The impact of the SARS-CoV2 pandemic on the prescription of thyroid medication in Austria - A nationwide population-based registry analysis.

ABSTRACT

BACKGROUND: Case reports indicate a clinical connection between SARS-CoV-2 and thyroid dysfunctions. However, evidence from large population-based registry analyses is sparse, especially in Europe, where iodine deficiency is common. This study aimed to analyze the impact of the COVID-19 pandemic on healthcare provision for thyroid diseases in Austria. METHODS: We performed a retrospective, population-based registry analysis of the Austrian health insurance fund database, covering more than 9 million inhabitants. Data from all patients with prescriptions of thyroid-specific drugs and/or inpatient thyroid-related diagnoses from 2017 to 2019 (pre-pandemic years) were compared to 2020 and 2021 (pandemic years; characterized by high numbers of SARS-CoV2 infections and population-wide vaccination strategy). The incidence rates of thyroid medication prescriptions for hypothyroidism and hyperthyroidism were calculated for every year to evaluate the impact of the pandemic. RESULTS: The incidence rate for total thyroid medication prescription was 539.07/100,000 individuals (534.23-543.93 95%CI) in 2018 and declined during the pandemic (2020 387.19/100,000 (383.12-391.29 95%CI); 2021 336.90/100,000 (333.11-340.73 95%CI)). Similarly, the incidence rate for levothyroxine prescription was higher pre-pandemic (2018 465.46/100,000 (460.97-469.98 95%CI) and declined during the pandemic (2020 348.14/100,000 (344.28-352.03 95%CI); 2021 300.30/100,000 (296.7-303.91 95%CI). The incidence rates of thiamazole prescriptions (2018 10.24/100,000 (9.58-10.93 95%CI); 2020 8.62/100,000 (8.03-9.26 95%CI); 2021 11.17/100,000 (10.49-11.89 95%CI) were stable. CONCLUSIONS: These findings suggest no clinically significant impact of SARS-CoV2 and/or vaccination on thyroid function at a population level.