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Risk factors, treatment and outcomes of subacute thyroiditis secondary to COVID-19: a systematic review.
Christensen, Jacob; O'Callaghan, Kevin; Sinclair, Holly; Hawke, Kate; Love, Amanda; Hajkowicz, Krispin; Stewart, Adam G.
  • Christensen J; Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  • O'Callaghan K; Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  • Sinclair H; Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  • Hawke K; Department of Endocrinology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  • Love A; Department of Endocrinology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  • Hajkowicz K; Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
  • Stewart AG; Infectious Diseases Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thyroiditis, Subacute / Thyrotoxicosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Intern Med J Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: Imj.15432

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thyroiditis, Subacute / Thyrotoxicosis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: Intern Med J Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: Imj.15432