Subacute thyroiditis after SARS‐CoV‐2 infection

Semikov, Vasiliy I.; Shulutko, A M; Хоробрых, Т В; Aleksandrov, Yu. K.; Mansurova, Gaukhar T.; Kazaryan, Airazat M.

doi:10.1002/ccr3.5109

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…After reviewing the titles and abstracts and excluding duplicates, we identified 38 cases in 26 articles published up to the end of December 2021. 4 , 5 , 10 – 33 A flow chart of the article selection process is shown in Figure 1 , and an overview of the 38 cases included in the study is provided in Table 1 . The quality of the 15 case reports, four case series, six (scientific) letters, and one brief report was assessed and scored using the CARE guideline checklist ( Supplemental Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

Subacute Thyroiditis after COVID-19: A Literature Review

Ando

Ono

Sano

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Subacute thyroiditis (SAT), potentially caused by severe acute respiratory syndrome coronavirus 2 infection, has been reported as a complication of COVID-19 since 2020. The clinical characteristics and outcomes of SAT after COVID-19 remain incompletely defined. Therefore, we aimed to collect and survey case reports of SAT after COVID-19. We performed a systematic search of PubMed/MEDLINE, Web of Science, and Google Scholar. The keywords and MeSH terms used for the searches were “subacute thyroiditis” and “COVID-19.” A total of 38 patients from 26 case reports, case series, and letters on SAT associated with COVID-19 were included and analyzed. The most frequent SAT symptom was neck pain (27 cases), followed by fever (22 cases). Of the 25 cases with information on the duration between onset of COVID-19 symptoms and onset of SAT symptoms, the shortest was simultaneous occurrence, and the longest was 4 months. In most cases, patients developed SAT at several days or weeks after the onset of COVID-19. All patients with SAT recovered with no severe complications or sequelae. Clinicians should be aware of the possibility of SAT development in patients with neck pain and fever following COVID-19. Further research is necessary to determine the relationship between SAT and COVID-19.

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Section: Resultsmentioning

confidence: 99%

Subacute Thyroiditis after COVID-19: A Literature Review

Ando

Ono

Sano

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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“…As for ordinally SAT, the average age of onset was mid-40's and the female-male ratio was 3.5-7:1 [5,14]. Among 34 published cases who developed SAT during/ after COVID-19 [32][33][34][35][36][37][38][39][40][41][42][43][49][50][51][52][53][54][55][56][57], the average age was 39.2 years (range, 18-69 years) and female-male ratio was 3.3:1 (n = 26/8). Therefore, there were no significant differences among ordinal SAT, SAT during/after COVID-19, and SAT after COVID-19 vaccination in terms of ages and sex ratio.…”

Section: Discussionmentioning

confidence: 99%

Subacute thyroiditis with liver dysfunction following coronavirus disease 2019 (COVID-19) vaccination: report of two cases and a literature review

2022

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Subacute thyroiditis is a transient inflammatory thyroid disease characterized by neck pain, fever, and typical symptoms associated with thyrotoxicosis. The incidence of subacute thyroiditis is higher in female than in male, and susceptibility is prominent in the 30-50-year age range. The variety of case reports on subacute thyroiditis associated with coronavirus disease 2019 (COVID-19) appears to be increasing, and subacute thyroiditis following COVID-19 vaccination has recently been reported. Herein, we report two cases of subacute thyroiditis that developed after receiving the COVID-19 mRNA vaccine, one of which exhibited remarkable liver dysfunction. The mechanism underlying the development of postvaccination subacute thyroiditis remains unknown; however, one theory suggests that adjuvants contained in vaccines may play a role in triggering diverse autoimmune and inflammatory responses. Another possibility is the potential cross-reactivity between the coronavirus spike protein target produced by the mRNA vaccine and thyroid cell antigens. Common side effects of the COVID-19 vaccine include pain at the injection site, fever, fatigue, headache, muscle pain, chills, and nausea. These symptoms are usually resolved within a few days. Subacute thyroiditis may present symptoms similar to those of short-term vaccination side effects or exhibit non-specific symptoms, potentially leading to misdiagnosis or underdiagnosis. Therefore, clinicians should be aware of the possible development of subacute thyroiditis after COVID-19 vaccination.

