COVID-19-Associated Subacute Thyroiditis: Evidence-Based Data From a Systematic Review

Trimboli, Pierpaolo; Cappelli, Carlo; Croce, Laura; Scappaticcio, Lorenzo; Chiovato, Luca; Rotondi, Mario

doi:10.3389/fendo.2021.707726

Cited by 62 publications

(91 citation statements)

References 60 publications

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“…There is some evidence of thyroid dysfunction in patients with COVID-19, characterized by changes in hormone levels (low triiodothyronine or low thyrotropin levels) or laboratory results compatible with the presence of subacute thyroiditis [15,19]. Italian researchers observed that in the spring of 2020, 15% of COVID-19 patients (n=93) admitted to the intensive care unit (ICU) at a hospital in Milan had changes in thyroid hormones.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and thyroid disease: an infodemiological pilot study

Ilias

Milionis

Koukkou

2021

Preprint

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Introduction: Some studies have linked COVID-19 with thyroid disease. Google Trends (GT) searches may reflect disease epidemiology. Recently, GT searches for COVID-19-associated terms have been linked to the epidemiology of COVID-19. In this study we aimed to assess COVID-19 cases per se vs COVID-19-associated GT searches and thyroid-associated GT searches. Materials-Methods: We collected data on worldwide weekly GT searches regarding “COVID-19”, “SARS-COV-2”, “coronavirus”, “smell”, “taste”, “fatigue”, “cough”, “thyroid”, “thyroiditis” and “subacute thyroiditis” for 92 weeks and worldwide weekly COVID-19 cases' statistics in the same time period. The study period was split in half and in each time period we performed cross-correlation analysis and mediation analysis. Results Significant positive CCF values were noted in both time periods; while COVID-19 cases per se were associated with “thyroid” searches in both time periods, significant CCFs for “fatigue”, “COVID-19” and “SARS-COV-s” were mostly found in the second time period. In the latter period, the effect of “COVID-19” searches on “thyroid” searches was significantly mediated by COVID-19 cases (p=0.048). Discussion COVID-19 cases per se were found to be associated with no lag with GT searches for COVID-19 symptoms in the first time period and in the second time period to lead searches for symptoms, COVID-19 terms as well as thyroid terms. Searches for a non-specific symptom or COVID-19 search terms mostly lead GT “thyroid” searches, in the second time period. This time frame/sequence particularly in the second time period (noted by the preponderance of the SARS-COV-2 delta variant), lends some credence to associations of COVID-19 cases per se with (apparent) thyroid disease (via searches for them).

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Section: Discussionmentioning

confidence: 99%

COVID-19 and thyroid disease: an infodemiological pilot study

Ilias

Milionis

Koukkou

2021

Preprint

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“…Main viruses associated with SAT are coxsackievirus A and B, echovirus, mumps, measles, influenza. Shortly after the onset of SARS-CoV-2 pandemic, many cases of SAT induced by this virus have been described [ 2 – 6 ]. Direct evidence of viral presence in the thyroid gland has been indeed demonstrated for several viruses [ 7 ], including SARS-CoV-2 [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 vaccine-associated subacute thyroiditis: insights from a systematic review

Ippolito¹,

Gallo²,

Rossini

et al. 2022

J Endocrinol Invest

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Purpose To perform a systematic review on published cases of subacute thyroiditis (SAT) secondary to SARS-CoV-2 vaccination, to highlight main features and increase the awareness of this condition. Methods Original reports of SAT developed after SARS-CoV-2 vaccination (mRNA, viral vector, or inactivated virus vaccines) were retrieved from a search of electronic databases. Individual patient data on demographics, medical history, type of vaccine, workup and therapies were collected. Wilcoxon rank-sum, Kruskal–Wallis and chi-squared tests were employed for comparisons. Results 30 articles including 48 reports were retrieved, 3 additional cases evaluated by the Authors were described and included for analysis. Of the 51 patients, 38 (74.5%) were women, median age was 39.5 years (IQR 34–47). Patients developed SAT after a median of 10 days (IQR 4–14) after the vaccine shot. Baseline thyroid exams revealed thyrotoxicosis in 88.2% of patients, decreasing at 31.6% at follow-up. Corticosteroids were used in 56.4% of treated patients. Patients undergoing non-mRNA vaccines were most frequently Asian (p = 0.019) and reported more frequently weight loss (p = 0.021). All patients with a previous diagnosis of thyroid disease belonged to the mRNA vaccine group. Conclusion SARS-CoV-2 vaccine-associated SAT is a novel entity that should be acknowledged by physicians. Previous history of thyroid disease may predispose to develop SAT after mRNA vaccines, but further studies and larger cohorts are needed to verify this suggestion. SARS-CoV-2 vaccine-associated SAT is usually of mild/moderate severity and could be easily treated in most cases, thus it should not raise any concern regarding the need to be vaccinated.

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“…In a systematic review of SARS-CoV-2-associated SAT cases, it was commented that the clinical features did not differ from classical SAT [ 46 ]. Consistent with this interpretation, in our study, CoV-SAT and NonCoV-SAT groups were similar regarding clinical features, laboratory findings and treatment characteristics.…”

Section: Discussionmentioning

confidence: 99%

Subacute thyroiditis during the COVID-19 pandemic: a prospective study

Mutlu

Karahan

Aydoğan

et al. 2022

J Endocrinol Invest

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Purpose Subacute thyroiditis(SAT) is a destructive thyroiditis associated with viral infections. Several SAT cases associated with SARS-CoV-2 infection/vaccination were recently reported. We aimed to evaluate prospectively all cases applied to our tertiary center and their relationship with SARS-CoV-2 during 16 months of the pandemic. Cases during similar pre-pandemic period were recorded for numeric comparison. Methods Prospective study took place between March 2020 and July 2021. SAT was diagnosed by classical criteria. Swabs for SARS-CoV-2 and a wide respiratory viral panel (RV-PCR) were taken. Previous COVID-19 was assessed by SARS-CoV-2 IgM&IgG levels. Study group was divided into three as: CoV-SAT, patients who had or still have COVID-19, Vac-SAT, patients diagnosed within three months after SARS-CoV-2 vaccination and NonCoV-SAT, those not associated with COVID-19 or vaccination. Results Out of 64 patients, 18.8% ( n = 12) was classified as CoV-SAT, 9.3% ( n = 6) as Vac-SAT and 71.9% as ( n = 46) NonCoV-SAT. SARS-CoV-2 RT-PCR tests on the diagnosis of SAT were negative in all, but two patients tested positive five days later, in second testing, performed upon clinical necessity. CoV-SAT and NonCoV-SAT groups were similar in terms of clinical, laboratory, and treatment characteristics. However, symptoms were milder and treatment was easier in Vac-SAT group ( p = 0.006). Conclusions Total number of SAT cases during the pandemic period was comparable to pre-pandemic period. However, a considerable rate of SARS-CoV-2 exposure in SAT patients was established. COVID-19 presented with SAT, as the first manifestation in three cases. Vaccine-related cases developed in a shorter time period, clinical presentation was milder, and only a few required corticosteroids.

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COVID-19-Associated Subacute Thyroiditis: Evidence-Based Data From a Systematic Review

Cited by 62 publications

References 60 publications

COVID-19 and thyroid disease: an infodemiological pilot study

COVID-19 and thyroid disease: an infodemiological pilot study

SARS-CoV-2 vaccine-associated subacute thyroiditis: insights from a systematic review

Subacute thyroiditis during the COVID-19 pandemic: a prospective study

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