AI Article Synopsis
- Lymphopenia, a condition linked to immune dysfunction in severe infections like bacterial sepsis and COVID-19, is connected to poor patient outcomes and may be influenced by thyroid function abnormalities.
- In a study involving hospitalized bacterial sepsis and COVID-19 patients, only T3 levels showed a significant correlation with lymphocyte counts, with severe lymphopenic patients exhibiting lower T3.
- The findings indicate that abnormal thyroid hormone levels are associated with lymphopenia, and while lymphocyte counts may recover over time, thyroid hormone disturbances persist, suggesting a complex relationship in severely ill patients.
Article Abstract
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.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989224 | PMC |
| http://dx.doi.org/10.1210/clinem/dgab148 | DOI Listing |
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