Atypical thyroid inflammation seen in early patients with COVID-19

Persistent atypical inflammation of the thyroid gland may be prevalent in patients with COVID-19, new results from a three-month assessment conducted at the start of the pandemic show.

According to data presented by a team of Italian investigators at ENDO 2021 this weekend, around a third of the patient population observed in who had been diagnosed with moderate to severe COVID-19 at the start of the epidemic in Europe had still showing signs of thyroid inflammation after 3 months, although thyroid function is already normalized

The dysfunction triggered by COVID-19 does not appear to be mediated by autoimmunity, investigators observed, and therefore warrants follow-up research in the event that patients may be at risk for permanent thyroid dysfunction.

Investigators, led by Ilaria Muller, MD, PhD, University of Milan, conducted a longitudinal follow-up study of patients to survive moderate to severe COVID-19 after hospitalization in short-term medical units in a facility from Milan. The patients observed in this study had no history of thyroid disorders and / or treatment for them.

Muller and colleagues assessed patients for serum thyroid function and autoantibodies, C reactive protein (CRP), complete blood count (FBC), and thyroid ultrasound every 3 months.

At the time of the ENDO 2021 presentation, 53 patients had been included in the follow-up trial. 3 months after infection with COVID-19, all patients had an increase in median serum TSH concentrations from baseline. Serum concentrations of free thyroxine, free triiodothyronine, CRP and FBC had normalized from baseline.

Negative autoantibodies against the TSH receptor were observed in all patients.

They observed atypical subacute thyroiditis in 15% of patients hospitalized for COVID-19 – a significant increase from the 1% seen with such presentations at the same facility in the spring of 2019, before the pandemic.

“Atypical thyroiditis induced by COVID-19 is not associated with neck pain, affects more men than women and especially critically ill people, therefore coexists with non-thyroid disease syndrome,” the investigators wrote . “Subacute thyroiditis is classically followed by the subsequent onset of permanent thyroid dysfunction and autoimmunity, which is why we have launched a program to systematically monitor these patients.”

In a statement accompanying the results, Muller stressed the importance of continuous monitoring of these patients with COVID-19 only.

“It is important to know if the SARS-CoV-2 virus has negative effects on the thyroid gland late in the day, in order to quickly diagnose, and possibly treat, the disease,” Muller said.

The study “Early follow-up of atypical thyroiditis induced by SARS-CoV-2” was presented at ENDO 2021.