A 33-year-old man with COVID-19 presented with subacute thyroiditis: A rare case report and literature review

Davoodi, Lotfollah; Oladi, Ziaeddin; Jafarpour, Hamed; Zakariaei, Zakaria; Soleymani, Eissa; Razavi, Alireza

doi:10.1016/j.nmni.2021.100871

Cited by 20 publications

(21 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Further insights can be obtained from detailed post-mortem examinations focusing on the thyroid in SARS-CoV-1 infected patients reporting extensive damage of parafollicular and follicular epithelial cells and destroyed epithelial cells, leading to the collapse and distortion of follicular architecture [ 22 ]. In the acute phase of thyroiditis associated with COVID-19, the thyroid volume was reported to be increased or normal [ 21 , 23 , 24 ], likely explained by the acute inflammation in the thyroid [ 25 ]. In the convalescence phase after acute COVID-19, however, the thyroid volume might be reduced because of the potential collapse and distortion of the thyroid follicular micro-structure extrapolating from changes reported with SARS-CoV-1 [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Higher SARS-CoV-2 viral loads correlated with smaller thyroid volumes on ultrasound among male COVID-19 survivors

et al. 2021

View full text Add to dashboard Cite

Purpose Thyroid dysfunction, including thyroiditis, is well recognized in COVID-19 patients. We evaluated thyroid ultrasonographic features among COVID-19 survivors, which are less well known. Methods Adult COVID-19 survivors without known thyroid disorders who attended dedicated COVID-19 clinic underwent thyroid ultrasonography and assessment of thyroid function and autoimmunity. Adults admitted for acute non-thyroidal surgical problems and negative for COVID-19 were recruited as control. SARS-CoV-2 viral load (VL) was presented as the inverse of cycle threshold values from the real-time reverse transcription-polymerase chain reaction of the respiratory specimen on admission. Results In total, 79 COVID-19 patients and 44 non-COVID-19 controls were included. All abnormal thyroid function tests during acute COVID-19 recovered upon follow-up. Thyroid ultrasonography was performed at a median of 67 days after acute COVID-19. The median thyroid volume was 9.73 mL (IQR: 7.87–13.70). In multivariable linear regression, SARS-CoV-2 VL on presentation (standardized beta −0.206, p = 0.042) inversely correlated with thyroid volume, in addition to body mass index at the time of ultrasonography ( p < 0.001). Sex-specific analysis revealed similar results among men but not women. Eleven COVID-19 patients (13.9%) had ultrasonographic changes suggestive of thyroiditis, comparable to non-COVID-19 patients ( p = 0.375). None of these 11 patients had isolated low thyroid-stimulating hormone levels suggestive of thyroiditis at initial admission or the time of ultrasonography. Conclusions Higher SARS-CoV-2 VL on presentation were associated with smaller thyroid volumes, especially in men. Further research is suggested to investigate this possible direct viral effect of SARS-CoV-2 on the thyroid gland. There was no increased rate of ultrasonographic features suggestive of thyroiditis in COVID-19 survivors.

show abstract

Section: Discussionmentioning

confidence: 99%

Higher SARS-CoV-2 viral loads correlated with smaller thyroid volumes on ultrasound among male COVID-19 survivors

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Using the above search strategy, 32 records were initially found. Among these, 14 were excluded because they did not fit with the study aim while the remaining 18 (16,17,(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) were included in the systematic review. Another paper (40), not included in the initial pool of retrieved records, was added to the systematic review because it was known by the authors.…”

Section: Retrieved Articlesmentioning

confidence: 99%

COVID-19-Associated Subacute Thyroiditis: Evidence-Based Data From a Systematic Review

