SARS-COV-2 INFECTION AND THYROID DISEASES

Year 2021, , 590 - 594, 01.10.2021

Özlem Çelik

https://doi.org/10.26650/IUITFD.2021.939684

Abstract

The severe acute respiratory syndrome-coronavirus-2 (SARSCoV- 2) virus, was identified as the cause of a pandemic of respiratory illness in Wuhan, China one year ago. The Coronavirus disease 2019 (COVID-19), may cause mild disease with nonspecific signs and symptoms such as fever, cough, myalgia, and fatigue, or severe pneumonia with respiratory failure and sepsis. However, endocrinological manifestations are yet to be established, in patients with COVID-19. The effect of COVID-19 on thyroid function is unknown at this time. Evidence support that patients with COVID-19 who are followed up in intensive care units may develop thyroid dysfunction as a non-thyroidal illness syndrome. Until now, twenty-two cases with subacute thyroiditis and five cases with Graves’ Diseases potentially associated with SARS-CoV-2 infection have been reported in literature. Physicians should be aware of possible relationships between thyroid dysfunction and COVID-19. This study aimed to review thyroid dysfunction in patients with COVID-19, and to overview thyroid diseases that are probably related to COVID-19.

Keywords

COVID-19, SARS-CoV-2, thyroid, non-thyroidal illness syndrome, subacute thyroiditis, Graves’ disease

SARS-COV-2 ENFEKSİYONU VE TİROİD HASTALIKLARI

Abstract

Şiddetli akut solunum sendromu-koronavirüs-2 (SARS-CoV-2) virüsü, bir yıl önce Çin’in Wuhan kentinde bir solunum yolu hastalığı salgınının nedeni olarak tanımlandı. Coronavirus hastalığı 2019 (COVID-19), ateş, öksürük, miyalji ve yorgunluk gibi spesifik olmayan bulgu ve semptomlarla hafif hastalığa veya solunum yetmezliği ve sepsisle birlikte şiddetli pnömoniye neden olabilir. Bununla birlikte, COVID-19 hastalarında endokrinolojik belirtiler henüz tanımlanmamıştır. Şu anda, COVID-19’un tiroid fonksiyonu üzerinde bir etkisinin olup olmadığı belirsizdir. Kanıtlar yoğun bakım ünitelerinde takip edilen COVID-19 hastalarının hasta ötiroid sendrom olarak tiroid disfonksiyonu geliştirebileceklerini desteklemektedir. Şimdiye kadar, literatürde potansiyel olarak SARS-CoV-2 enfeksiyonu ile ilişkili yirmi iki subakut tiroidit vakası ve beş Graves’ hastalığı vakası bildirilmiştir. Hekimler, tiroid disfonksiyonu ile COVID-19 arasındaki olası ilişkilerin farkında olmalıdır. Bu derlemede, COVID-19 hastalarında tiroid disfonksiyonu ve muhtemelen COVID-19 ile ilişkili tiroid hastalıklarının gözden geçirilmesi amaçlanmıştır.

Keywords

COVID-19, SARS-CoV-2, tiroid, non-tiroidal hastalık sendromu, subakut tiroidit, Graves’ hastalığı

