Subacute Thyroiditis After Sars-COV-2 Infection

Brancatella, Alessandro; Ricci, Debora; Viola, Nicola; Daniele, Simona; Santini, Ferruccio; Latrofa, Francesco

doi:10.1210/clinem/dgaa276

Cited by 312 publications

(309 citation statements)

References 20 publications

(31 reference statements)

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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: 81%

“…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

186

163

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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: 81%

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

186

163

View full text Add to dashboard Cite

show abstract

“…At laboratory exams, T3 and T4 were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated, with hypoechoic areas detected at neck ultrasound. She was diagnosed with subacute thyroiditis [20].…”

Section: Figure 2: Flowchartmentioning

confidence: 99%

Thyrotoxic Crisis and COVID-19 Infection: An Extraordinary Case and Literature Review

Pastor¹,

Molina²,

Celis³

2020

Cureus

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The novel coronavirus SARS-CoV-2, which causes the disease commonly known as COVID-19, has spread around the world, associated mostly with respiratory tract symptoms. We report the first case of a thyrotoxic crisis precipitated by COVID-19 and describe its identification, diagnosis, and management in the emergency unit. We also conduct a systematic review of thyrotoxic crisis literature and COVID-19 infection. This case highlights the importance of considering the SARS-CoV2 virus as a potential trigger of a thyroid storm. It also shows the need to maintain extreme contact precautions even after one month of COVID-19 symptom onset.

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“…13,35 It is also not yet known whether COVID-19 infection results in thyroid dysfunction, although there have been a few case reports of subacute thyroiditis in infected patients. 38 Therefore, screening for thyroid functions may be advised in COVID-19 infected patients who present with significant tachycardia and neck or ear pain. Whether COVID-19 can cause direct damage to thyroid tissue should be evaluated in prospective studies.…”

Section: Thyroid Disordersmentioning

confidence: 99%

Endocrinology and Covid-19: A Multifaceted Interaction

Priya

Grewal

Maisnam

2020

Indian Journal of Cardiovascular Disease in Women WINCARS

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Women with diabetes, obesity and other endocrine or metabolic disorders form a distinct vulnerable group, who are at increased risk during the COVID-19 pandemic, either due to increased risk of severe infection or due to challenges in healthcare delivery during the pandemic.Diabetes is a major risk factor for increased morbidity and mortality from COVID-19. Optimal cardiometabolic control and preventive measures to reduce risk of infection are needed in people afflicted with diabetes. Women with diabetes are at greater risk as they have limited access to diabetes care facilities even outside the time frame of a pandemic and this gender gap in care is likely to widen during the pandemic. Moreover, the care of pregnant women with pre-existing diabetes or gestational diabetes mellitus (GDM) also cannot be compromised. While alternate screening strategies for GDM such as the use of fasting plasma glucose and glycosylated hemoglobin are being considered, telemedicine services can offer a platform for remote monitoring and delivery of optimal diabetes care to pregnant women.Telemedicine services can also be used for delivery of long-term care for other endocrine disorders. Elective surgery or evaluation of endocrine disorders that are not immediately life-threatening can be deferred till appropriate safety precautions can be taken. At the same time, there is a need ensure that care of endocrinopathies such as diabetes, obesity, thyroid disorders and osteoporosis, all of which affect women more severely, is not compromised during the pandemic.Many endocrine organs, including pancreas, thyroid, testis, ovary, adrenals and pituitary, express the angiotensin-converting enzyme 2 (ACE2) that is the receptor for SARS-CoV-2 virus. Since ACE2 expression is different in men and women, there is a need to evaluate the impact of the virus on endocrine system and assess whether this is gender-specific.

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Subacute Thyroiditis After Sars-COV-2 Infection

Cited by 312 publications

References 20 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

Thyrotoxic Crisis and COVID-19 Infection: An Extraordinary Case and Literature Review

Endocrinology and Covid-19: A Multifaceted Interaction

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