Compliance to levothyroxine treatment of the patients with hypothyroidism during SARS-CoV-2 pandemic era

• Main Authors: Satilmis Bilgin, Burcin Meryem Atak Tel, Tuba Taslamacioglu Duman, Ozge Kurtkulagi, Gizem Bakir Kahveci, Tugrul Sagdic, Gulali Aktas
• Format: Article
• Language: English
• Published: Publishing House Zaslavsky 2021-04-01
• Series: Mìžnarodnij Endokrinologìčnij Žurnal
• Subjects: hypothyroidism, levothyroxine, compliance, thyroid stimulation hormone
• Online Access: http://iej.zaslavsky.com.ua/article/view/230563

Background. Hypothyroidism requires treatment with levothyroxine (L-T4) to keep patients euthyroid. The rate of hospital admissions for chronic conditions decreased during COVID-19 era. We aimed to observe whether hospital admissions of the patients with hypothyroidism decreased during COVID-19 compared to the same time period in 2019. We also aimed to find out the rate of treatment compliance in subjects with hypothyroidism during pandemic era. Materials and methods. This cross-sectional study was performed on patients who applied to Internal Medicine Department of Abant Izzet Baysal University Hospital, and who received L-T4 replacement therapy due to hypothyroidism. 108 hypothyroidism patients were included in the study with their consent forms. The patients were divided into 2 groups according to the treatment compliance; either as compliant or incompliant patients. Results. The last TSH level of compliant group was significantly lower than incompliant group (p < 0.001). The last fT4 level of the compliant group was significantly higher than that of the incompliant group (p = 0.04). The median of the LT-4 treatment used irregularly was 35 (10–90) days in incompliant group and was 0 (0–0) days in compliant group (p < 0.001). The number of irregularly L-T4 used days was significantly positively correlated with last TSH value (r = 0.564, p < 0.001), and negatively correlated with last FT4 value (r = –0.492, p < 0.001). Mean corpuscular volume (MCV) of the compliant and incompliant groups were 85 (69.1–97.5) fL and 89 (66–96.6) fL, respectively (p = 0.03). Retrospective nature and relatively small study population are two main limitations of our study. Conclusions. Compliance to treatment is very important to achieve euthyroid hormone levels in patients with hypothyroidism during COVID-19 pandemic. Elevated MCV levels could predict incompliance to treatment in hypothyroidism.