@Article{info:doi/10.2196/66003,
author="Nian, Hui
and Bai, Yu
and Yu, Hua",
title="Assessing the Causal Association Between COVID-19 and Graves Disease: Mendelian Randomization Study",
journal="JMIR Form Res",
year="2025",
month="Apr",
day="8",
volume="9",
pages="e66003",
keywords="Graves disease; COVID-19; Mendelian randomization; causal relationship; autoimmune disease",
abstract="Background: Graves disease (GD) is an autoimmune thyroid disorder characterized by hyperthyroidism and autoantibodies. The COVID-19 pandemic has raised questions about its potential relationship with autoimmune diseases like GD. Objective: This study aims to investigate the causal association between COVID-19 and GD through Mendelian randomization (MR) analysis and assess the impact of COVID-19 on GD. Methods: We conducted an MR study using extensive genome-wide association study data for GD and COVID-19 susceptibility and its severity. We used stringent single nucleotide polymorphism selection criteria and various MR methodologies, including inverse-variance weighting, MR-Egger, and weighted median analyses, to assess causal relationships. We also conducted tests for directional pleiotropy and heterogeneity, as well as sensitivity analyses. Results: The MR analysis, based on the largest available dataset to date, did not provide evidence supporting a causal relationship between COVID-19 susceptibility (odds ratio [OR] 0.989, 95{\%} CI 0.405‐2.851; P=.93), COVID-19 hospitalization (OR 0.974, 95{\%} CI 0.852‐1.113; P=.70), COVID-19 severity (OR 0.979, 95{\%} CI 0.890‐1.077; P=.66), and GD. Tests for directional pleiotropy and heterogeneity, as well as sensitivity analyses, supported these findings. Conclusions: This comprehensive MR study does not provide sufficient evidence to support a causal relationship between COVID-19 and the onset or exacerbation of GD. These results contribute to a better understanding of the potential association between COVID-19 and autoimmune diseases, alleviating concerns about a surge in autoimmune thyroid diseases due to the pandemic. Further research is warranted to explore this complex relationship thoroughly. ",
issn="2561-326X",
doi="10.2196/66003",
url="https://formative.jmir.org/2025/1/e66003",
url="https://doi.org/10.2196/66003"
}