The Impact of Interferon Beta-1b Therapy on Thyroid Function and Autoimmunity Among COVID-19 Survivors.

Abstract

Background:

Some studies have indicated that interferon (IFN) may be valuable in COVID-19. We aimed to evaluate the impact of short-term IFN on incident thyroid dysfunction and autoimmunity among COVID-19 survivors.

Methods:

We included consecutive adults without known thyroid disorder admitted to Queen Mary Hospital for COVID-19 from July 2020 to January 2021 who had thyroid function tests (TFTs) and anti-thyroid antibodies measured both on admission and at three months.

Results:

226 patients were included (median age 55.0 years; 49.6% men): 135 were IFN-treated. There tended to be more abnormal TFTs upon reassessment in IFN-treated patients (8.1% vs 2.2%, p=0.080). 179 patients (65.4% IFN-treated) had a complete reassessment of anti-thyroid antibodies. There were significant increases in titres of both anti-thyroid peroxidase antibodies (anti-TPO: baseline 29.21 units [IQR: 14.97 - 67.14] vs reassessment 34.30 units [IQR: 18.82 - 94.65], p<0.001) and anti-thyroglobulin antibodies (anti-Tg: baseline 8.23 units [IQR: 5.40 - 18.44] vs reassessment 9.14 units [IQR: 6.83 - 17.17], p=0.001) in the IFN-treated group but not IFN-naïve group. IFN treatment (standardised beta 0.245, p=0.001) was independently associated with changes in anti-TPO titre. Of the 143 patients negative for anti-TPO at baseline, 8 became anti-TPO positive upon reassessment (seven IFN-treated; one IFN-naïve). Incident anti-TPO positivity was more likely to be associated with abnormal TFTs upon reassessment (phi 0.188, p=0.025).

Conclusion:

IFN for COVID-19 was associated with modest increases in anti-thyroid antibody titres, and a trend of more incident anti-TPO positivity and abnormal TFTs during convalescence. Our findings suggest that clinicians monitor the thyroid function and anti-thyroid antibodies among IFN-treated COVID-19 survivors, and call for further follow-up studies regarding the clinical significance of these changes.

• Authors: David Tak Wai Lui, Ivan Fan Ngai Hung, Chi Ho Lee, Alan Chun Hong Lee, Anthony Raymond Tam, Polly Pang, Tip Yin Ho, Chloe Yu Yan Cheung, Carol Ho Yi Fong, Chun Yiu Law, Kelvin Kai Wang To, Ching Wan Lam, Wing Sun Chow, Yu Cho Woo, Karen Siu Ling Lam, Kathryn Choon Beng Tan
• Journal: Frontiers in endocrinology (Front Endocrinol (Lausanne)) Vol. 12 Pg. 746602 ( 2021) ISSN: 1664-2392 [Print] Switzerland
• PMID: 34659128 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Lui, Hung, Lee, Lee, Tam, Pang, Ho, Cheung, Fong, Law, To, Lam, Chow, Woo, Lam and Tan.

Chemical References

• Antibodies
• Immunoglobulins, Thyroid-Stimulating
• Triiodothyronine
• Interferon beta-1b
• Thyrotropin
• Thyroxine

Topics

• Adult
• Antibodies (analysis)
• Autoimmunity (drug effects)
• COVID-19 (immunology)
• Cohort Studies
• Female
• Follow-Up Studies
• Humans
• Immunoglobulins, Thyroid-Stimulating (analysis)
• Interferon beta-1b (adverse effects, therapeutic use)
• Male
• Middle Aged
• Survivors
• Thyroid Diseases (chemically induced, immunology)
• Thyroid Function Tests
• Thyroid Gland (drug effects)
• Thyrotropin (blood)
• Thyroxine (blood)
• Triiodothyronine (blood)
• COVID-19 Drug Treatment