The cytokine storm and thyroid hormone changes in COVID-19.
The cytokine storm and thyroid hormone changes in COVID-19.
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DOI：
10.1007/s40618-021-01506-7
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发表时间：
2021-05
影响因子：
5.4
通讯作者：
Chiovato L
中科院分区：
文献类型：
--
作者：
Croce L;Gangemi D;Ancona G;Liboà F;Bendotti G;Minelli L;Chiovato L
COVID-19现已成为全球性大流行病。在COVID-19的许多肺外表现中，最近的证据表明可能发生甲状腺功能障碍。本综述的目的是总结关于COVID-19患者甲状腺功能改变的现有研究，并概述可能的生理病理学解释。COVID-19对甲状腺的影响似乎部分与“细胞因子风暴”的发生有关，而“细胞因子风暴”反过来又会诱发“非甲状腺疾病”。一些特定的细胞因子和趋化因子似乎对下丘脑-垂体-甲状腺轴有直接作用。另一方面，一些作者观察到COVID-19患者中破坏性甲状腺炎（亚急性或无痛性）的发生率增加。SARS-Cov-2直接感染甲状腺的假设源于观察到其受体ACE 2在甲状腺组织中强烈表达。最后，一些主要用于治疗COVID-19的药物很可能在甲状腺功能参数的实验室评价中作为混杂因素。
COVID-19 is now a worldwide pandemic. Among the many extra-pulmonary manifestations of COVID-19, recent evidence suggested a possible occurrence of thyroid dysfunction. The Aim of the present review is to summarize available studies regarding thyroid function alterations in patients with COVID-19 and to overview the possible physio-pathological explanations. The repercussions of the thyroid of COVID-19 seem to be related, in part, with the occurrence of a “cytokine storm” that would, in turn, induce a “non-thyroidal illness”. Some specific cytokines and chemokines appear to have a direct role on the hypothalamus–pituitary–thyroid axis. On the other hand, some authors have observed an increased incidence of a destructive thyroiditis, either subacute or painless, in patients with COVID-19. The hypothesis of a direct infection of the thyroid by SARS-Cov-2 stems from the observation that its receptor, ACE2, is strongly expressed in thyroid tissue. Lastly, it is highly probable that some pharmaceutical agents largely used for the treatment of COVID-19 can act as confounding factors in the laboratory evaluation of thyroid function parameters.
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