Subacute thyroiditis associated with COVID-19

Mattar, Shaikh Abdul Matin; Koh, Samuel Ji Quan; Chandran, Suresh; Cherng, Benjamin Pei Zhi

doi:10.1136/bcr-2020-237336

Cited by 114 publications

(139 citation statements)

References 8 publications

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“…We learned that both SARS and COVID-19 survivors had thyroid abnormalities. Based on the available results in the SARS-CoV-2 pandemic [18][19][20][21][22][23][24][25][58][59][60], more attention has to be paid both to patients with not diagnosed thyroid disorder and to treated thyroid patients with COVID-19. Routine control of thyroid function is not recommended by the guidelines however, we suggest the importance of monitoring thyroid hormones in COVID-19.…”

Section: Resultsmentioning

confidence: 99%

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Thyroid complications of SARS and coronavirus disease 2019 (COVID-19)

Speer¹,

Somogyi²

2021

Endocr J

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We have reviewed the available literature on thyroid diseases and coronavirus disease 2019 (COVID-19), and data from the previous coronavirus pandemic, the severe acute respiratory syndrome (SARS) epidemic. We learned that both SARS and COVID-19 patients had thyroid abnormalities. In the limited number of SARS cases, where it was examined, decreased serum T3, T4 and TSH levels were detected. In a study of survivors of SARS approximately 7% of the patients had hypothyroidism. In the previous evaluation evidence was found that pituitary function was also affected in SARS. Others suggested a hypothalamic-pituitary-adrenal axis dysfunction. One result published recently indicates that a primary injury to the thyroid gland itself may play a key role in the pathogenesis of thyroid disorders in COVID-19 patients, too. Subacute thyroiditis, autoimmune thyroiditis and an atypical form of thyroiditis are complications of COVID-19. Thyroid hormone dysfunction affects the outcome by increasing mortality in critical illnesses like acute respiratory distress syndrome, which is a leading complication in COVID-19. Angiotensin-converting enzyme 2 is a membrane-bound enzyme, which is also expressed in the thyroid gland and the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) uses it for docking, entering as well as replication. Based on the available results obtained in the SARS-CoV-2 pandemic, beside others, we suggest that it is necessary to monitor thyroid hormones in COVID-19.

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Section: Resultsmentioning

confidence: 99%

“…Recently four cases of subacute thyroiditis (de Quervain's thyroiditis) have been reported in COVID-19 patients [19][20][21][22]. Thyroid function assessments showed thyrotoxicosis, with suppressed serum TSH, elevated fT4, fT3 and thyroglobulin levels as well as the absence of thyroid autoantibodies.…”

Section: Sars-cov-2 and Thyroidmentioning

confidence: 99%

Thyroid complications of SARS and coronavirus disease 2019 (COVID-19)

Speer¹,

Somogyi²

2021

Endocr J

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“…In fact, cases of thyroxine thyrotoxicosis have been also described (318). Several case reports and a case series were focused on the prevalence of subacute thyroiditis and thyroxine thyrotoxicosis in patients with severe presentation of COVID-19 from ICU (319)(320)(321)(322)(323)(324). More recently in a retrospective study on 50 COVID-19 patients it was found a decrease in total T3 and TSH concentrations in 56% of patients (325)(326)(327).…”

Section: Thyroidmentioning

confidence: 99%

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

et al. 2020

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The explosion of the new coronavirus (SARS-CoV-2) pandemic has brought the role of the angiotensin converting enzyme 2 (ACE2) back into the scientific limelight. Since SARS-CoV-2 must bind the ACE2 for entering the host cells in humans, its expression and body localization are critical to track the potential target organ of this infection and to outline disease progression and clinical outcomes. Here, we mapped the physiological body distribution, expression, and activities of ACE2 and discussed its potential correlations and mutal interactions with the disparate symptoms present in SARS-CoV-2 patients at the level of different organs. We highlighted that despite during SARS-CoV-2 infection ACE2-expressing organs may become direct targets, leading to severe pathological manifestations, and subsequent multiple organ failures, the exact mechanism and the potential interactions through which ACE2 acts in these organs is still heavily debated. Further scientific efforts, also considering a personalized approach aimed to consider specific patient differences in the mutual interactions ACE2-SARS-CoV-2 and the long-term health effects associated with COVID-19 are currently mandatory.

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“…Although the pulmonary system is the main target of SARS-CoV2 infection [1], extrapulmonary organs can be affected with potential negative impact on clinical outcome of COVID-19 [2]. Interestingly, alterations of thyroid hormones resembling a subacute thyroiditis (SAT) have been consistently reported in a substantial number of subjects with COVID-19 [3][4][5][6][7][8][9][10][11], prompting to hypothesize that thyroid gland may be a frequent target of SARS-CoV2 infection [12,13]. However, the clinical relevance of thyrotoxicosis associated with SARS-CoV2 infection is still controversial [3,14,15,4] and data on the outcome of thyroid function after remission of COVID-19 are scanty [14].…”

Section: Introductionmentioning

confidence: 99%

Outcome of SARS-COV-2-Related Thyrotoxicosis in Survivors of COVID-19: A Prospective Study

Pizzocaro

Colombo

Vena

et al. 2021

Preprint

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PurposeTo evaluate the post- coronavirus disease-19 (COVID-19) outcome of thyroid function in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyrotoxicosis. MethodsThis was a single-center prospective study involving 29 patients (11 females, 18 males; median age 64 years, range: 43-85) with thyrotoxicosis diagnosed after hospitalization for COVID-19 and then followed-up for a median period of 90 days (range: 30-120) after hospital discharge. At the follow-up, patients were evaluated for serum thyrotropic (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure.ResultsAfter recovery of COVID-19, serum TSH values significantly increased (P<0.001) and FT4 values significantly decreased (P=0.001), without significant change in serum FT3 (P=0.572). At the follow-up, 28 subjects (96.6%) became euthyroid whereas overt hypothyroidism developed in one case. At the ultrasound evaluation of thyroid gland, hypoecogenicity was found in 10 patients (34.5%) with a prevalence that was significantly higher in cases with serum TSH > 3.0 mU/l as compared to those with TSH values below 1.0 mU/L (P=0.039). All subjects resulted to be negative for TgAb, TPOAb and TRAb. ConclusionIn a short-term follow-up, thyroid function spontaneously normalized in most subjects with SARS-CoV-2-related thyrotoxicosis. However, thyroid hypoecogenicity was found in a remarkable number of them and future longer-term studies are needed to clarify whether this ultrasonographic alteration may predispose to develop late-onset thyroid dysfunction.

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Subacute thyroiditis associated with COVID-19

Cited by 114 publications

References 8 publications

Thyroid complications of SARS and coronavirus disease 2019 (COVID-19)

Thyroid complications of SARS and coronavirus disease 2019 (COVID-19)

Body Localization of ACE-2: On the Trail of the Keyhole of SARS-CoV-2

Outcome of SARS-COV-2-Related Thyrotoxicosis in Survivors of COVID-19: A Prospective Study

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