Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 8 de 8
Filter
1.
Cardiol Young ; 32(6): 988-992, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1692700

ABSTRACT

We report a case of thyroid storm precipitated by SARS-CoV-2 infection in an adolescent girl with a history of Graves disease and dilated cardiomyopathy. This case highlights that SARS-CoV-2 infection can potentially trigger a thyrotoxicosis crisis and acute decompensated heart failure in a patient with underlying thyroid disease and myocardial dysfunction even in the absence of multi-system inflammatory syndrome in children. We systematically reviewed the thyrotoxicosis cases with SARS-CoV-2 infection and described its impact on pre-existing dilated cardiomyopathy.


Subject(s)
COVID-19 , Cardiomyopathy, Dilated , Heart Failure , Thyroid Crisis , Thyrotoxicosis , Adolescent , COVID-19/complications , Child , Female , Heart Failure/etiology , Humans , SARS-CoV-2 , Systemic Inflammatory Response Syndrome , Thyroid Crisis/complications , Thyroid Crisis/diagnosis , Thyrotoxicosis/complications , Thyrotoxicosis/diagnosis
2.
J Endocrinol Invest ; 45(5): 1079-1083, 2022 May.
Article in English | MEDLINE | ID: covidwho-1626066

ABSTRACT

PURPOSE: It is well established that thyroiditis and other thyroid disorders can be induced by COVID-19 infection, but there is limited information about the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. We report two cases of thyrotoxicosis following SARS-CoV-2 vaccine. METHODS AND RESULTS: Two young health care peoples (wife and husband) received a first dose of SARS-CoV-2 vaccine, and few weeks later developed clinical manifestations of thyroid hyperactivity, with increased thyroid hormone levels on thyroid function tests, suppressed thyroid-stimulating hormone and negative antithyroid antibodies, despite being healthy before vaccination. They were diagnosed at the 4th week after first dose of SARS-Cov-2 vaccine as silent thyroiditis and followed without treatment, since their symptoms were not severe. At the 6th week, the patients became wholly asymptomatic and their thyroid function returned to normal. CONCLUSIONS: Thyrotoxicosis can occur after SARS-CoV-2 vaccination probably related to silent thyroiditis.


Subject(s)
COVID-19 , Thyroiditis, Autoimmune , Thyroiditis, Subacute , Thyroiditis , Thyrotoxicosis , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , SARS-CoV-2 , Thyroiditis/diagnosis , Thyroiditis/etiology , Thyroiditis, Subacute/diagnosis , Thyroiditis, Subacute/etiology , Thyrotoxicosis/diagnosis , Thyrotoxicosis/etiology , Vaccination/adverse effects
3.
J Endocrinol Invest ; 45(5): 1071-1077, 2022 May.
Article in English | MEDLINE | ID: covidwho-1616317

ABSTRACT

AIM: To describe a case series of thyrotoxicosis likely triggered by SARS-CoV-2 vaccination and to warn physicians about this potential correlation. To report clinical, laboratory and imaging findings and provide further information that goes in line with the underlying mechanisms. METHODS: Single-center case series based on all the information collected in the hospital medical records, as well as the temporal sequence between the onset of symptoms and COVID-19 vaccination. RESULTS: We report 8 cases with thyrotoxicosis after SARS-CoV-2 vaccination. 4 cases of Graves' disease (GD), 2 cases of subacute painful thyroiditis (SAT), 1 case of concurrent GD and SAT and 1 case of atypical subacute thyroiditis. Five patients received BNT162b2 mRNA vaccine, 3 patients 1273 mRNA vaccine. The onset of symptoms following vaccination ranged from 10 to 14 days in six of eight patients and from 7 to 8 weeks in two patients. CONCLUSIONS: Several hypotheses have been proposed to explain the potential correlation between SARS-CoV-2 vaccination and thyrotoxicosis, including immune system hyper-stimulation, molecular mimicry and Autoimmune/Autoinflammatory Syndrome Induced by Adjuvants (ASIA). We should pay greater attention to thyroid disorders in patients receiving vaccine against SARS-CoV-2.


Subject(s)
COVID-19 , Graves Disease , Thyroiditis, Subacute , Thyrotoxicosis , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Graves Disease/diagnosis , Humans , SARS-CoV-2 , Thyroiditis, Subacute/diagnosis , Thyroiditis, Subacute/etiology , Thyrotoxicosis/diagnosis , Thyrotoxicosis/etiology , Vaccination/adverse effects , Vaccines, Synthetic , mRNA Vaccines
4.
J Clin Endocrinol Metab ; 106(2): e1060-e1061, 2021 01 23.
Article in English | MEDLINE | ID: covidwho-1484818
6.
Intern Med J ; 52(4): 522-529, 2022 04.
Article in English | MEDLINE | ID: covidwho-1273102

ABSTRACT

BACKGROUND: COVID-19 is known to cause an acute respiratory illness, although clinical manifestations outside of the respiratory tract may occur. Early reports have identified SARS-CoV-2 as a cause of subacute thyroiditis (SAT). METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Web of Science and PubMed databases were queried in February 2021 for studies from December 2019 to February 2021. MeSH search terms 'COVID-19', 'SARS-CoV-2' and 'coronavirus' along with search terms 'thyroiditis', 'thyrotoxicosis' and 'thyroid' were used. Descriptive statistics for continuous variables and proportions for categorical variables were calculated. RESULTS: Fifteen publications reporting on 17 individual cases of COVID-19-induced SAT were identified. Age ranged from 18 to 69 years. The majority (14 of 17; 82%) of cases were female. The delay between onset of respiratory symptoms and diagnosis of SAT ranged from 5 to 49 days (mean, 26.5). Systemic inflammatory response syndrome related to viral infection was uncommonly reported at the time of SAT diagnosis. Thyroid ultrasonography frequently reported an enlarged hypoechoic thyroid with decreased vascularity and heterogenous echotexture. Elevated C-reactive protein (CRP) was common at the time of SAT diagnosis, with results ranging from 4.5 to 176 mg/L (mean, 41 mg/L). Antithyroid antibodies were frequently negative. SAT-specific treatment included corticosteroids for 12 of 17 (70.5%) patients. Most returned to normal thyroid status. CONCLUSION: COVID-19-associated SAT may be difficult to identify in a timely manner due to potential absence of classic symptoms, as well as cross-over of common clinical features between COVID-19 and thyrotoxicosis.


