SARS-CoV-2 Aşısıyla İlişkili Subakut Tiroidit: Pandemi Hastanesi Deneyimi

Abstract

Subakut tiroidit (SAT), kendi kendini sınırlayan inflamatuar bir hastalıktır. Bu çalışma, koronavirüs hastalığı 2019 (COVID-19) aşısıyla ilişkili subakut tiroidit vakalarının özelliklerini tanımlamayı amaçlamıştır. Retrospektif yapılan çalışmaya pandemi dönemi öncesi tanı alan 45 hasta ve COVİD-19 aşısından sonraki üç ay içinde SAT tanısı alan 19 hasta dahil edildi. Hastaların demografik, klinik özellikleri, laboratuvar parametreleri ve ultrasonografi bulguları kaydedildi. Ayrıca yaptırdıkları aşıların türü, aşı sonrası SAT ortaya çıkana kadar geçen süre, verilen tedavi ve tedaviye yanıt değerlendirildi. COVID-19 aşısı ile ilişkili SAT grubu (Grup-1) (n=19) ile pandemi öncesi saptanan SAT grubunun (n=45) (Grup-2) demografik, klinik özellikleri, laboratuvar parametreleri ve aldıkları tedaviler benzerdi. Sadece serum C-reaktif protein ve ortalama eritrosit sedimantasyon hızı Grup-2’de Grup-1’e göre daha yüksekti (p <0,05). Takip sırasında Grup-1 ve Grup-2’de ötiroid saptanan vakalar sırasıyla 15/19 (%78,9), 15/45 (%33,3) saptandı (p<0.05). Nüks oranları arasında fark yoktu. İnaktif COVID-19 aşısı sonrası 7 hastada, mRNA COVID-19 aşısı sonrası ise 12 hastada SAT gözlendi. Aşılamadan sonra semptomların başlamasına kadar geçen ortanca süre 11 (4-45) gündü. Pandemi döneminde COVID-19 aşılama oranlarının artmasıyla birlikte aşı ilişkili SAT vakalarına daha sık rastlanmıştır. Bu çalışma, COVID-19 aşısı ile ilişkili vakaların pandemi dönemi öncesi görülen SAT vakaları ile benzer tanısal özelliklere ve klinik gidişata sahip olduğunu göstermiştir.

Keywords

• Subakut tiroidit
• COVİD-19
• SARS-CoV-2 aşısı
• Pandemi

Subacute Thyroiditis Associated with SARS-CoV-2 Vaccines: Pandemic Hospital Experience

Abstract

Subacute thyroiditis (SAT) is a self-limiting inflammatory disease. This study aimed to describe the characteristics of coronavirus disease 2019 (COVID-19) vaccine-associated subacute thyroiditis cases. Forty-five patients diagnosed before the pandemic period and 19 patients diagnosed with SAT within three months after the COVID-19 vaccine were included in this retrospective study. Demographic, clinical characteristics, laboratory parameters, and ultrasonography findings of the patients were recorded. In addition, the type of vaccines they received, the time until SAT appeared after vaccination, the treatment given, and the response to treatment were evaluated. The demographics, clinical characteristics, laboratory parameters, and treatments they received were similar between the SAT group (Group-1) (n=19) associated with the COVID-19 vaccine and the SAT group (n=45) (Group-2) detected before the pandemic. Only serum C-reactive protein and mean erythrocyte sedimentation rate were higher in Group-2 than in Group-1 (p <0.05). During follow-up, euthyroid cases were detected in 15/19 (78.9%) and 15/45 (33.3%) in Group-1 and Group-2, respectively (p<0.05). There was no difference in relapse rates. SAT was observed in 7 patients after the inactive COVID-19 vaccine and 12 patients after the mRNA COVID-19 vaccine. The median time to symptom onset after vaccination was 11 (4-45) days. As COVID-19 vaccination rates increased during the pandemic, vaccine-related SAT cases became more common. This study showed that COVID-19 vaccine-associated cases have diagnostic features and clinical courses similar to classical SAT.

Keywords

• Subacute thyroiditis
• COVID-19
• SARS-CoV-2 vaccine
• Pandemic.

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