Non-Thyroidal Illness Syndrome in a Pediatric Intensive Care Unit During the COVID-19 Era

Articles in Press

Document Type : original article

Authors

1 Department of pediatrics, Mashhad university of medical sciences,mahshhad,iran

2 Professor of Pediatric Endocrinology, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran.

4 Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/jpp.2026.94655.5631

Abstract

Background

Non-thyroidal illness syndrome (NTIS) is defined as a condition during acute illness. In this study, we evaluated thyroid function tests in pediatrics with COVID-19 infection who were admitted in pediatric intensive care unit(PICU) and compared them with children who were admitted to PICU due to other disorders

Methods and materials:

This was a cross-sectional study, all patients between the ages of 1 month and 16 years admitted to the PICUs of Covid 19 referral Hospital were evaluated during a 6 month period. A checklist was used for gathering patients information .Thyroid hormones evaluated included: measurement of freet3, t3, t4 and TSH on first day of admission Data was analyzed using the Spss 21 statistical package.

Results:

A total of 73 patients were evaluated during the 6 month study period. 40 (54.8%) of them were male and 53(45.2%) were female. Mean age of the study population was 5.9±4.3 years.13 patients were admitted due to SARS-COV19 infection.

Thyroid functions consistent with Non thyroidal illness syndrome was observed in 25(34.2%) of these patients. The level of T3 and FT3 in patients with covid-19 was significantly lower than patients without covid-19 infection (P<0.05).Body temperature in patients with abnormal thyroid tests was significantly higher than in patients with normal thyroid tests (P=0.040).

Conclusion

We showed that one-third of children admitted to the PICU had NTIS. We suggest that FT3 can be a marker of COVID-19 patient severity, as its lower level was observed in pediatric patients admitted to PICU.

Keywords

Journal of Pediatric Perspectives

Articles in Press, Accepted Manuscript
Available Online from 14 March 2026

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