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Multicenter Study
. 2024 Jun 24;13(3):e240083.
doi: 10.1530/ETJ-24-0083. Print 2024 Jun 1.

Subacute thyroiditis in the SARS-CoV-2 era: a multicentre prospective study

Sara De Vincentis  1   2 , Simona Loiacono  1 , Eleonora Zanni  1 , Roberta Sueri  1 , Maria Laura Monzani  1   2 , Daniele Santi  1   2 , Ilaria Muller  3   4 , Francesco Di Marco  5 , Erica Crivicich  5 , Mirco Armenti  5 , Uberto Pagotto  6   7 , Lorenzo Tucci  6   7 , Carolina Cecchetti  6   7 , Tommaso Trenti  8 , Valentina Pecoraro  8 , Giulia Canu  8 , Manuela Simoni  1   2 , Giulia Brigante  1   2
Affiliations
Multicenter Study

Subacute thyroiditis in the SARS-CoV-2 era: a multicentre prospective study

Sara De Vincentis et al. Eur Thyroid J. .

Abstract

Objective: Many cases of subacute thyroiditis (SAT) have been described related to SARS-CoV-2 infection, but no prospective data about follow-up are known. This prospective, longitudinal, 3-year, multicentre study aims to explore the clinical peculiarities and outcome of SAT in relation to SARS-CoV-2 infection, ascertained with antibody dosage.

Methods: All patients receiving SAT diagnosis from November 2020 to May 2022 were enrolled. Data on anamnesis, physical examination, blood tests (TSH, freeT4, freeT3, thyroglobulin, anti-thyroid antibodies, C-reactive protein, erythrocyte sedimentation rate, complete blood count), and thyroid ultrasound were collected. At baseline, the presence of IgG against the SARS-CoV-2 spike protein or nucleocapsid was investigated. Patients were evaluated after 1, 3, 6, and 12 months.

Results: Sixty-six subjects were enrolled. At baseline, 54 presented with pain, 36 (67%) for at least 15 days. Serum SARS-CoV-2 IgG measurements documented that 7 out of 52 subjects (13.5%) had infection before SAT diagnosis (COVID+). No significant differences between the COVID+ and COVID- groups were found at baseline, except for respiratory symptoms and fever, which were more common in COVID+ (P = 0.039 and P = 0.021, respectively). Among the 41 subjects who completed follow-up, COVID+ and COVID- did not differ for therapeutic approach to SAT or outcome, all having an improvement in neck pain, inflammation parameters, and ultrasound features.

Conclusion: This is the first prospective study investigating any difference both at diagnosis and at follow-up between SAT presentation in patients with previous SARS-CoV-2 infection and those without. Our data demonstrate that SARS-CoV-2 does not impact on SAT onset, evolution, and outcome.

Keywords: COVID-19; SARS-CoV-2; pandemic; thyroid; thyrotoxicosis; vaccine.

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Conflict of interest statement

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the study reported.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Temporal trend along visits of neck pain score in COVID− (blue line) and COVID+ (red line). Whiskers correspond to the 95% confidence interval. V0, baseline; V1, visit at 1 month; V2, visit at 3 months; V3, visit at 6 months; V4, visit at 12 months.
Figure 3
Figure 3
Percentages of dysthyroid and euthyroid subjects at each visit in the COVID− and COVID+ groups. V0, baseline; V1, visit at 1 month; V2, visit at 3 months; V3, visit at 6 months; V4, visit at 12 months.
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