COVID-19-associated thyroid diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Overview

COVID-19 has been found to affect several organs and body systems, including the endocrine system, with short-term and possible long-term consequences.

Classification

There is no established system for the classification of COVID-19-associated thyroid disorders.

Pathophysiology

The exact pathogenesis of COVID-19-associated thyroid diseases is not fully understood. However, the following hypotheses have been suggested for the development of thyroid dysfunction in COVID-19 patients.

COVID-19 infection may trigger:

• the activation of pre-existing thyroid disease or
• autoimmunity.

Angiotensin-converting enzyme 2 (ACE2) receptors are essentially involved in SARS-CoV-2 internalization into host cells. the thyroid gland is amongst the organs which have the highest levels of ACE2 expression and activity.

Risk Factors

There are no established risk factors for COVID-19-associated [[[thyroid diseases]].

Screening

There is insufficient evidence to recommend routine screening for COVID-19-associated thyroid diseases.

Natural History, Complications, and Prognosis

A number of observational studies have shown that COVID-19 infection may be linked to some thyroid diseases, including:

• Subacute thyroiditis
• Graves’ disease
• Non-thyroidal illness or euthyroid sick syndrome
• Thyrotoxicosis
• Hashimoto’s thyroiditis

Diagnosis

Diagnostic Study of Choice

The diagnosis of COVID-19-associated thyroid diseases is made based on the thyroid function test (TFT), which measures serum levels of triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH).

X-ray

There are no x-ray findings associated with COVID-19-associated thyroid diseases.