Thyroid function and associated mood changes after COVID-19 vaccines in patients with Hashimoto thyroiditis

Abstract

ContextSevere acute respiratory syndrome-coronavirus 2 (COVID-19) vaccines may incur changes in thyroid functions followed by mood changes, and patients with Hashimoto thyroiditis (HT) were suggested to bear a higher risk.ObjectivesWe primarily aim to find whether COVID-19 vaccination could induce potential subsequent thyroid function and mood changes. The secondary aim was to find inflammatory biomarkers associated with risk.MethodsThe retrospective, multi-center study recruited patients with HT receiving COVID-19–inactivated vaccines. C-reactive proteins (CRPs), thyroid-stimulating hormones (TSHs), and mood changes were studied before and after vaccination during a follow-up of a 6-month period. Independent association was investigated between incidence of mood state, thyroid functions, and inflammatory markers. Propensity score–matched comparisons between the vaccine and control groups were carried out to investigate the difference.ResultsFinal analysis included 2,765 patients with HT in the vaccine group and 1,288 patients in the control group. In the matched analysis, TSH increase and mood change incidence were both significantly higher in the vaccine group (11.9% versus 6.1% for TSH increase and 12.7% versus 8.4% for mood change incidence). An increase in CRP was associated with mood change (p< 0.01 by the Kaplan–Meier method) and severity (r = 0.75) after vaccination. Baseline CRP, TSH, and antibodies of thyroid peroxidase (anti-TPO) were found to predict incidence of mood changes.ConclusionCOVID-19 vaccination seemed to induce increased levels and incidence of TSH surge followed by mood changes in patients with HT. Higher levels of pre-vaccine serum TSH, CRP, and anti-TPO values were associated with higher incidence in the early post-vaccine phase.

Increased Risk of Thyroid Eye Disease Following Covid-19 Vaccination

“…In TED, the hypothesized immune disruption following Covid-19 vaccination may be compared with that induced by radioiodine treatment, which triggers an immunological activation due to massive thyroid antigen release, with consequent increase in serum thyroid autoantibodies titers ( 64 ). Indeed, an increase in thyroglobulin autoantibodies, thyroid peroxidase autoantibodies, and autoantibodies stimulating the thyrotropin receptor has also been reported following Covid-19 vaccination ( 65 , 66 ), as well as changes in serum thyrotropin concentrations ( 67 ). As observed with the radioiodine-induced form, TED triggered by Covid-19 vaccination is not transient, has the same clinical characteristics as the spontaneous form, can present with all grades of severity, and has been approached with conventional treatments.…”

Real-Life Experience in the Efficacy and Safety of COVID-19 Vaccination in Patients with Advanced Cirrhosis

“…This was consistent with previous reports of autoimmune hypothyroidism after a COVID vaccination [36] and another report of sub-acute thyroiditis occurring after vaccination with mRNA-based vaccines (68.7%), viral vector vaccines (15.7%), and 14.5% following inactivated vaccines [37]. A recent study enrolled 2765 patients and revealed that a COVID-19 vaccination seemed to induce increased levels of TSH followed by mood disturbance, and pre-vaccine serum TSH, CRP, and anti-TPO should be evaluated [38].…”