Activation of Type I and Type II Interferon Signaling in SARS-CoV-2-Positive Thyroid Tissue of Patients Dying from COVID-19

Poma, Anello Marcello; Basolo, Alessio; Bonuccelli, Diana; Proietti, Agnese; Macerola, Elisabetta; Ugolini, Clara; Torregrossa, Liborio; Alì, Greta; Giannini, Raffaello; Vignali, Paola; Santini, Ferruccio; Toniolo, Antonio; Basolo, Fulvio

doi:10.1089/thy.2021.0345

Cited by 28 publications

(27 citation statements)

References 40 publications

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“…Furthermore, as ACE2 and TMPRSS2 expression levels are higher in the thyroid gland than in the lungs, this provides a mechanistic link for the direct thyroid damage causing thyroid dysfunction amongst COVID-19 patients [ 15 ]. SARS-CoV-2 has been shown in the thyroid tissues in an autopsy study [ 9 ]. Studies have specifically demonstrated the expression of ACE2 mRNA in thyroid cells [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…These cases of SARS-CoV-2-related thyroiditis could present as either overt or subclinical thyrotoxicosis. The causal link between COVID-19 and thyroiditis has been strengthened by reports of SARS-CoV-2 in the thyroid tissues amongst patients who died from COVID-19 [ 9 ], and studies demonstrating ACE2 mRNA expression in thyroid cells [ 10 , 11 ]. It is crucial to identify SARS-CoV-2-related thyroiditis, given its potential evolution into hypothyroidism requiring thyroxine replacement [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Development of a prediction score (ThyroCOVID) for identifying abnormal thyroid function in COVID-19 patients

Lui

Lee

Chow

et al. 2022

J Endocrinol Invest

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Purpose Thyroid dysfunction in COVID-19 carries clinical and prognostic implications. In this study, we developed a prediction score (ThyroCOVID) for abnormal thyroid function (TFT) on admission amongst COVID-19 patients. Methods Consecutive COVID-19 patients admitted to Queen Mary Hospital were prospectively recruited during July 2020–May 2021. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were measured on admission. Multivariable logistic regression analysis was performed to identify independent determinants of abnormal TFTs. ThyroCOVID was developed based on a clinical model with the lowest Akaike information criteria. Results Five hundred and forty six COVID-19 patients were recruited (median age 50 years, 45.4% men, 72.9% mild disease on admission). 84 patients (15.4%) had abnormal TFTs on admission. Patients with abnormal TFTs were more likely to be older, have more comorbidities, symptomatic, have worse COVID-19 severity, higher SARS-CoV-2 viral loads and more adverse profile of acute-phase reactants, haematological and biochemical parameters. ThyroCOVID consisted of five parameters: symptoms (malaise), comorbidities (ischaemic heart disease/congestive heart failure) and laboratory parameters (lymphocyte count, C-reactive protein, and SARS-CoV-2 cycle threshold values). It was able to identify abnormal TFT on admission with an AUROC of 0.73 (95% CI 0.67–0.79). The optimal cut-off of 0.15 had a sensitivity of 75.0%, specificity of 65.2%, negative predictive value of 93.5% and positive predictive value of 28.1% in identifying abnormal TFTs on admission amongst COVID-19 patients. Conclusion ThyroCOVID, a prediction score to identify COVID-19 patients at risk of having abnormal TFT on admission, was developed based on a cohort of predominantly non-severe COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of a prediction score (ThyroCOVID) for identifying abnormal thyroid function in COVID-19 patients

Lui

Lee

Chow

et al. 2022

J Endocrinol Invest

View full text Add to dashboard Cite

show abstract

“…Outside the setting of SAT, some studies on patients deceased for SARS-CoV-2 failed to identify the viral genome on thyroid tissue [ 10 ], whereas others reported the detection of SARS-CoV-2 antigens and genome at least in severe cases [ 20 , 21 ], with the expression of the ACE-2 mRNA reported as a potential clue for the entry of the virus into the follicular cells [ 22 ]. SARS-CoV-2-infected thyroid tissues showed marked infiltration of neutrophils and macrophages as well as the activation of type I and type II interferon pathways [ 23 ]. These changes are consistent with SAT.…”

Section: Discussionmentioning

confidence: 99%

Salvage total thyroidectomy for amiodarone-induced thyrotoxicosis in a SARS-CoV-2 positive patient: results of the viral genome research on the pathology sample of this destructive thyroiditis

et al. 2022

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“…Autopsy studies in patients who died from COVID-19 revealed that the presence of the virus in the thyroid tissue was associated with a significant inflammatory infiltration and upregulation of immune genes involved in the interferon pathways, while tissues negative for SARS-CoV-2 did not present these inflammatory changes [ 31 ]. In our study, we evaluated patients with previously diagnosed thyroid conditions (associated with the chronic HCV infection); this may explain the increased thyroid inflammation we found in our patients, expressed by the high levels of autoantibodies,…”

Section: Discussionmentioning

confidence: 99%

A Prospective Observational Study of 42 Patients with COVID-19 infection and a History of Hepatitis C Virus Infection and Thyroid Disease with Follow-Up Thyroid Function and Autoantibody Testing

et al. 2021

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Background Thyroiditis is an important extrahepatic association in chronic hepatitis C virus (HCV) infection. There have been reports of an association between SARS-CoV-2 infection and the onset or re-activation of autoimmune hypothyroidism. Therefore, we performed this prospective observational study of 42 patients with COVID-19 infection and a history of hepatitis C virus infection and thyroid disease with follow-up thyroid function and autoantibody testing. Material/Methods From April 2020 to October 2020, we performed a prospective observational study of patients with cured hepatitis C virus (HCV) infection and documented thyroid disease who became infected with SARS-CoV-2 (confirmed by SARS-CoV-2 RNA detection via reverse-transcription polymerase chain reaction [RT-PCT] from the upper respiratory tract, both nasal and pharyngeal swabs). Evaluation at 1 and 3 months after SARS-CoV-2 infection included serum determination of antithyroid antibodies (anti-thyroglobulin [anti-Tg] and antithyroid peroxidase [ATPO]), thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and evaluation of thyroid medication, with dose adjustment if required. Results One-month follow-up showed that both patients with autoimmune thyroiditis as well as patients without antibodies had increased ATPO levels. Also, levels of TSH, fT3, and fT4 were significantly decreased. At 3-month follow-up, levels of ATPO were decreased in all patient groups and the levels of thyroid hormones increased to normal values. Conclusions This study supports previous reports of an association between SARS-CoV-2 infection and thyroid dysfunction associated with thyroid autoantibodies. Thyroid function tests may be considered as part of the laboratory work-up in patients with COVID-19.

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Activation of Type I and Type II Interferon Signaling in SARS-CoV-2-Positive Thyroid Tissue of Patients Dying from COVID-19

Cited by 28 publications

References 40 publications

Development of a prediction score (ThyroCOVID) for identifying abnormal thyroid function in COVID-19 patients

Development of a prediction score (ThyroCOVID) for identifying abnormal thyroid function in COVID-19 patients

Salvage total thyroidectomy for amiodarone-induced thyrotoxicosis in a SARS-CoV-2 positive patient: results of the viral genome research on the pathology sample of this destructive thyroiditis

A Prospective Observational Study of 42 Patients with COVID-19 infection and a History of Hepatitis C Virus Infection and Thyroid Disease with Follow-Up Thyroid Function and Autoantibody Testing

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