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. 2021 Aug;73(2):255-260.
doi: 10.1007/s12020-021-02758-2. Epub 2021 May 28.

Outcome of Sars-COV-2-related thyrotoxicosis in survivors of Covid-19: a prospective study

Alessandro Pizzocaro  1 , Paolo Colombo  1 , Walter Vena  1 , Salvatore Ariano  1 , Paola Magnoni  2 , Francesco Reggiani  3 , Giuseppe Favacchio  1 , Marco Mirani  1 , Elisabetta Lavezzi  1 , Antonio Voza  4 , Marta Calatroni  3 , Gherardo Mazziotti  5   6 , Andrea Lania  1   7 ; Humanitas COVID-19 Task force
Collaborators, Affiliations

Outcome of Sars-COV-2-related thyrotoxicosis in survivors of Covid-19: a prospective study

Alessandro Pizzocaro et al. Endocrine. 2021 Aug.

Abstract

Purpose: To evaluate the post- coronavirus disease-19 (COVID-19) outcome of thyroid function in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyrotoxicosis.

Methods: This was a single-center prospective study involving 29 patients (11 females, 18 males; median age 64 years, range: 43-85) with thyrotoxicosis diagnosed after hospitalization for COVID-19 and then followed-up for a median period of 90 days (range: 30-120) after hospital discharge. At follow-up, patients were evaluated for serum thyrotropin (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure.

Results: After recovery of COVID-19, serum TSH values significantly increased (P < 0.001) and FT4 values significantly decreased (P = 0.001), without significant change in serum FT3 (P = 0.572). At follow-up, 28 subjects (96.6%) became euthyroid whereas overt hypothyroidism developed in one case. At the ultrasound evaluation of thyroid gland, hypoecogenicity was found in 10 patients (34.5%) and in these cases serum TSH values tended to be higher than those without thyroid hypoecogenity (P = 0.066). All subjects resulted to be negative for TgAb, TPOAb and TRAb.

Conclusion: In a short-term follow-up, thyroid function spontaneously normalized in most subjects with SARS-CoV-2-related thyrotoxicosis. However, thyroid hypoecogenicity was found in a remarkable number of them and future longer-term studies are needed to clarify whether this ultrasonographic alteration may predispose to develop late-onset thyroid dysfunction.

Keywords: Covid-19; Hyperthyroidism; SARS-CoV2; Thyroid; Thyroiditis; Thyrotoxicosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Individual outcome of serum thyrotropin (TSH) values, expressed in logarithmic scale, in 29 subjects with SARS-CoV2-related thyrotoxicosis followed up for a median period of 90 days (range 30–120)
Fig. 2
Fig. 2
Thyroid hypoecogenicity (indicated by the arrows) in a patient with recent SARS-CoV-2-related thyrotoxicosis
See this image and copyright information in PMC

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