Purpose
To evaluate the post- coronavirus disease-19 (COVID-19) outcome of thyroid function in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyrotoxicosis.
Methods
This was a single-center prospective study involving 29 patients (11 females, 18 males; median age 64 years, range: 43-85) with thyrotoxicosis diagnosed after hospitalization for COVID-19 and then followed-up for a median period of 90 days (range: 30-120) after hospital discharge. At the follow-up, patients were evaluated for serum thyrotropic (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure.
Results
After recovery of COVID-19, serum TSH values significantly increased (P<0.001) and FT4 values significantly decreased (P=0.001), without significant change in serum FT3 (P=0.572). At the follow-up, 28 subjects (96.6%) became euthyroid whereas overt hypothyroidism developed in one case. At the ultrasound evaluation of thyroid gland, hypoecogenicity was found in 10 patients (34.5%) with a prevalence that was significantly higher in cases with serum TSH > 3.0 mU/l as compared to those with TSH values below 1.0 mU/L (P=0.039). All subjects resulted to be negative for TgAb, TPOAb and TRAb.
Conclusion
In a short-term follow-up, thyroid function spontaneously normalized in most subjects with SARS-CoV-2-related thyrotoxicosis. However, thyroid hypoecogenicity was found in a remarkable number of them and future longer-term studies are needed to clarify whether this ultrasonographic alteration may predispose to develop late-onset thyroid dysfunction.

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Posted 15 Mar, 2021
Received 06 Mar, 2021
Invitations sent on 06 Mar, 2021
On 04 Mar, 2021
On 28 Feb, 2021
Posted 15 Mar, 2021
Received 06 Mar, 2021
Invitations sent on 06 Mar, 2021
On 04 Mar, 2021
On 28 Feb, 2021
Purpose
To evaluate the post- coronavirus disease-19 (COVID-19) outcome of thyroid function in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related thyrotoxicosis.
Methods
This was a single-center prospective study involving 29 patients (11 females, 18 males; median age 64 years, range: 43-85) with thyrotoxicosis diagnosed after hospitalization for COVID-19 and then followed-up for a median period of 90 days (range: 30-120) after hospital discharge. At the follow-up, patients were evaluated for serum thyrotropic (TSH), free-thyroxine (FT4), free-triiodiothyronine (FT3), TSH receptor antibodies (TRAb), thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb) and ultrasonographic thyroid structure.
Results
After recovery of COVID-19, serum TSH values significantly increased (P<0.001) and FT4 values significantly decreased (P=0.001), without significant change in serum FT3 (P=0.572). At the follow-up, 28 subjects (96.6%) became euthyroid whereas overt hypothyroidism developed in one case. At the ultrasound evaluation of thyroid gland, hypoecogenicity was found in 10 patients (34.5%) with a prevalence that was significantly higher in cases with serum TSH > 3.0 mU/l as compared to those with TSH values below 1.0 mU/L (P=0.039). All subjects resulted to be negative for TgAb, TPOAb and TRAb.
Conclusion
In a short-term follow-up, thyroid function spontaneously normalized in most subjects with SARS-CoV-2-related thyrotoxicosis. However, thyroid hypoecogenicity was found in a remarkable number of them and future longer-term studies are needed to clarify whether this ultrasonographic alteration may predispose to develop late-onset thyroid dysfunction.

Figure 1

Figure 2
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