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Subacute Thyroiditis and Heart Failure in a Patient Presenting With COVID-19.
Mathews, Sherin Elsa; Castellanos-Diaz, Jessica; Srihari, Ashok; Kadiyala, Sushma; Leey-Casella, Julio; Ghayee, Hans K; Ogunsakin, Amie.
  • Mathews SE; Malcom Randall Veteran Hospital, Gainesville, FL, USA.
  • Castellanos-Diaz J; University of Florida, Gainesville, FL, USA.
  • Srihari A; Malcom Randall Veteran Hospital, Gainesville, FL, USA.
  • Kadiyala S; University of Florida, Gainesville, FL, USA.
  • Leey-Casella J; Malcom Randall Veteran Hospital, Gainesville, FL, USA.
  • Ghayee HK; University of Florida, Gainesville, FL, USA.
  • Ogunsakin A; Malcom Randall Veteran Hospital, Gainesville, FL, USA.
J Investig Med High Impact Case Rep ; 9: 23247096211009412, 2021.
Article in English | MEDLINE | ID: covidwho-1186542
ABSTRACT
A 67-year-old male was admitted with shortness of breath and diarrhea. His COVID-19 polymerase chain reaction test was positive, and he was found to be in acute heart failure. Troponin levels were elevated, echocardiogram showed ejection fraction of 24%, and his electrocardiogram was normal. Inflammatory markers were elevated. Further testing revealed suppressed thyroid-stimulating hormone and elevated free thyroxine (T4). Differential diagnosis at this point included possible myocarditis from the viral illness, exacerbation of heart failure from the viral infection or from thyrotoxicosis was considered. Patient's heart failure improved with initiation of heart failure therapies; however, biochemically, his thyroid function tests (TFTs) did not improve, despite empiric methimazole. Thyroid antibody tests were unremarkable. Thyroid ultrasound showed mildly enlarged thyroid gland with no increased vascularity and 5-mm bilateral cysts. Thyroid dysfunction was attributed to subacute thyroiditis from COVID-19, methimazole was tapered, and prednisone was initiated. The patient's TFTs improved. With the ongoing COVID-19 pandemic, it is imperative that clinicians keep a broad differential in individuals presenting with heart failure, and obtaining baseline TFTs may be reasonable. Rapid treatment of the underlying thyroiditis is important in these patients to improve the cardiovascular outcomes. In our experience, steroid therapy showed a rapid improvement in the TFTs.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thyroiditis, Subacute / COVID-19 / Heart Failure Type of study: Case report / Diagnostic study Topics: Long Covid Limits: Aged / Humans / Male Language: English Journal: J Investig Med High Impact Case Rep Year: 2021 Document Type: Article Affiliation country: 23247096211009412

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thyroiditis, Subacute / COVID-19 / Heart Failure Type of study: Case report / Diagnostic study Topics: Long Covid Limits: Aged / Humans / Male Language: English Journal: J Investig Med High Impact Case Rep Year: 2021 Document Type: Article Affiliation country: 23247096211009412