References

• 1. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18):1708-20. [CrossRef]
• 2. Pal R, Banerjee M. COVID-19 and the endocrine system: exploring the unexplored. J Endocrinol Invest 2020; 43(7):1027-31. [CrossRef]
• 3. Liu F, Long X, Zhang B, Zhang W, Chen X, Zhang Z. ACE2 expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol 2020;18(9):2128-2130.e2. [CrossRef]
• 4. Li MY, Li L, Zhang Y, Wang XS. Expression of the SARSCoV- 2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty 2020;9(1):45. [CrossRef]
• 5. Ding Y, He L, Zhang Q, Huang Z, Che X, Hou J, et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: Implications for pathogenesis and virus transmission pathways. J Pathol 2004;203(2):622-30. [CrossRef]
• 6. Wei L, Sun S, Xu CH, Zhang J, Xu Y, Zhu H et al. Pathology of the thyroid in severe acute respiratory syndrome. Hum Pathol 2007;38(1):95-102. [CrossRef]
• 7. Yao XH, Li TY, He ZC, Ping YF, Liu HW, Yu SC, et al. Histopathological study of new coronavirus pneumonia (COVID-19) in three patients. Zhonghua Bing Li Xue Za Zhi 2020;8 49(5):411-417.
• 8. Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 autopsies, Oklahoma, USA. Am J Clin Pathol 2020;153(6):725-33. [CrossRef]
• 9. Bradley BT, Maioli H, Johnston R, Chaudhry I, Fink SL, Xu H, et al. Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: a case series. Lancet 2020;396(10247):320-32. [CrossRef]
• 10. Rotondi M, Coperchini F, Ricci G, Denegri M, Croce L, Ngnitejeu ST, et al. Detection of SARS-COV-2 receptor ACE- 2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis. J Endocrinol Invest 2021;44(5):1085-90. [CrossRef]
• 11. Croce L, Gangemi D, Ancona G, Liboà F, Bendotti G, Minelli L, et al. The cytokine storm and thyroid hormone changes in COVID-19. J Endocrinol Invest 2021;44(5):891- 904. [CrossRef]
• 12. Lania A, Sandri MT, Cellini M, Mirani M, Lavezzi E, Mazziotti G. Thyrotoxicosis in patients with COVID-19: THE THYRCOV STUDY. Eur J Endocrinol 2020;183(4):381-7. [CrossRef]
• 13. Chen M, Zhou W, Xu W. TThyroid function analysis in 50 patients with COVID-19: A retrospective study. Thyroid 2021; 31(1):8-11. [CrossRef]
• 14. Muller I, Cannavaro D, Dazzi D, Covelli D, Mantovani G, Muscatello A, et al. SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrinol 2020; 8(9):739-741. [CrossRef]
• 15. Khoo B, Tan T, Clarke SA, Mills EG, Patel B, Modi M, et al. Thyroid function before, during and after Covid-19. J Clin Endocrinol Metab 2021; 23:106(2): e803-11. [CrossRef]
• 16. Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Fong CHY, et al. Thyroid dysfunction in relation to immune profile, disease status and outcome in 191 patients with Covid-19. J Clin Endocrinol Metab 2021; 23:106(2): e926-35. [CrossRef]
• 17. Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Fong CHY et al. Role of non-thyroidal illness syndrome in predicting adverse outcomes in COVID-19 patients predominantly of mild-to-moderate severity. Clin Endocrinol (Oxf) 2021 Apr 4. [CrossRef]
• 18. Gao W, Guo W, Guo Y, Shi M, Dong G, Wang G, et al. Thyroid hormone concentrations in severely or critically ill patients with Covid-19. J Endocrinol Invest 2021; 44(5):1031- 40. [CrossRef]
• 19. Schwarz Y, Percik R, Oberman B, Yaffe D, Zimlichman E, Tirosh A. Sick euthyroid syndrome on presentation of patients with COVID-19: A potential marker for disease severity. Endocr Pract 2021; 27(2):101-9. [CrossRef]
• 20. Campi I, Bulgarelli I, Dubini A, Perego GB, Tortorici E, Torlasco C, et al. The spectrum of thyroid function tests during hospitalization for SARS COV-2 infection. Eur J Endocrinol 2021;184(5):699-709. [CrossRef]
• 21. Samuels MH. Subacute, silent, and postpartum thyroiditis. Med Clin North Am 2012;96: 223-33. [CrossRef]
• 22. Alfadda AA, Sallam RM, Elawad GE, Aldhukair H, Alyahya MM. Subacute thyroiditis: clinical presentation and long term outcome. Int J Endocrinol 2014;2014: 794943. [CrossRef]
• 23. Erdem N, Erdogan M, Ozbek M, Karadeniz M, Cetinkalp S, Ozgen AG, et al. Demographic and clinical features of patients with subacute thyroiditis: results of 169 patients from a single university center in Turkey. J Endocrinol Invest 2007;30(7):546-50. [CrossRef]
• 24. Stasiak M, Tymoniuk B, Stasiak B, Lewiński A. The risk of recurrence of subacute thyroiditis is HLA-Dependent. Int J Mol Sci 2019;20(5):1089. [CrossRef] 25. Desaillud R, Hober D. Virus and thyroiditis: an update. Virol J 2009;6: 5. [CrossRef]
