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SARS-CoV-2-Related Subacute Thyroiditis, Myocarditis, and Hepatitis After Full Resolution of COVID-19 Serum Markers.
Osorio Martínez, Alejandra; González-Razo, Victoria Taís; Navarro-Sánchez, Valeria; Souto Meiriño, Carlos A; Ahumada-Ayala, Miguel.
  • Osorio Martínez A; Department of Biochemistry and Medicine, La Salle University School of Medicine, Mexico City, Mexico.
  • González-Razo VT; Department of Biochemistry and Medicine, La Salle University School of Medicine, Mexico City, Mexico.
  • Navarro-Sánchez V; Department of Biochemistry and Medicine, La Salle University School of Medicine, Mexico City, Mexico.
  • Souto Meiriño CA; Coronary Care Unit, Angeles del Pedregal Hospital, Mexico City, Mexico.
  • Ahumada-Ayala M; Department of Biochemistry and Medicine, La Salle University School of Medicine, Mexico City, Mexico.
Am J Case Rep ; 22: e932321, 2021 Jun 17.
Article in English | MEDLINE | ID: covidwho-1395309
ABSTRACT
BACKGROUND Subacute thyroiditis, myocarditis, and hepatitis are inflammatory disorders that may develop after viral infections, including SARS-CoV-2. These entities may appear after resolution of the respiratory syndrome. CASE REPORT A previously healthy 64-year-old male patient came to the hospital reporting severe chest pain. He had a history of a COVID-19 pneumonia with PCR confirmation 4 weeks before. On admission to the Coronary Care Unit (CCU), the patient had a negative PCR for SARS-CoV-2; the following tests were performed total T3 643.4 ng/dl (reference 35-193 ng/dl), total thyroxine 12.0 µg/dl (reference 4.8-11.7 µg/dl), free T4 1.85 ng/dl (reference 0.7-1.48 ng/dl), TSH 0.01 µIU/ml (reference 0.35-4.94 µIU/ml); total bilirubin 0.76 mg/dl (reference 0.0-1.5 mg/dl), alkaline phosphatase 185 U/L (reference 40-150 U/L), alanine aminotransferase 194.6 U/L (reference 6-66 U/L), aspartate aminotransferase 93.4 U/L (reference 9-55 U/L); on admission to the CCU high-sensitivity troponin I 548.3 pg/ml (reference 0.0-34.2 pg/ml), after 24 h in the CCU 801 pg/ml, and after 11 days (as an outpatient) 4.5 pg/ml. A thyroid gammagram revealed absent uptake of the radionuclide. Normal cardiac gammagraphy and cardiac enzymes ruled out myocardial ischemia and infarction. The following diagnoses were made myocarditis, subacute thyroiditis, and reactive hepatitis due to SARS-CoV-2 infection. CONCLUSIONS COVID-19 has been demonstrated to be a multisystemic inflammatory disorder. The serious illness that developed in our patient after relief of his pulmonary disease underlines this nature. We suggest close follow-up of patients even after apparent clinical resolution, and performing thyroid, myocardial, and liver tests if clinically indicated.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thyroiditis, Subacute / COVID-19 / Hepatitis / Myocarditis Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Limits: Humans / Male / Middle aged Language: English Journal: Am J Case Rep Year: 2021 Document Type: Article Affiliation country: Ajcr.932321

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thyroiditis, Subacute / COVID-19 / Hepatitis / Myocarditis Type of study: Case report / Cohort study / Diagnostic study / Prognostic study Limits: Humans / Male / Middle aged Language: English Journal: Am J Case Rep Year: 2021 Document Type: Article Affiliation country: Ajcr.932321