Subject(s)
COVID-19 , Thyroiditis, Subacute , Thyrotoxicosis , Adolescent , Adult , Aged , COVID-19/complications , Female , Humans , Male , Middle Aged , Risk Factors , SARS-CoV-2 , Thyroiditis, Subacute/diagnosis , Thyroiditis, Subacute/drug therapy , Thyroiditis, Subacute/epidemiology , Thyrotoxicosis/complications , Thyrotoxicosis/diagnosis , Treatment Outcome , Young Adult
7.
J Clin Endocrinol Metab ; 105(8)2020 08 01.
Article in English | MEDLINE | ID: covidwho-1067369

ABSTRACT

CONTEXT: The potential for endocrine care via telemedicine has been recognized since the early 2000s when clinical outcome data demonstrated improvements in glycemic control with telemedicine. The widespread use of telemedicine during the COVID-19 pandemic has pushed telemedicine beyond diabetes care and into clinical areas with a paucity of published data. The evaluation and treatment of thyrotoxicosis heavily relies on laboratory assessment and imaging with physical exam playing a role to help differentiate the etiology and assess the severity of thyrotoxicosis. CASE DESCRIPTION: We describe a patient presenting for evaluation of new thyrotoxicosis via telemedicine, and describe modifications to consider for thorough, safe evaluation via telemedicine. CONCLUSION: Telemedicine may be an ideal way to assess and treat patients with thyrotoxicosis who are not able to physically attend a visit with an endocrinologist but still have access to a laboratory for blood draws. Potential challenges include access to imaging and high-volume surgeons if needed. Clinical and economic outcomes of telemedicine care of thyrotoxicosis should be studied so that standards of care for endocrine telemedicine can be established.


Subject(s)
Coronavirus Infections/prevention & control , Endocrinology/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Symptom Assessment/methods , Telemedicine/methods , Thyrotoxicosis/diagnosis , Adult , Betacoronavirus , COVID-19 , Female , Humans , SARS-CoV-2
8.
J Clin Endocrinol Metab ; 106(2): e926-e935, 2021 01 23.
Article in English | MEDLINE | ID: covidwho-901968

ABSTRACT

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyroiditis is increasingly recognized. The role of thyroid autoimmunity and SARS-CoV-2 viral load in SARS-CoV-2-related thyroid dysfunction is unclear. We evaluated the thyroid function of a cohort of coronavirus disease 2019 (COVID-19) patients, in relation to their clinical features, and biochemical, immunological, and inflammatory markers. METHODS: Consecutive adult patients, without known thyroid disorders, admitted to Queen Mary Hospital for COVID-19 from July 21 to August 21, 2020, were included. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine (fT3), and antithyroid antibodies were measured on admission. RESULTS: Among 191 patients with COVID-19 (mean age 53.5 ±â€…17.2 years; 51.8% male), 84.3% were mild, 12.6% were moderate, and 3.1% were severe. Abnormal thyroid function was seen in 13.1%. Ten patients had isolated low TSH, suggestive of subclinical thyrotoxicosis due to thyroiditis, although the contribution of autoimmunity was likely in 2 of them. Autoimmune thyroiditis probably also contributed to subclinical hypothyroidism in another patient. Ten patients had isolated low fT3, likely representing nonthyroidal illness syndrome. Lower SARS-Cov-2 polymerase chain reaction cycle threshold values and elevated C-reactive protein were independently associated with occurrence of low TSH (P = .030) and low fT3 (P = .007), respectively. A decreasing trend of fT3 with increasing COVID-19 severity (P = .032) was found. Patients with low fT3 had more adverse COVID-19-related outcomes. CONCLUSION: Around 15% of patients with mild to moderate COVID-19 had thyroid dysfunction. There may be a direct effect of SARS-CoV-2 on thyroid function, potentially leading to exacerbation of pre-existing autoimmune thyroid disease. Low fT3, associated with systemic inflammation, may have a prognostic significance.


Subject(s)
COVID-19/diagnosis , Immune System/physiology , Thyroid Diseases/diagnosis , Thyroid Diseases/immunology , Adult , Aged , Aged, 80 and over , COVID-19/complications , COVID-19/epidemiology , COVID-19/immunology , Cohort Studies , Euthyroid Sick Syndromes/complications , Euthyroid Sick Syndromes/diagnosis , Euthyroid Sick Syndromes/epidemiology , Euthyroid Sick Syndromes/immunology , Female , Humans , Immune System/physiopathology , Male , Middle Aged , Prognosis , SARS-CoV-2/physiology , Severity of Illness Index , Thyroid Diseases/complications , Thyroid Diseases/epidemiology , Thyroid Function Tests , Thyroid Gland/physiology , Thyroiditis, Autoimmune/complications , Thyroiditis, Autoimmune/diagnosis , Thyroiditis, Autoimmune/epidemiology , Thyrotoxicosis/complications , Thyrotoxicosis/diagnosis , Thyrotoxicosis/epidemiology , Thyrotoxicosis/immunology
SELECTION OF CITATIONS
SEARCH DETAIL