• 26. Brancatella A, Ricci D, Viola N, Sgrò D, Santini F, Latrofa F. Subacute thyroiditis after Sars-COV-2 infection. J Clin Endocrinol Metab 2020;105(7): dgaa276. [CrossRef]
• 27. Ippolito S, Dentali F, Tanda ML. SARS‑CoV‑2: a potential trigger for subacute thyroiditis? Insights from a case report. J Endocrinol Invest 2020;43(8):1171-1172. [CrossRef]
• 28. Asfuroglu Kalkan E, Ates I. A case of subacute thyroiditis associated with Covid-19 infection J Endocrinol Invest 2020;43(8):1173-1174. [CrossRef]
• 29. Ruggeri RM, Campennì A, Siracusa M, Frazzetto G, Gullo D. Subacute thyroiditis in a patient infected with SARSCOV- 2: an endocrine complication linked to the COVID-19 pandemic. Hormones (Athens) 2021;20(1):219-221. [CrossRef]
• 30. Brancatella A, Ricci D, Cappellani D, Viola N, Sgrò D, Santini F, Latrofa F. Is subacute thyroiditis an underestimated manifestation of SARS-CoV-2 infection? Insights From a Case Series. J Clin Endocrinol Metab 2020;105(10):dgaa537. [CrossRef]
• 31. Mattar SAM, Koh SJQ, Rama Chandran S, Cherng BPZ. Subacute thyroiditis associated with COVID-19. BMJ Case Rep 2020;13(8):e237336. [CrossRef]
• 32. Khatri A, Charlap E, Kim A. Subacute thyroiditis from COVID-19 infection: A case report and review of literature. Eur Thyroid J 2021;9(6):324-8. [CrossRef]
• 33. Campos-Barrera E, Alvarez-Cisneros T, Davalos-Fuentes M. Subacute thyroiditis associated with COVID-19. 2020 Sep 28; 2020:8891539. [CrossRef]
• 34. Ruano R, Zorzano-Martinez M, Campos A, Rius F, Hernández M. Subacute thyroiditis might be a complication triggered by SARS-CoV-2. Endocrinol Diabetes Nutr (Engl Ed). 2020 13; S2530-0164(20)30206-8. [CrossRef]
• 35. Chong WH, Shkolnik B, Saha B, Beegle S. Subacute thyroiditis in the setting of Coronavirus Disease 2019. Am J Med Sci 2021 ;361(3):400-2. [CrossRef]
• 36. San Juan MDJ, Florencio MQV, Joven MH. Subacute thyroiditis in a patient with coronavirus disease 2019. AACE Clin Case Rep 2020;6(6):e361-4. [CrossRef]
• 37. Álvarez Martín MC, Del Peso Gilsanz C, Hernández López A. Subacute De Quervain thyroiditis after SARSCoV- 2 infection. Endocrinol Diabetes Nutr 2020;S2530- 0164(20)30244-5. [CrossRef]
• 38. Chakraborty U, Ghosh S, Chandra A, Ray AK. Subacute thyroiditis as a presenting manifestation of COVID-19: a report of an exceedingly rare clinical entity. BMJ Case Rep 2020;13(12):e239953. [CrossRef]
• 39. Sohrabpour S, Heidari F, Karimi E, Ansari R, Tajdini A, Heidari F. Subacute thyroiditis in COVID-19 patients. Eur Thyroid J 2021;9(6):321-3. [CrossRef]
• 40. Caron P. Thyroiditis and SARS-CoV-2 pandemic: a review. Endocrine 2021;72(2):326-31. [CrossRef]
• 41. Antonelli A, Ferrari SM, Ragusa F, Elia G, Paparo SR, Ruffilli I, et al. Graves’ Disease: Epidemiology, genetic and environmental risk factors and viruses. Best Pract Res Clin Endocrinol Metab 2020;34(1):101387. [CrossRef]
• 42. Valtonen VV, Ruutu P, Varis K, Ranki M, Malkamäki M, Mäkelä PH. Serological evidence for the role of bacterial infections in the pathogenesis of thyroid diseases. Acta Med Scand 1986;219(1):105-11. [CrossRef]
• 43. Davies TF. Infection and autoimmune thyroid disease. J Clin Endocrinol Metab 2008;93(3):674-6. [CrossRef]
• 44. Mateu-Salat M, Urgell E, Chico A. SARS-COV-2 as a trigger for autoimmune disease: report of two cases of Graves’ disease after COVID-19. J Endocrinol Invest 2020;43(10):1527-8. [CrossRef]
• 45. Jiménez-Blanco S, Pla-Peris B, Marazuela M. COVID-19: a cause of recurrent Graves’ hyperthyroidism? J Endocrinol Invest 2021;44(2):387-8. [CrossRef]
• 46. Pastor S, Molina Á Sr, De Celis E. Thyrotoxic crisis and COVID-19 infection: an extraordinary case and literature review. Cureus 2020;12(11):e11305. [CrossRef]
• 47. Dayan CM. Stressful life events and Graves’ disease revisited. Clin Endocrinol (Oxf) 2001;55(1):13-4. [CrossRef]
• 48. Vita R, Lapa D, Trimarchi F, Benvenga S. Stress triggers the onset and the recurrences of hyperthyroidism in patients with Graves’ disease. Endocrine 2015;48(1):254-63. [CrossRef]
• 49. Topcu CB, Celik O, Tasan E. Effect of stressful life events on the initiation of Graves’ disease. Int J Psychiatry Clin Pract 2012;16(4):307-11. [CrossRef]
• 50. Agcaoglu O, Sezer A, Makay O, Erdogan MF, Bayram F, Guldiken S, et al. Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options. Updates Surg. 2021:1-11. [CrossRef]