{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T23:54:04Z","timestamp":1776297244080,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Existing studies reported the potential prognostic role of non\u2010thyroidal illness syndrome (NTIS), characterized by low triiodothyronine (T3) with normal\/low thyroid\u2010stimulating hormone (TSH), mainly in severe COVID\u201019. None considered the significant impact of SARS\u2010CoV\u20102 viral load on adverse outcomes. We aimed to clarify the prognostic role of NTIS among predominantly mild\u2010to\u2010moderate COVID\u201019 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A prospective study of COVID\u201019 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Measurements<\/jats:title><jats:p>Consecutive adults admitted to Queen Mary Hospital for confirmed COVID\u201019 from July to December 2020 were prospectively recruited. SARS\u2010CoV\u20102 viral load was represented by cycle threshold (Ct) values from real\u2010time reverse transcription\u2010polymerase chain reaction of the respiratory specimen on admission. Serum TSH, free thyroxine and free T3 were measured on admission. The outcome was deterioration in clinical severity, defined as worsening in \u22651 category of clinical severity according to the Chinese National Health Commission guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We recruited 367 patients. At baseline, 75.2% had mild disease, and 27 patients (7.4%) had NTIS. Fifty\u2010three patients (14.4%) had clinical deterioration. Patients with NTIS were older, had more comorbidities, worse symptomatology, higher SARS\u2010CoV\u20102 viral loads and worse profiles of inflammatory and tissue injury markers. They were more likely to have clinical deterioration (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). In multivariable stepwise logistic regression analysis, NTIS independently predicted clinical deterioration (adjusted odds ratio 3.19, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.017), in addition to Ct value &lt;25 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), elevated C\u2010reactive protein (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.004), age &gt;50\u00a0years (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.011) and elevated creatine kinase (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.017).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010thyroidal illness syndrome was not uncommon even in mild\u2010to\u2010moderate COVID\u201019 patients. NTIS on admission could predict clinical deterioration in COVID\u201019, independent of SARS\u2010CoV\u20102 viral load, age and markers of inflammation and tissue injury.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14476","type":"journal-article","created":{"date-parts":[[2021,4,4]],"date-time":"2021-04-04T09:44:36Z","timestamp":1617529476000},"page":"469-477","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Role of non\u2010thyroidal illness syndrome in predicting adverse outcomes in COVID\u201019 patients predominantly of mild\u2010to\u2010moderate severity"],"prefix":"10.1111","volume":"95","author":[{"given":"David Tak Wai","family":"Lui","sequence":"first","affiliation":[{"name":"Department of Medicine The University of Hong Kong Queen Mary Hospital Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department 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