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“…SAT, also called de Quervain thyroiditis, is a self-limited, inflammatory disorder characterized by neck pain and systemic symptoms [ 74 ], with a picture including suppressed thyroid-stimulating hormone (TSH), high free thyroxine (FT4) and thyroglobulin, and absence of TSH receptor antibodies [ 41 , 64 ] ( Figure 1 ). Thyroid dysfunction presenting as typical painful SAT was principally diagnosed in female patients with mild to moderate COVID-19 disease, as described in several case reports [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ] and reported in up to 20% of noncritically ill hospitalized patients [ 41 ], at a much higher incidence than that recorded in the general population [ 75 ]. SAT is presumed to be caused by a viral infection or a postviral inflammatory process in genetically predisposed individuals [ 24 , 40 ].…”

Section: Bidirectional Interaction Between Thyroid Dysfunction and Co...mentioning

confidence: 99%

“…For certain viruses, direct evidence based on epidemiological and serological data of viral infection on the thyroid is available, although it is not clear if they are responsible for thyroid diseases (reviewed in [ 24 ]) ( Table 1 ). The onset of SAT may occur concurrently with COVID-19 diagnosis [ 30 , 35 , 39 ] or, in most cases, after a few weeks as a late complication of SARS-CoV-2 infection [ 31 , 32 , 33 , 34 , 36 , 37 , 38 ]. The clinical course of SAT generally comprises multiple phases: first is the thyrotoxicosis (lasting a period of weeks or months) in the majority of patients, followed, in some cases, by hypothyroidism, while treatment with anti-inflammatory agents or corticosteroids in the most severe cases, generally resulted in rapid clinical resolution [ 31 , 35 , 36 , 37 , 38 , 39 , 40 , 76 , 77 ].…”

Section: Bidirectional Interaction Between Thyroid Dysfunction and Co...mentioning

confidence: 99%

“…The onset of SAT may occur concurrently with COVID-19 diagnosis [ 30 , 35 , 39 ] or, in most cases, after a few weeks as a late complication of SARS-CoV-2 infection [ 31 , 32 , 33 , 34 , 36 , 37 , 38 ]. The clinical course of SAT generally comprises multiple phases: first is the thyrotoxicosis (lasting a period of weeks or months) in the majority of patients, followed, in some cases, by hypothyroidism, while treatment with anti-inflammatory agents or corticosteroids in the most severe cases, generally resulted in rapid clinical resolution [ 31 , 35 , 36 , 37 , 38 , 39 , 40 , 76 , 77 ]. Although it is conceivable that SARS-CoV-2 could be associated with SAT, in none of the patients, the presence of the virus was demonstrated in the thyroid tissue.…”

Section: Bidirectional Interaction Between Thyroid Dysfunction and Co...mentioning

confidence: 99%

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Thyroid Dysfunction and COVID-19: The Emerging Role of Selenium in This Intermingled Relationship

Gorini

Sabatino

Coi

et al. 2022

IJERPH

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COVID-19 represents a worldwide public health emergency, and, beyond the respiratory symptoms characterizing the classic viral disease, growing evidence has highlighted a possible reciprocal relationship between SARS-CoV-2 infection and thyroid dysfunction. The updated data discussed in this review suggests a role of SARS-CoV-2 infection on the thyroid gland, with multiple thyroid pictures described. Conversely, no conclusion can be drawn on the association between pre-existing thyroid disease and increased risk of SARS-CoV-2 infection. In this scenario, selenium (Se), an essential trace element critical for thyroid function and known as an effective agent against viral infections, is emerging as a potential novel therapeutic option for the treatment of COVID-19. Large multicentre cohort studies are required to elucidate the mechanisms underlying thyroid dysfunction during or following recovery from COVID-19, including Se status. Meanwhile, clinical trials should be performed to evaluate whether adequate intake of Se can help address COVID-19 in Se-deficient patients, also avoiding thyroid complications that can contribute to worsening outcomes during infection.

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Subacute thyroiditis after SARS‐CoV‐2 infection

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri butio n-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Cited by 8 publications

References 26 publications

Subacute Thyroiditis after COVID-19: A Literature Review

Subacute Thyroiditis after COVID-19: A Literature Review

Subacute thyroiditis with liver dysfunction following coronavirus disease 2019 (COVID-19) vaccination: report of two cases and a literature review

Thyroid Dysfunction and COVID-19: The Emerging Role of Selenium in This Intermingled Relationship

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