Increased prevalence of autoimmune thyroid disease after COVID-19: A single-center, prospective study

Abstract

IntroductionThyroid dysfunctions associated with SARS-CoV-2 acute infection have been extensively described since the beginning of COVID-19 pandemics. Conversely, few data are available on the occurrence of thyroid autoimmunity after COVID-19 resolution. We assessed the prevalence of autoimmune thyroid disease (ATD) and thyroid dysfunctions in COVID-19 survivors three months after hospital admission.Design and methodsSingle-center, prospective, observational, cohort study performed at ASST Papa Giovanni XXIII Hospital, Bergamo, Italy. 599 COVID-19 survivors were prospectively evaluated for thyroid function and autoimmunity thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb). When a positive antibody concentration was detected, thyroid ultrasound was performed. Multiple logistic regression model was used to estimate the association between autoimmunity and demographic characteristics, respiratory support, and comorbidities. Autoimmunity results were compared to a cohort of 498 controls referred to our Institution for non-thyroid diseases before the pandemic onset. A sensitivity analysis comparing 330 COVID-19 patients with 330 age and sex-matched controls was performed.ResultsUnivariate and multivariate analysis found that female sex was positively associated (OR 2.01, SE 0.48, p = 0.003), and type 2 diabetes (T2DM) was negatively associated (OR 0.36, SE 0.16, p = 0.025) with thyroid autoimmunity; hospitalization, ICU admission, respiratory support, or COVID-19 treatment were not associated with thyroid autoimmunity (p > 0.05). TPOAb prevalence was greater in COVID-19 survivors than in controls: 15.7% vs 7.7%, p = 0.002. Ultrasonographic features of thyroiditis were present in 94.9% of the evaluated patients with positive antibodies. TSH was within the normal range in 95% of patients.ConclusionsAutoimmune thyroid disease prevalence in COVID-19 survivors was doubled as compared to age and sex-matched controls, suggesting a role of SARS-CoV-2 in eliciting thyroid autoimmunity.

Prevalence and factors associated with thyroid autoimmunity among children newly diagnosed with type 1 diabetes before and during the COVID‐19 pandemic: Evidence from Kuwait

“…33 Consistent with our findings, among COVID-19 survivors, females had higher odds of having thyroid autoimmunity. 33 Gender differences have been welldescribed in ATD in both adult and paediatric populations, 35,36 however, mechanisms are yet to be understood.…”

“…However, there have been reports on the effect of the pandemic and the virus on ATD. [32][33][34] A recent study from Italy found that the prevalence of thyroid autoimmunity, specifically TPO antibodies, was greater in COVID-19 survivors in comparison to controls matched for age and gender. 33 Consistent with our findings, among COVID-19 survivors, females had higher odds of having thyroid autoimmunity.…”

“…[32][33][34] A recent study from Italy found that the prevalence of thyroid autoimmunity, specifically TPO antibodies, was greater in COVID-19 survivors in comparison to controls matched for age and gender. 33 Consistent with our findings, among COVID-19 survivors, females had higher odds of having thyroid autoimmunity. 33 Gender differences have been welldescribed in ATD in both adult and paediatric populations, 35,36 however, mechanisms are yet to be understood.…”

“…To the best of our knowledge, there have been no reports of increased thyroid autoimmunity in children with T1D during the pandemic. However, there have been reports on the effect of the pandemic and the virus on ATD 32–34 . A recent study from Italy found that the prevalence of thyroid autoimmunity, specifically TPO antibodies, was greater in COVID‐19 survivors in comparison to controls matched for age and gender 33 .…”