Thyroid disorders and Covid-19: a literature review
Keywords:Thyroid gland diseases; Covid-19; Thyroid gland; Subacute thyroiditis; Angiotensin 2 converting enzyme.
COVID-19 is a highly contagious disease caused by SARS-CoV-2, a single-stranded, enveloped RNA virus belonging to the beta-coronavirus family. SARS-CoV-2 is phylogenetically related to SARS-CoV-1, the virus that causes severe acute respiratory syndrome (SARS). Like SARS-CoV-1, SARS-CoV-2 infects human tissues by entering cells via the angiotensin-converting enzyme 2 (ACE2) receptor. It was alarming that, during the SARS-CoV-1 outbreak, many infected patients had thyroid gland disorders, even causing severe cellular damage. As SARS-CoV-2 is similar to SARS-CoV-1, researchers began to assess the possibility of developing thyroid diseases, especially subacute thyroiditis, in infected patients. Objective: To establish a possible relationship between the development of thyroid disorders and the infectious process caused by SARS-CoV-2 infection. Method: Literature review, supported by results obtained in studies related to the topic. Results: Studies carried out in the different stages of SARS-COV-2 infection suggest the existence of an association between SARS-CoV-2 infection and changes in thyroid function. Conclusion: Although most patients are euthyroid or have subacute thyroiditis, other thyroid diseases can manifest during SARS-CoV-2 infection, indicating the importance of assessing thyroid function in hospitalized, symptomatic and asymptomatic patients.
Agarwal, S., & Agarwal, S. K. (2020).Endocrine changes in SARS-CoV-2 patients and lessons from SARSCoV. Postgrad Med J.96:412-6.
Altay, F. A., Güz, G., & Altay, M. (2016). Subacute thyroiditis following seasonal influenzavaccination. Hum Vaccines Immunother. 12:1033-4.
Bernardo, W. M., Nobre, M. R. C., & Jatene, F. B. (2004) A prática clinica baseada em evidências. Parte II: buscando as evidências em fontes de informação. Rev Assoc Med Bras. 50(1):1-9.
Brancatella, A., Ricci, D., Cappellani, D., et al. (2020). Is subacute thyroiditis in the underestimated manifestation of SARS-CoV-2 infection? Insights from the case series. J Clin Endocrinol Metab.105(10):e3742-46.
Brancatella, A., Ricci, D., Viola, N., Sgro, D., Santini, F., & Latrofa, F. (2020). Subacute thyroiditis after Sars-COV-2 infection. J Clin Endocrinol Metab.105(7):2367-70.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology.Qualitative research in psychology,3(2), 77-101
Chappell, M. C. (2021). Commentary for endocrine significance of SARS-CoV-2's reliance on ACE2. Endocrinology.162:bqaa222.
Chen, M., Zhou, W., & Xu W. (2020).Thyroid function analysis in 50 patients with COVID-19: A retrospective study. Thyroid. 31(1):8-11.
Chen, T., Wu, D., Chen, H., et al. (2020). Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ.368:m1091.
Chen, W., Tian, Y., Li, Z., et al. (2021). Potential interaction between SARS-CoV-2 and thyroid: A review. Endocrinology. 162:bqab004.
Christensen, J., O'Callaghan, K., Sinclair, H., Hawke, K., et al. (2020). Risk factors, treatment and outcomes of subacute thyroiditis secondary to COVID-19: a systematic review. Intern Med J. 52(4):522-29.
Dong, M., Zhang, J., Ma, X., Tan, J., et al. (2020). ACE2, TMPRSS2 distribution and extrapulmonary organ injury in patients with COVID- Biomed Pharmacother. 131:110678.
Duntas, L. H., & Jonklaas, J. (2021). COVID-19 and thyroid diseases: A bidirectional impact. J Endocr Soc.5:bvab076.
Franquemont, S., & Galvez, J. (2021). Subacute thyroiditis after mRNA vaccine for Covid-19. J Endocr Soc. 5:A956-7.
Grassi, T., Varotto, E., & Galassi, F.M. (2020). COVID-19, the viral endocrinological disease? Eur J Intern Med. 77:156-7.
Jiménez-Blanco, S., Pla-Peris, B., & Marazuela M. (2021). COVID-19: a cause of recurrent Graves' hyperthyroidism? J Endocrinol Invest.44:387-8.
Kakodkar, P., Kaka, N., & Baig, M.N. (2020). A comprehensive literature review on the clinical presentation, and management of the pandemic coronavirus disease 2019 COVID-19]. Cures. 12: e7560.
