Influence of thyroid autoimmunity at various clinical stages of hypothyroidism on the risk of miscarriage before 20 weeks of gestation.

PURPOSE: We aimed to clarify the influence of thyroid autoantibodies at various clinical stages of hypothyroidism on the risk of pregnancy loss before 20 weeks of gestation. METHODS: We enrolled 230 pregnant women with a history of recurrent miscarriage. Detailed clinical history, physical examination, and laboratory testing of thyroid function, antithyroid peroxidase (anti-TPO), and antithyroglobulin (anti-TG) were applied among all participants. RESULTS: Coexisting overt hypothyroidism and positive thyroid autoantibodies quadrupled the risk of miscarriage in women before 20 weeks of gestation (OR 4.04, 95% CI = 2.08-7.96, P < 0.001). Women with subclinical hypothyroidism (OR 1.44, 95% CI = 0.81-2.57, P = 0.132,) or who were euthyroid (OR 1.53, 95% CI = 0.86-2.73, P = 0.094) showed a non-significant risk of miscarriage even with positive thyroid autoantibodies. Thyroid-stimulating hormone (TSH) was positively correlated with the number of miscarriages rather than anti-TPO (P < 0.001 and 0.209, respectively). CONCLUSION: Coexistence of overt hypothyroidism and thyroid autoimmunity was the only significant driver of pregnancy loss before 20 weeks of gestation.

Long-term clinical and biochemical residue after COVID-19 recovery.

BACKGROUND: The long-term health consequences of coronavirus disease 2019 (COVID-19) are still unclear. The majority of previous trials addressed the post-COVID-19 symptoms through comprehensive medical questionnaires for relatively short periods after recovery. We tried to detect the potential pathological clinical signs and biochemical residue which persist for more than 3 months after the negative real-time polymerase chain reaction (RT-PCR) test of SARS-CoV-2. RESULTS: Among 120 COVID-19 survivors of mean age 38.29 and 55.6% male proportion, systolic blood pressure was significantly elevated ( P =0.001). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), D-dimer showed higher values in COVID-19 survivors ( P < 0.001). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl trans-peptidase (GGT), and alkaline phosphatase (ALP) were significantly elevated in contrast to serum albumin that was reduced in COVID-19 survivors ( P ≤0.001). Serum lipase, amylase and albuminuria were higher in COVID-19 survivors ( P ≤0.001). Regression analysis (AOR, 95% CI) showed that ESR ( P = 0.014), haemoglobin concentration ( P = 0.039), serum lipase ( P = 0.018), blood urea nitrogen ( P = 0.003), albuminuria ( P = 0.046), 25(OH) vitamin D ( P = 0.002), and serum uric acid ( P = 0.005) were the significant predictors of COVID-19 survivors (94.8% an overall prediction). CONCLUSION: COVID-19 survivors experienced residual significant clinical and biochemical alterations that necessitate comprehensive medical care and close follow-up for longer periods.