A case of subacute thyroiditis associated with Covid-19 infection

Kalkan, Emra Asfuroglu; Ateş, İhsan

doi:10.1007/s40618-020-01316-3

Cited by 117 publications

(145 citation statements)

References 4 publications

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“…The results of the present study suggest that the thyroid might be vulnerable to SARS-CoV-2 infection. This would fit with the recent clinical descriptions of COVID-19related SAT [17][18][19][20]. It is interesting to remember that thyroid repercussions were also described during the 2002 outbreak of SARS-CoV [17,23].…”

Section: Discussionsupporting

confidence: 80%

“…The possibility that SARS-CoV-2 could also infect thyroid cells derives from the notion that different viruslike particles are detectable in the follicular epithelium of patients with subacute thyroiditis (SAT) [16] and, most recently, by some independent case reports of SAT related to SARS-CoV-2 [17][18][19][20][21][22]. The anatomic location of the thyroid, which is contiguous to the upper airways, a main entrance site of corona viruses, further supports the hypothesis that the thyroid could be a target of SARS-CoV-2.…”

Section: Introductionmentioning

confidence: 99%

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Detection of SARS-COV-2 receptor ACE-2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis

Rotondi

Coperchini

Ricci

et al. 2020

J Endocrinol Invest

201

176

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Purpose SARS-COV-2 is a pathogenic agent belonging to the coronavirus family, responsible for the current global world pandemic. Angiotensin-converting enzyme 2 (ACE-2) is the receptor for cellular entry of SARS-CoV-2. ACE-2 is a type I transmembrane metallo-carboxypeptidase involved in the Renin-Angiotensin pathway. By analyzing two independent databases, ACE-2 was identified in several human tissues including the thyroid. Although some cases of COVID-19-related subacute thyroiditis were recently described, direct proof for the expression of the ACE-2 mRNA in thyroid cells is still lacking. Aim of the present study was to investigate by RT-PCR whether the mRNA encoding for ACE-2 is present in human thyroid cells. Methods RT-PCR was performed on in vitro ex vivo study on thyroid tissue samples (15 patients undergoing thyroidectomy for benign thyroid nodules) and primary thyroid cell cultures. Results The ACE-2 mRNA was detected in all surgical thyroid tissue samples (n = 15). Compared with two reporter genes (GAPDH: 0.052 ± 0.0026 Cycles−1; β-actin: 0.044 ± 0.0025 Cycles−1; ACE-2: 0.035 ± 0.0024 Cycles−1), the mean level of transcript expression for ACE-2 mRNA was abundant. The expression of ACE-2 mRNA in follicular cells was confirmed by analyzing primary cultures of thyroid cells, which expressed the ACE-2 mRNA at levels similar to tissues. Conclusions The results of the present study demonstrate that the mRNA encoding for the ACE-2 receptor is expressed in thyroid follicular cells, making them a potential target for SARS-COV-2 entry. Future clinical studies in patients with COVID-19 will be required for increase our understanding of the thyroid repercussions of SARS-CoV-2 infection.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Detection of SARS-COV-2 receptor ACE-2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis

Rotondi

Coperchini

Ricci

et al. 2020

J Endocrinol Invest

201

176

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“…In fact, cases of thyroxine thyrotoxicosis have been also described (318). Several case reports and a case series were focused on the prevalence of subacute thyroiditis and thyroxine thyrotoxicosis in patients with severe presentation of COVID-19 from ICU (319)(320)(321)(322)(323)(324). More recently in a retrospective study on 50 COVID-19 patients it was found a decrease in total T3 and TSH concentrations in 56% of patients (325)(326)(327).…”

Section: Thyroidmentioning

confidence: 99%

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

et al. 2020

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The explosion of the new coronavirus (SARS-CoV-2) pandemic has brought the role of the angiotensin converting enzyme 2 (ACE2) back into the scientific limelight. Since SARS-CoV-2 must bind the ACE2 for entering the host cells in humans, its expression and body localization are critical to track the potential target organ of this infection and to outline disease progression and clinical outcomes. Here, we mapped the physiological body distribution, expression, and activities of ACE2 and discussed its potential correlations and mutal interactions with the disparate symptoms present in SARS-CoV-2 patients at the level of different organs. We highlighted that despite during SARS-CoV-2 infection ACE2-expressing organs may become direct targets, leading to severe pathological manifestations, and subsequent multiple organ failures, the exact mechanism and the potential interactions through which ACE2 acts in these organs is still heavily debated. Further scientific efforts, also considering a personalized approach aimed to consider specific patient differences in the mutual interactions ACE2-SARS-CoV-2 and the long-term health effects associated with COVID-19 are currently mandatory.

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“…Most of the published studies were a collection of expert opinions and recommendations on the new strategies of care of thyroid patients in the face of COVID-19 transmission risk and health care surge capacity [8,[28][29][30][31][32][33][34]. Instead, only 13 articles explored thyroid function and/or reported new-onset thyroid diseases in patients contracting COVID-19 [7,[35][36][37][38][39][40][41][42][43][44][45][46]. Only two studies investigated the histopathological characteristics of the thyroid gland and viral thyroid tropism from patients who died of severe COVID-19 [47,48].…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 on the thyroid gland: an update

Scappaticcio

Pitoia

Esposito

et al. 2020

Rev Endocr Metab Disord

208

195

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Coronavirus disease 2019 (COVID-19) is the pandemic of the new millennium. COVID-19 can cause both pulmonary and systemic inflammation, potentially determining multi-organ dysfunction. Data on the relationship between COVID-19 and thyroid have been emerging, and rapidly increasing since March 2020. The thyroid gland and the virus infection with its associated inflammatory-immune responses are known to be engaged in complex interplay. SARS-CoV-2 uses ACE2 combined with the transmembrane protease serine 2 (TMPRSS2) as the key molecular complex to infect the host cells. Interestingly, ACE2 and TMPRSS2 expression levels are high in the thyroid gland and more than in the lungs. Our literature search provided greater evidence that the thyroid gland and the entire hypothalamic–pituitary–thyroid (HPT) axis could be relevant targets of damage by SARS-CoV-2. Specifically, COVID-19-related thyroid disorders include thyrotoxicosis, hypothyroidism, as well as nonthyroidal illness syndrome. Moreover, we noticed that treatment plans for thyroid cancer are considerably changing in the direction of more teleconsultations and less diagnostic and therapeutical procedures. The current review includes findings that could be changed soon by new results on the topic, considering the rapidity of worldwide research on COVID-19.

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A case of subacute thyroiditis associated with Covid-19 infection

Cited by 117 publications

References 4 publications

Detection of SARS-COV-2 receptor ACE-2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis

Detection of SARS-COV-2 receptor ACE-2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

Impact of COVID-19 on the thyroid gland: an update

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