Influence of COVID-19 vaccines on endocrine system

Abstract

The COVID-19 pandemic has posed a significant health threat globally. Timely and appropriate vaccination is a key step to reduce the morbidity and mortality from COVID-19. The clinical course of COVID-19 infection and the effects of COVID-19 vaccination are influenced by patients’ health situations and involve a systemic physiological reaction. Just like an “endocrine phenotype” of COVID-19 infection, endocrine dysfunction after COVID-19 vaccination also acquired clinical concerns. In the present review, we briefly introduce the commonly available vaccines against SARS-CoV-2, summarize the influence of COVID-19 vaccines on the endocrine system, and explore the underlying pathogenic mechanisms.

Endocrine system after 2 years of COVID-19 vaccines: A narrative review of the literature

“…Moreover, the available retrospective and prospective clinical studies showed that COVID-19 vaccines led to none or only temporary perturbations of blood glucose levels (7).…”

“…Of the 64 patients, 50 (78.1%) received an mRNA vaccine (Pfizer/BioNTech BNT162b2 or Moderna mRNA-1273), 13 (20.3%) received a viral vector vaccine (Vaxzevria ChAdOx1 or Convidecia AD5-nCOV or Jennsen), and only one (1.6%) received an inactivated virus vaccine (Sinovac Biotech CoronaVac). Median time between the vaccine shot (any type) and the symptoms' development was 10 days (4)(5)(6)(7)(8)(9)(10)(11)(18)(19)(20)(21)(22)(23). Concerning the relationship between the dose of vaccine and Graves' disease onset, 35 patients (54.7%) became symptomatic after the first dose, in 27 (42.2%) after the second dose, and in one case after the third dose.…”

Impact of the COVID-19 pandemic on the incidence, seasonal distribution, and characteristics of subacute thyroiditis

“…The possible relationship between COVID-19 and SAT became one of the hot topics in the Endocrinology community during the pandemic. Some cases of SAT have been reported following COVID-19 infection and its vaccination, including in our clinic [12][13][14][15][16][17]. The high expression of the angiotensin-converting enzyme-2 (ACE2) receptor used by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter the cell in thyroid follicular cells suggests that COVID-19 may directly cause inflammation in thyroid cells [19][20][21].…”

“…In addition to the fatal complications of COVID-19, autoimmune/inflammatory events that developed during or after the infection have been carefully followed. During the pandemic, COVID-19 infection and vaccination-associated endocrine dysfunctions were reported for several endocrine organs such as pituitary, thyroid, pancreas, and adrenal gland, thus the "endocrine phenotype" of COVID-19 has gained popularity and increased clinical concerns [12].…”

“…Considering the possible relationship of SAT with viral pathogens, it can be expected that this pathology may also occur as a late complication of COVID-19. There are reports in the literature of SAT cases developing post-COVID-19 infection and even after COVID-19 vaccines [12][13][14][15][16][17]. These reported cases also raise the question of whether there has been an increase in the incidence of SAT and/or a variation in its character during the pandemic.…”