The potential impact of COVID-19 on thyroid gland volumes among COVID-19 survivors.

PURPOSE: Data about the effects of COVID-19 on the endocrine system are increasing over time. In the present study, we investigated the effects of COVID-19 on the thyroid gland among COVID-19 survivors by comparing them with healthy subjects. METHODS: Adult COVID-19 survivors who were managed and followed up in the Infectious Disease clinic were asked to participate in this study. COVID-19 survivors were recruited via a convenience sampling and those who agreed to participate in this study were seen by endocrinologists for assessments. The blood tests were obtained for thyroid antibodies and thyroid function tests. Thyroid ultrasonography (USG) was done by the same physician. The ellipsoid formula was used for the calculation of thyroid gland volume. RESULTS: 64 adult COVID-19 survivors and 70 control subjects were enrolled in the study. The COVID-19 survivors were evaluated at median 5.7 months (IQR: 4-6.5) (range: 2-7 months) after acute infection. The mean thyroid gland volume was significantly lower in COVID-19 survivors (10.3 ± 3.4 mL) than in the controls (14 ± 5.3 mL) (p = 0.001). There was no significant difference in free triiodothyronine (fT3), free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels between the groups. Among the twelve patients who had thyroid function evaluated in acute COVID-19, fT3 values were lower in acute COVID-19 than at the time of USG evaluation (3.04 ± 0.41 vs 3.47 ± 0.31 pg/mL), (p = 0.02). Among COVID-19 survivors, mild TSH elevation was detected in 4 (6.2%) patients and all of the other COVID-19 survivors (93.7%) were euthyroid. CONCLUSIONS: At 6 months after acute COVID, COVID-19 survivors had smaller thyroid gland volume than healthy controls, and only a few of the COVID-19 survivors had abnormal thyroid function.

Incidental detection of COVID-19 associated pneumonia by thyroid scintigraphy.

This report presents a case of a 49-year-old woman with complaint of sore throat and front neck pain, who referred to a hospital for thyroid scan due to suppressed TSH level (0.005 mU/L). Diffuse and bilateral lungs uptake in the scan was noticed incidentally. The patient had positive history of COVID-19 symptoms. Multifocal and bilateral ground-glass opacities (GGOs) in both lungs were compatible with typical features of lung involvement in COVID-19-associated pneumonia.

Analysis of the involvement of the thyroid gland using computed tomography in patients with suspected SARS-CoV-2 infection: a retrospective study.

OBJECTIVE: SARS-CoV-2 primarily infects the respiratory tract and leads to severe pneumonia by binding to the ACE-2 receptor. The virus can also interact with ACE-2 receptors expressed in other tissues as in thyroid. This study predicted the complications involving the thyroid in patients with suspected SARS-CoV-2. PATIENTS AND METHODS: Patients with suspected SARS-CoV-2 infection between March 11, 2020-May 31, 2020 were retrospectively evaluated. Sixty-nine patients who were radiologically diagnosed as COVID-19 according to thoracic CT and had previously performed thoracic CT before November 2019 were included in the study according to the exclusion and inclusion criteria. Age and gender-matched controls (No. 69) were selected with normal thoracic CT whose PCR tests were also negative. Thyroid densities of participants were calculated and compared from the previous and current thoracic CTs. Results were also compared with the control group. RESULTS: Participants were composed of 69 patients (39 male, mean age 64.35 years). Thyroid densities were significantly decreased from 89HU to 76HU for whole gland, from 88HU to 76HU for right lobes and from 87.5HU to 75.5HU for left lobes at current thoracic CTs performed during COVID-19 (p<0.001, p<0.001, p<0.001 respectively). The decrease in densities of the whole thyroid gland, both left and right lobes, was correlated with mortality (p<0.001). The changes in thyroid densities were not correlated with age nor gender. The decreases in HU values of thyroid densities for whole gland, left and right lobes, were correlated with mortality (p<0.001, p<0.001, and p<0.001 respectively). CONCLUSIONS: COVID-19 is a multi-systemic disease that threatens vital organs, including the thyroid. Future studies are needed to investigate the association between SARS-CoV-2 and other complications.

Subacute thyroiditis as a presenting manifestation of COVID-19: a report of an exceedingly rare clinical entity.

The SARS-CoV-2 has wreaked havoc globally and has claimed innumerable lives all over the world. The symptoms of this disease may range from mild influenza-like symptoms to severe acute respiratory distress syndrome with high morbidity and mortality. With improved diagnostic techniques and better disease understanding, an increased number of cases are being reported with extrapulmonary manifestations of this disease ranging from renal and gastrointestinal to cardiac, hepatic, neurological and haematological dysfunction. Subacute thyroiditis is a self-limiting and painful thyroid gland inflammation most often secondary to viral infections. We report a case of subacute thyroiditis in a 58-year-old gentleman presenting with a painful swelling in the neck who was subsequently detected to be positive for SARS-CoV-2. We seek to highlight the broad clinical spectrum of the COVID-19 by reporting probably the first case of subacute thyroiditis possibly induced by SARS-CoV-2 infection from India.

Contrast enhanced ultrasonography (CEUS) to detect abdominal microcirculatory disorders in severe cases of COVID-19 infection: First experience.

In the hands of experienced examiners, the contrast enhanced sonography (CEUS) offers the possibility to analyze dynamic microcirculatory disturbances in real time dynamically without any risk for kidneys and thyroid gland even in severe progressing disease bedside. Based on severe COVID-19 infections, first experiences with abdominal CEUS examinations are presented. In the stage of an imminent organ failure with significantly reduced kidney and liver function, CEUS can be used to show a narrowing of the organ-supplying arteries, as well as a delayed capillary filling of vessels near the capsule, a regional reduced parenchymal perfusion or an inflammatory hyperemia with capillary hypercirculation. It is possible to quickly rule out organ infarction and to dynamically record the mesenteric arterial and venous blood flow.