et al. 2021

View full text Add to dashboard Cite

Subacute thyroiditis (SAT) is a thyroid disease of viral or post-viral origin. Whether SAT represents a complication of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still unclear. Our aim was to systematically review the literature to 1) explore the size of the literature about SAT in COVID-19 and 2) evaluate the clinical characteristics of SAT. PubMed/MEDLINE, Embase, and Scopus were searched until April 20, 2021. Original papers, case reports, and case series reporting SAT in COVID-19 patients were included. Authors and their country, journal, year of publication, COVID-19 and SAT clinical presentation, thyroid function, therapy, and follow-up data were extracted. Nineteen papers (17 case reports and 2 case series) were included, describing 27 patients, 74.1% females, aged 18 to 69 years. COVID-19 was diagnosed by nasopharyngeal swab in 66.7% cases and required hospitalization in 11.1%. In 83.3% cases, SAT occurred after COVID-19. Neck pain was present in 92.6% cases and fever in 74.1%. Median TSH, fT3, and fT4 were 0.01 mU/l, 10.79 pmol/l, and 27.2 pmol/l, respectively. C-reactive-protein and erythrocyte sedimentation rate were elevated in 96% of cases. Typical ultrasonographic characteristics of SAT were observed in 83.3% of cases. Steroids were the most frequent SAT therapy. Complete remission of SAT was recorded in most cases. In conclusion, the size and quality of published data of SAT in COVID-19 patients are poor, with only case reports and case series being available. SAT clinical presentation in COVID-19 patients seems to be similar to what is generally expected.

show abstract

“… At last follow up, 45 days later, TFTs were within normal ranges. [ 48 ] Brancatella A et al . Italy F 18 No 17 Fever, anterior neck pain, fatigue, palpitations, TSH <0.04 mIU/L FT3 8.7 pmol/L (n v 4.6–8.4) FT4 27.2 nmol/L (nv 11–23) Tg 5.6 pg/ml TgAb 120.2 IU/mL (v.n.…”

Section: Destructive Thyrotoxicosis In Covid-19 Patientsmentioning

confidence: 99%

“…Also, concurrent interfering factors, like drugs or iodine-containing contrast agents, should be taken into account in this setting of patients ( Table 2 ) [ 61 ]. As concerns imaging studies, when allowed to perform them in isolated patients, thyroid ultrasonography often demonstrated a heterogeneous hypoechoic, non-vascularized gland, while scintigraphy revealed a reduced or near-absent uptake, representing the diagnostic hallmark of SAT [ 31 , 44 , 46 , 48 , 53 , 59 , 61 ]. While some patients were followed up without any specific treatment or received only symptomatic treatment with beta-blockers, an anti-inflammatory therapy with corticosteroids or non-steroidal drugs (NSAID) was prescribed in those who experienced a severe discomfort and have developed SAT after the resolution of COVID-19 symptoms (or were asymptomatic for COVID-19).…”

Section: Destructive Thyrotoxicosis In Covid-19 Patientsmentioning

confidence: 99%

SARS-COV-2-related immune-inflammatory thyroid disorders: facts and perspectives

Ruggeri

Campennì

Deandreis

et al. 2021

Expert Review of Clinical Immunology

View full text Add to dashboard Cite

Introduction : During the COVID-19 pandemic thyroid gland alteration/dysfunction has been emerged as a possible endocrine complication. The present review is focused on inflammatory and autoimmune thyroid complications triggered by SARS-CoV-2 infection by searching through databases like MEDLINE and Scopus up to April 2021. Areas covered : Beside the occurrence of ‘non-thyroidal illness’ in severe clinical conditions, alterations of thyroid function and structure may occur during COVID-19 as a consequence of either direct or indirect effects of SARS-CoV-2 infection on the gland. On the one hand, SARS-CoV-2 uses ACE2 as a receptor to infect the host cells and ACE2 is highly expressed by follicular thyroid cells. On the other hand, COVID-19 is associated with a systemic inflammatory and immune response, involving Th1/Th17/Th2 lymphocytes and proinflammatory cytokines, which resembles the immune activation that occurs in immune-mediated thyroid diseases. COVID-19-related thyroid disorders include destructive thyroiditis and onset or relapse of autoimmune thyroid disorders, leading to a broad spectrum of thyroid dysfunction ranging from thyrotoxicosis to hypothyroidism, that may worsen COVID-19 clinical course and affect prognosis. Expert opinion : Physicians should be aware of the possible occurrence of thyroid dysfunction during and after SARS-CoV-2 infection. Further longitudinal studies are warranted to evaluate potential long-term sequelae.

show abstract

A 33-year-old man with COVID-19 presented with subacute thyroiditis: A rare case report and literature review

Cited by 20 publications

References 17 publications

Higher SARS-CoV-2 viral loads correlated with smaller thyroid volumes on ultrasound among male COVID-19 survivors

Higher SARS-CoV-2 viral loads correlated with smaller thyroid volumes on ultrasound among male COVID-19 survivors

COVID-19-Associated Subacute Thyroiditis: Evidence-Based Data From a Systematic Review

SARS-COV-2-related immune-inflammatory thyroid disorders: facts and perspectives

Contact Info

Product

Resources

About