{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:38:47Z","timestamp":1754145527617,"version":"3.41.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Since 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\u2019 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\u2019 disease (GDC) and COVID-19 coinfection holds significant clinical importance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This 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 (\u22645 days), G2 (6\u20138 days), and G3 (\u22659 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariate 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Post-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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1597083","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T04:10:41Z","timestamp":1752725441000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of COVID-19 on thyroid function and psychological state of Graves\u2019 disease: a one-year prospective 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