Khatri, A., Charlap, E., & Kim, A. (2021). Subacute thyroiditis from COVID-19 Infection: A case report and review of literature. Eur Thyroid J. 9(6):324-8.
Kothandaraman, N., Rengaraj, A., Xue, B., Yew, W. S., et al. (2021). COVID-19 endocrinopathy with hindsight from SARS. Am J Physiol Endocrinol Metab. 320:E139-50.
Khoo, B., Tan, T., Clarke, S. A., et al. (2020).Thyroid function before, during and after COVID-19. J Clin Endocrinol Metab. 106(2):e803-11.
Kumari, K., Chainy, G. B. N., & Subudhi, U. (2020). Prospective role of thyroid disorders in monitoring COVID-19 pandemic. Heliyon.6:e05712.
Lania, A., Sandri, M. T., Cellini, M., Mirani, M., et al. (2020). Thyro-toxicosis in patients with COVID-19: the THYRCOV study. Eur J Endocrinol. 183:381-7.
Leow, M. K., Kwek, D. S., Ng, A. W., Ong, K. C., et al. (2005). Hypocortisolism in survivors of severe acute respiratory syndrome [SARS]. Endocrinol Clin. 63:197-202.
Liang, W., Guan, W., Chen, R., et al. (2020). Cancer patients in SARS-CoV-2 infection: a Nationwide analysis in China. Lancet Oncol. 21:335-7.
Li, M. Y., Li, L., Zhang, Y., & Wang, X. S. (2020). Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 9:45.
Madjid, M., Safavi-Naeini, P., Solomon, S. D., et al. (2020). Potential effects of coronaviruses on the cardiovascular system: A Review. JAMA Cardiol 5: 831–840.
Mateu-Salat, M., Urgell, E., & Chico A. (2020). SARS-COV-2 as a trigger for autoimmunedisease: report of two cases of Graves' disease after COVID-19. J Endocrinol Invest.43:1527-8.
Murugan, A. K., &Alzahrani, A. S. (2021). SARS-CoV-2: Emerging Role in the Pathogenesis of Various Thyroid Diseases. J Inflamm Res.14:6191-221.
Mongioì, L. M., Barbagallo, F., Condorelli, R. A., Cannarella, R., et al. (2020). Possible long-term endocrine-metabolic complications in COVID-19: lesson from the SARS model. Endocrine. 68:467-70.
Muller, I., Cannavaro, D., Dazzi, D., Covelli, D., et al. (2020). SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrine. 8:739-41.
Oyibo, S. O. (2021). Subacute Thyroiditis after receiving the adenovirus-vectored vaccine for coronavirus disease (COVID-19). Cures. 13:e16045.
Rehman, M. A. U., Farooq, H., Ali, M. M., Rehman, M. E. U., et al. (2021).The association of subacute thyroiditis with COVID-19: a systematic review. SN Compr Clin Med. 18(3):1.
Scappaticcio, L., Pitoia, F., Esposito, K., et al. (2020).Impact of COVID-19 on the thyroid gland: an update. Rev Endocr Metab Disord.22:1-13.
Toft, J., Larsen, S., & Toft, H. (1998). Subacute thyroiditis after hepatitis B vaccination. Endocr J. 45:135.
Wang, W., Ye, Y. X., Yao, H., Sun, L. Q., et al. (2003). Evaluation and observation of serum thyroid hormone and parathyroid hormone in patients with severe acute respiratory syndrome. J Chin Anti-tuberculous Assoc. 25: 232-4.
Wei, L., Sun, S., Xu, C. H., Zhang, J., et al. (2007). Pathology of the thyroid in severe acute respiratory syndrome. Hmm Pathol.38:95-102.
Wu, Z., & McGoogan, J. M. (2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the chinese center for disease control and prevention. JAMA.323:1239-42.
Zhang, Y., Lin, F., Tu, W., et al. (2021). Thyroid dysfunction may be associated with poor outcomes in patients with COVID-19. Mol Cell Endocrinol. 521:111097.
Ziegler, C. G. K., Allon, S. J., Nyquist, S. K., et al. (2020). SARS-CoV-2 ACE2 receptor is in the interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues. Cell.181:1016-1035.e19.
How to Cite
Copyright (c) 2022 Flávia Coelho Mohana Pinheiro; Hugo Coelho Mohana Pinheiro; José Delfim Mohana Pinheiro; Joana D´Arc Matos França de Abreu; Carla Souza Pereira Sobral
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.