Delayed Follow-up Visits and Thyrotropin Among Patients With Levothyroxine During the COVID-19 Pandemic!
The indirect effects of the COVID-19 pandemic on clinical practice have received great attention, but evidence regarding thyroid disease management is lacking. Levothyroxine, a medication used to treat both overt and subclinical hypothyroidism, has been commonly prescribed worldwide. Ample evidence has shown that, if untreated or uncontrolled, such hypothyroid status increases the risk of long-term adverse health outcomes (eg, cardiovascular disease and death). Recent reports in the literature have suggested a possible link between COVID-19 and thyroid disorders, such as subacute thyroiditis related to SARS-CoV-2 and severe complications due to SARS-CoV-2 in uncontrolled thyrotoxicosis.
@rajanya The mean age was 52.8 years and women were 88%. Patients who were older and had a higher dose or longer duration of levothyroxine prescriptions were more likely to make a delayed follow-up visit during the pandemic. Changes in TSH were larger among the delayed-visit groups than the scheduled-visit group. We found increased risks of elevated TSH levels during the pandemic among the delayed visit groups, particularly those with delayed visit of 30 or more days (TSH > 4.5 mIU/L, aRR [95% CI] = 1.72 [1.60–1.85]; and TSH > 10 mIU/L, aRR [95% CI] = 2.38 [2.16–2.62]).