SARS-CoV-2 vaccine-associated subacute thyroiditis: insights from a systematic review

Area of Science:

• Endocrinology
• Immunology
• Vaccinology

Background:

• Subacute thyroiditis (SAT) is an inflammatory condition of the thyroid gland.
• The association between SARS-CoV-2 vaccination and SAT is an emerging clinical observation.

Purpose of the Study:

• To systematically review published cases of SAT following SARS-CoV-2 vaccination.
• To delineate the key features of vaccine-associated SAT.
• To enhance clinical awareness of this potential adverse event.

Main Methods:

• Systematic literature search for original reports of SAT post-SARS-CoV-2 vaccination (mRNA, viral vector, inactivated virus).
• Data extraction on patient demographics, medical history, vaccine type, clinical presentation, and treatment.
• Statistical analysis using Wilcoxon rank-sum, Kruskal-Wallis, and chi-squared tests.

Main Results:

• Analysis of 51 patients (74.5% female, median age 39.5 years) who developed SAT a median of 10 days post-vaccination.
• Thyrotoxicosis was present in 88.2% at baseline, resolving to 31.6% at follow-up; corticosteroids were used in 56.4%.
• Patients receiving non-mRNA vaccines showed higher rates of Asian ethnicity and weight loss; those with prior thyroid disease received mRNA vaccines.

Conclusions:

• SARS-CoV-2 vaccine-associated SAT is a newly recognized condition requiring physician awareness.
• A prior history of thyroid disease might be a risk factor for developing SAT after mRNA vaccines, warranting further investigation.
• Vaccine-associated SAT is generally mild to moderate, treatable, and should not deter vaccination efforts.