ABSTRACT
PurposeTo 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. MethodsThis 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 the follow-up, patients were evaluated for serum thyrotropic (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure.ResultsAfter 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 the 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%) with a prevalence that was significantly higher in cases with serum TSH > 3.0 mU/l as compared to those with TSH values below 1.0 mU/L (P=0.039). All subjects resulted to be negative for TgAb, TPOAb and TRAb. ConclusionIn 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.