Since its outbreak in the city of Wuhan, China in December 2019, coronavirus disease 2019 (COVID-19), caused by the new type of coronavirus identified as SARS-CoV-2, has spread all around the world. Since then, the mechanisms involved in the differential progression of the respiratory illness and the body organs that are affected by the virus have been under medical scientific focus. The risk of severe COVID-19 infection is known to be higher in the elderly population and in those with underlying health conditions, including cardiovascular disease, chronic respiratory disease, chronic kidney disease, neurological disorders, hypertension, but also endocrine disorders, among others [1]. Referring to endocrine comorbidities, COVID-19 patients with diabetes are at high risk for serious illness, but people with other endocrine diseases such as obesity, malnutrition, and adrenal insufficiency can also be severely affected if they contract the virus [2]. In high-risk patients, SARS-CoV-2 infection can cause both pulmonary symptoms and systemic inflammation, determining multiorgan dysfunction [3]. Among the multiple organs that can be affected by COVID-19 is the thyroid gland. Since the main causes of thyroid diseases are autoimmune in origin, if the COVID-19 infection causes an overactive immune reaction and generalized inflammation (“cytokine storm”), it could also affect the thyroid.
References
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- Guo YR., et al. “The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak-an update on the status”. Military Medical Research 7 (2020): 11.
- Lazartigues E., et al. “Endocrine significance of SARS-CoV-2’s reliance on ACE2”. Endocrinology 161 (2020): bqaa108.
- Ziegler CGK., et al. “SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues”. Cell 181 (2020): 1016-1035.
- Li MY., et al. “Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues”. Infectious Diseases of Poverty 9 (2020): 1-7.
- Klecha AJ., et al. “Immune-endocrine interactions in autoimmune thyroid diseases”. Neuro Immuno Modulation 15 (2008): 68-75.
- Desailloud R and Hober D. “Viruses and thyroiditis: an update”. Virology Journal 6 (2009):5.
- Antonelli A., et al. “Graves’ disease: epidemiology, genetic and environmental risk factors and viruses”. Best Practice and Research: Clinical Endocrinology and Metabolism 34 (2020): 101387.
- Wei L., et al. “Pathology of the thyroid in severe acute respiratory syndrome”. Human Pathology 38 (2007): 95-102.
- Lania A., et al. “Thyrotoxicosis in patients with COVID-19: the THYRCOV study”. European Journal of Endocrinology 183 (2020): 381-387.
- Muller I., et al. “SARS-CoV-2-related atypical thyroiditis”. The Lancet Diabetes and Endocrinology 8 (2020): 739-741.
- Asfuroglu Kalkan E and Ates I. “A case of subacute thyroiditis associated with Covid-19 infection”. Journal of Endocrinological Investigation 43 (2020): 1173-1174.
- Brancatella A., et al. “Subacute thyroiditis after sars-COV-2 infection”. The Journal of Clinical Endocrinology and Metabolism 105 (2020): dgaa276.
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- Guven M. “Subacute Thyroiditis in the Course of Coronavirus Disease 2019: A Case Report”. Journal of Endocrinology and Metabolism 10 (2020): 110-112.
- Ruggeri RM., et al. “Subacute thyroiditis in a patient infected with SARS-COV-2: An endocrine complication linked to the COVID-19 pandemic”. Hormones (2020): 1-3.
- Mattar SAM., et al. “Subacute thyroiditis associated with COVID-19”. BMJ Case Reports 13 (2020): e237336.
- Zhang J., et al. “Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China”. Allergy 75 (2020): 1730-1741.
- Khoo B., et al. “Thyroid function before, during and after COVID-19”. The Journal of Clinical Endocrinology and Metabolism 12 (2020): dgaa830.
- Chen M., et al. “Thyroid function analysis in 50 patients with COVID-19: a retrospective study”. Thyroid (2020): 1-4.
- Fliers E., et al. “Thyroid function in critically ill patients”. The Lancet Diabetes and Endocrinology . 3 (2015): 816-825.
- Pantos C., et al. “Triiodothyronine for the treatment of critically ill patients with COVID-19 infection: A structured summary of a study protocol for a randomised controlled trial”. Trials 21 (2020): 573.
- Hariyanto TI and Kurniawan A. “Thyroid disease is associated with severe coronavirus disease 2019 (COVID-19) infection”. Diabetes and Metabolic Syndrome 14 (2020): 1429-1430.
- Paulazo MA., et al. “Hypothyroidism-related zinc deficiency leads to suppression of T lymphocyte activity”. Endocrine 66 (2019): 266-277.
- Boelaert K., et al. “Endocrinology in the time of COVID-19: Management of hyperthyroidism and hypothyroidism”. European Journal of Endocrinology 183 (2020): G33-G39.
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