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| __NOTOC__
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| {{COVID-19 thyroid disorders}}
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| {{CMG}} {{AE}}
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| ==Overview==
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| COVID-19 has been found to affect several organs and body systems, including the endocrine system, with short-term and possible long-term consequences.
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| ==Historical Perspective==
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| In March 2020, the first case of subacute thyroiditis in an 18-year-old woman with COVID-19 was described. <ref name="pmid32436948">{{cite journal| author=Brancatella A, Ricci D, Viola N, Sgrò D, Santini F, Latrofa F| title=Subacute Thyroiditis After Sars-COV-2 Infection. | journal=J Clin Endocrinol Metab | year= 2020 | volume= 105 | issue= 7 | pages= | pmid=32436948 | doi=10.1210/clinem/dgaa276 | pmc=7314004 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32436948 }} </ref>
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| ==Classification==
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| There is no established system for the classification of [[COVID-19-associated thyroid disorders]].
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| ==Pathophysiology==
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| 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.
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| * 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. Therefore, following SARS-CoV-2 infection, thyroid damage could result from either a direct or immune-mediated injury.
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| * COVID-19 may also cause an immune system imbalance and in severe cases a cytokine storm, which may break immunotolerance in susceptible patients, leading to new onset of immune-mediated thyroiditis, exacerbating a previous thyroid disease, or inducing a recurrence of thyroid disease.
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| ==Causes==
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| [[Coronavirus disease 2019]] ([[COVID-19]]) caused by a novel [[coronavirus]] called [[SARS-CoV-2]] is the cause of [[COVID-19]]-associated [[thyroid diseases]].
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| ==Differentiating COVID-19-associated thyroid diseases from other Diseases==
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| ==Epidemiology and Demographics==
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| Several cases of subacute thyroiditis <ref name="pmid32436948">{{cite journal| author=Brancatella A, Ricci D, Viola N, Sgrò D, Santini F, Latrofa F| title=Subacute Thyroiditis After Sars-COV-2 Infection. | journal=J Clin Endocrinol Metab | year= 2020 | volume= 105 | issue= 7 | pages= | pmid=32436948 | doi=10.1210/clinem/dgaa276 | pmc=7314004 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32436948 }} </ref> <ref name="pmid32843467">{{cite journal| author=Mattar SAM, Koh SJQ, Rama Chandran S, Cherng BPZ| title=Subacute thyroiditis associated with COVID-19. | journal=BMJ Case Rep | year= 2020 | volume= 13 | issue= 8 | pages= | pmid=32843467 | doi=10.1136/bcr-2020-237336 | pmc=7449350 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32843467 }} </ref> <ref name="pmid32504458">{{cite journal| author=Asfuroglu Kalkan E, Ates I| title=A case of subacute thyroiditis associated with Covid-19 infection. | journal=J Endocrinol Invest | year= 2020 | volume= 43 | issue= 8 | pages= 1173-1174 | pmid=32504458 | doi=10.1007/s40618-020-01316-3 | pmc=7273820 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32504458 }} </ref> <ref name="pmid32780854">{{cite journal| author=Brancatella A, Ricci D, Cappellani D, Viola N, Sgrò D, Santini F | display-authors=etal| title=Is Subacute Thyroiditis an Underestimated Manifestation of SARS-CoV-2 Infection? Insights From a Case Series. | journal=J Clin Endocrinol Metab | year= 2020 | volume= 105 | issue= 10 | pages= | pmid=32780854 | doi=10.1210/clinem/dgaa537 | pmc=7454668 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32780854 }} </ref> <ref name="pmid33370933">{{cite journal| author=Chakraborty U, Ghosh S, Chandra A, Ray AK| title=Subacute thyroiditis as a presenting manifestation of COVID-19: a report of an exceedingly rare clinical entity. | journal=BMJ Case Rep | year= 2020 | volume= 13 | issue= 12 | pages= | pmid=33370933 | doi=10.1136/bcr-2020-239953 | pmc=7750881 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33370933 }} </ref> <ref name="pmid33005461">{{cite journal| author=Campos-Barrera E, Alvarez-Cisneros T, Davalos-Fuentes M| title=Subacute Thyroiditis Associated with COVID-19. | journal=Case Rep Endocrinol | year= 2020 | volume= 2020 | issue= | pages= 8891539 | pmid=33005461 | doi=10.1155/2020/8891539 | pmc=7522602 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33005461 }} </ref>, have been reported in COVID-19 patients wordwide.
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| several other cases have been reported worldwide [40,41,42]. Subacute thyroiditis symptoms occurred 16–36 days after the resolution of COVID-19 [43, 44]. A prompt response to oral prednisone usually occurs, and euthyroidism returns after a few weeks of treatment
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| ==Risk Factors==
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| There are no established risk factors for [[COVID-19]]-associated [[thyroid diseases]].
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| ==Screening==
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| There is insufficient evidence to recommend routine screening for [[COVID-19]]-associated [[thyroid diseases]].
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| ==Natural History, Complications, and Prognosis==
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| A number of observational studies have shown that [[COVID-19]] infection may be linked to some [[thyroid diseases]], including:
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| *[[Subacute thyroiditis]]
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| *[[Graves’ disease]]
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| *[[Non-thyroidal illness]] or [[euthyroid sick syndrome]]
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| *[[Thyrotoxicosis]]
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| *[[Hashimoto’s thyroiditis]]
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| ==Diagnosis==
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| ===Diagnostic Study of Choice===
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| 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]]).
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| ===History and Symptoms===
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| ===Physical Examination===
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| ===Laboratory Findings===
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| ===Electrocardiogram===
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| * There are no [[The electrocardiogram|ECG]] findings associated with [[COVID-19|COVID-1]]9-associated [[thyroid disease]].
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| * However, the following findings may be seen on [[The electrocardiogram|ECG]] in patients with [[thyrotoxicosis]]:
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| **[[Tachycardia]], ...
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| ===X-ray===
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| There are no x-ray findings associated with [[COVID-19]]-associated [[thyroid diseases]].
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| ===Echocardiography or Ultrasound===
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| *There are no [[echocardiography]]findings associated with [[COVID-19]]-associated thyroid diseases.
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| *Thyroid ultrasoongraphy
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| ===CT scan===
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| *There are no CT scan findings associated with COVID-19-associated thyroid diseases.
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| ===MRI===
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| There are no MRI findings associated with COVID-19-associated thyroid diseases.
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| ===Other Imaging Findings===
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| ===Other Diagnostic Studies===
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| ==Treatment==
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| ===Medical Therapy===
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| ===Surgery===
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| Surgery is not a treatment option for patients with COVID-19-associated thyroid diseases.
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| ===Primary Prevention===
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| There are no established measures for the primary prevention of COVID-19-associated thyroid diseases.
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| ===Secondary Prevention===
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| ==References==
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