East England with implications for the United Kingdom. Clin Endocrinol (Oxf). 2017 Dec;87(6):860-864. doi:10.1111/cen.13440.
Brown SJ, Bremner AP, Hadlow NC, et al. The log TSH-free T4 relationship in a community-based cohort is nonlinear and is influenced by age, smoking and thyroid peroxidase antibody status. Clin Endocrinol (Oxf). 2016 Nov;85(5):789-796. doi:10.1111/cen.13107.
Fitzgerald SP, Bean NG. Thyroid stimulating hormone (TSH) autoregulation reduces variation in the TSH response to thyroid hormones. Temperature (Austin). 2018 Oct 8;5(4):380-389. doi:10.1080/23328940.2018.1513110.
Hennessey JV, Espaillat R. Current evidence for the treatment of hypothyroidism with levothyroxine/levotriiodothyronine combination therapy versus levothyroxine monotherapy. Int J Clin Pract. 2018 Feb;72(2):e13062. doi:10.1111/ijcp.13062.
Jonklaas J, Bianco AC, Bauer AJ, et al; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014 Dec;24(12):1670-751. doi:10.1089/thy.2014.0028.
Taylor PN, Razvi S, Pearce SH, Dayan CM. Clinical review: A review of the clinical consequences of variation in thyroid function within the reference range. J Clin Endocrinol Metab. 2013 Sep;98(9):3562-71. doi:10.1210/jc.2013-1315.
Cerqueira C, Knudsen N, Ovesen L, et al. Doubling in the use of thyroid hormone replacement therapy in Denmark: association to iodization of salt? Eur J Epidemiol. 2011 Aug;26(8):629-35. doi:10.1007/s10654-011-9590-5.
Mafham MM, Spata E, Goldacre R, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet. 2020 Aug 8;396(10248):381-389. doi:10.1016/S0140-6736(20)31356-8.
Zhang Y, Wen J, Alamgir M, et al. Impact of the COVID-19 pandemic on inpatient dermatology: a multicentre study from Hubei, China. J Eur Acad Dermatol Venereol. 2021 Mar;35(3):e179-e181. doi:10.1111/jdv.17041.
Silva AB, Freschi G, Carrera RV, et al. COVID-19 pandemic impact on clinical outcomes of patients with obstructive pyelonephritis. Int Urol Nephrol. 2021 Apr;53(4):627-633. doi:10.1007/s11255-020-02708-3.
Nef HM, Elsässer A, Möllmann H, et al; CoVCAD –Study Group. Impact of the COVID-19 pandemic on cardiovascular mortality and catherization activity during the lockdown in central Germany: an observational study. Clin Res Cardiol. 2021 Feb;110(2):292-301. doi:10.1007/s00392-020-01780-0.
Stöhr E, Aksoy A, Campbell M, et al. Hospital admissions during Covid-19 lock-down in Germany: Differences in discretionary and unavoidable cardiovascular events. PLoS One. 2020 Nov 20;15(11):e0242653. doi:10.1371/journal.pone.0242653.
Karia M, Gupta V, Zahra W, Dixon J, Tayton E. The effect of COVID-19 on the trauma burden, theatre efficiency and training opportunities in a district general hospital: planning for a future outbreak. Bone Jt Open. 2020 Aug 18;1(8):494-499. doi:10.1302/2633-1462.18.BJO-2020-0074.R1.
Fahy S, Moore J, Kelly M, Flannery O, Kenny P. Analysing the variation in volume and nature of trauma presentations during COVID-19 lockdown in Ireland. Bone Jt Open. 2020 Nov 1;1(6):261-266. doi:10.1302/2046-3758.16.BJO-2020-0040.R1.
Grech V, Borg D, Agius S, Scherb H. WITHDRAWN: Sharp decline in acute and elective hospital attendances and admissions due to COVID-19 in Malta (Q1 2020) - A population-based study. Early Hum Dev. 2020 Nov 12:105250. doi:10.1016/j.earlhumdev.2020.105250.
Atik F, Aktas G, Kocak MZ, Erkus E, Savli H. Analysis of the Factors Related to the Blood Pressure Control in Hypertension. J Coll Physicians Surg Pak. 2018 Jun;28(6):423-426. doi:10.29271/jcpsp.2018.06.423.