The aim of this multidisciplinary study is to explore the possibility to treat NonThyroidal Illness Syndrome (NTIS), affecting the majority of patients hospitalized in the Intensive Care Units (ICU)s. NTIS is considered an adaptative response to reduced calories availability and, therefore, treatment is currently not recommended. The interventional clinical trials, performed so far, failed to demonstrate any benefit of treatment with thyroid hormones.
Recently, we analyzed epidemiological, clinical and laboratory characteristics of patients that presented NTIS during the first wave of COVID-19 pandemic, demonstrating that this syndrome is associated with the markers of disease severity. We analyzed also the effects of NTIS on water and electrolyte balance at the periphery during the second wave of COVID-19 pandemic (manuscript in preparation), demonstrating that it is associated with water and salt retention, in a picture that resembles that observed in severe hypothyroid patients with myxedema. We, therefore, hypothesize that NTIS is, indeed, manifestation of an acute form of hypothyroidism and needs to be treated. This study is also aimed to better understand the underlying mechanism of NTIS and its correlation with the psychological conditions at the basis of acute stress accumulation, bringing new insights into the pathogenesis of the severity of this syndrome
The three aims are:
Aim 1 Validate the utility of measurement of fluid and electrolyte balance at the periphery, by Bioelectrical Impedance Analysis (BIA) in patients with NTIS hospitalized in ICUs
Aim 2 Evaluate the efficacy of treatment with T3 in these patients in an interventional clinical trial based on the endpoints validated in the first aim.
Aim 3 Investigate if the development of NTIS is associated with exposure to psychological chronic stress, and with the presence of psychopathological symptoms, by means of a psychometric assessment.
