The effect of COVID-19 on the presentation of thyroid disease in children

McCowan, Rebecca; Wild, Edith; Lucas‐Herald, Angela K; McNeilly, Jane; Mason, Avril; Wong, Sze Choong; Ahmed, Shahana; Shaikh, M. Guftar

doi:10.3389/fendo.2022.1014533

Cited by 8 publications

(9 citation statements)

References 17 publications

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“…McCowan et al . did not observe a significant difference in the presentation of thyroid dysfunction in children before and during the pandemic period [ 5 ]. Shidid et al .…”

Section: Discussionmentioning

confidence: 99%

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Differences in the clinical picture at the onset of diagnosis of severe autoimmune hypothyroidism in children depending on the time of diagnosis: before or during the SARS-CoV-2 pandemic

Munarin,

Tuli

2023

pedm

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Introduction There are few data about effects of COVID-19 on thyroid disease presentation in children, due to difficulties in healthcare services access. Aim of the study To assess the differences in hypothyroidism presentation before and during the COVID-19 pandemic. Material and methods All paediatric patients with autoimmune hypothyroidism (AIT) diagnosed from January 2017 to December 2022 were analysed. Results A total of 150 subjects were enrolled (94 in before and 56 during the pandemic period). Severe AIT was detected in 7.4% before and 12.5% during the pandemic. Age at the onset in the pre-pandemic period was lower ( p = 0.04). Diagnosis delay (time elapsed from onset of symptoms and diagnosis) was significantly different between the before and during the pandemic groups ( p = 0.02). In the pre-pandemic period the TSH value was 447.7 ±59.1, and it was 713.7 ±104.4 mUI/l during the pandemic ( p = 0.04), whereas mean fT4 values were 2.66 ±0.34 and 0.58 ±0.08 ng/l, respectively ( p = 0.0002). Significantly greater thyroid volume and bone age delay SDS were observed during the pandemic ( p = 0.04). Neurological symptoms were mostly observed during the pandemic, especially slow speech and impaired school performance. Conclusions A higher rate of severe AIT was observed during the pandemic period, mostly related to difficulties in access to healthcare services. The diagnosis delay led to a more severe biochemical thyroid hormone profile, goitre, and more frequent presence of bone age delay and neurological symptoms at the onset. Recognizing hypothyroidism and recalling symptoms in childhood, even if often non-specific, is fundamental for avoiding diagnosis delay.

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“…McCowan et al . did not observe a significant difference in the presentation of thyroid dysfunction in children before and during the pandemic period [ 5 ]. Shidid et al .…”

Section: Discussionmentioning

confidence: 99%

“…Patients faced difficulties accessing facilities for primary care, tertiary referral centre evaluations, as well as diagnostic and therapeutic procedures. Chronic clinical disorders, including hypothyroidism, which are treated in an outpatient setting, have been heavily conditioned by the pandemic scenario [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Differences in the clinical picture at the onset of diagnosis of severe autoimmune hypothyroidism in children depending on the time of diagnosis: before or during the SARS-CoV-2 pandemic

Munarin,

Tuli

2023

pedm

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“…Very limited studies and reports describe the association between SARS-CoV-2 infection and thyroid disease in pediatric subjects [ 14 , 15 ]. McCowan et al [ 14 ] conducted a study on 244 children with anomalies in thyroid function, either hypothyroidism or hyperthyroidism, in a tertiary pediatric endocrine center in the United Kingdom before and after COVID-19 to identify any change in their presentation. Despite an unchanged rate of thyroid dysfunction before and after the pandemic, they observed an increase in the number of cases of untreated transient thyroid dysfunction.…”

Section: Thyroidmentioning

confidence: 99%

“…Despite an unchanged rate of thyroid dysfunction before and after the pandemic, they observed an increase in the number of cases of untreated transient thyroid dysfunction. They speculated that this finding may be due to the development of thyroiditis secondary to SARS-CoV-2 infection, which regressed before requiring treatment [ 14 ].…”

Section: Thyroidmentioning

confidence: 99%

Endocrinological Involvement in Children and Adolescents Affected by COVID-19: A Narrative Review

Calcaterra

Tagi

Santis

et al. 2023

JCM

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Since the advent of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, an increased incidence of several endocrinological anomalies in acute-phase and/or long-term complications has been described. The aim of this review is to provide a broad overview of the available literature regarding changes in the worldwide epidemiology of endocrinological involvement in children since December 2019 and to report the evidence supporting its association with coronavirus disease 2019 (COVID-19). Although little is known regarding the involvement of endocrine organs during COVID-19 in children, the current evidence in adults and epidemiological studies on the pediatric population suggest the presence of a causal association between the virus and endocrinopathies. Untreated transient thyroid dysfunction, sick euthyroid syndrome, nonthyroidal illness syndrome, and hypothalamic–pituitary–adrenal (HPA) axis and central precocious puberty have been observed in children in acute infection and/or during multisystem inflammatory syndrome development. Furthermore, a higher frequency of ketoacidosis at onset in children with a new diagnosis of type 1 diabetes is reported in the literature. Although the direct association between COVID-19 and endocrinological involvement has not been confirmed yet, data on the development of different endocrinopathies in children, both during acute infection and as a result of its long-term complications, have been reported. This information is of primary importance to guide the management of patients with previous or current COVID-19.

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“…When considering effects of the pandemic, on incidence and severity of thyroid disease among children, a retrospective cohort study among 244 paediatric patients (median age 11.5 years) showed an increase in rate of mild transient thyroid dysfunction not requiring treatment (70.0% vs. 49.6%, p=0.009), while rate of overall thyroid dysfunction remained stable [94] . Further, while worsening of thyroiditis and Graves’ disease have been documented among adults in association with COVID-19, such manifestations were not reported among children [4] .…”

Section: Thyroid Disordersmentioning

confidence: 99%

Endocrine manifestations of COVID-19 in children: A scoping review

Nimali Seneviratne,

Kumarihamy Karunathilake,

Pallegama

et al. 2023

Best Practice & Research Clinical Endocrinology & Metab

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The effect of COVID-19 on the presentation of thyroid disease in children

Cited by 8 publications

References 17 publications

Differences in the clinical picture at the onset of diagnosis of severe autoimmune hypothyroidism in children depending on the time of diagnosis: before or during the SARS-CoV-2 pandemic

Differences in the clinical picture at the onset of diagnosis of severe autoimmune hypothyroidism in children depending on the time of diagnosis: before or during the SARS-CoV-2 pandemic

Endocrinological Involvement in Children and Adolescents Affected by COVID-19: A Narrative Review

Endocrine manifestations of COVID-19 in children: A scoping review

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