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Updated: Sep 28, 2025

Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19

Comparing Objective Conjunctival Hyperemia Grading and the Ocular Surface Disease Index Score in Dry Eye Syndrome During COVID-19

Published on: May 25, 2022

COVID-19-Induced Graves' Disease.

Hagop Ghareebian¹, Cary Mariash¹

¹Internal Medicine/Endocrinology Division, Indiana University, Indianapolis, USA.

|March 28, 2022

Summary

COVID-19 may trigger Graves' disease, an autoimmune thyroid condition, in individuals without prior thyroid issues. This case highlights the need for awareness of SARS-CoV-2's potential role in new-onset Graves' hyperthyroidism.

Area of Science:

Endocrinology
Infectious Diseases
Immunology

Background:

COVID-19 (caused by SARS-CoV-2) is a multi-system disease with emerging links to thyroid dysfunction.
Reports indicate a potential increase in thyroiditis and Graves' disease following SARS-CoV-2 infection, though the exact relationship remains unclear.

Observation:

A 48-year-old male with no prior thyroid history presented with cough, fatigue, and palpitations after testing positive for SARS-CoV-2.
Initial presentation showed suppressed thyroid-stimulating hormone (TSH) and elevated free T4, initially suspected as viral thyroiditis.
Further investigation revealed positive thyroid-stimulating immunoglobulin (TSI) and characteristic Doppler ultrasound findings, confirming Graves' hyperthyroidism.

Findings:

This case uniquely presents new-onset Graves' disease following SARS-CoV-2 infection, distinct from previously reported relapses of pre-existing conditions.

Keywords:

autoimmunity covid-19 graves’ disease sars covid2 thyroid thyrotoxicosis

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The patient's positive TSI and ultrasound findings strongly suggest an autoimmune pathway activated by SARS-CoV-2 infection.

Implications:

Physicians, especially endocrinologists, should consider SARS-CoV-2-induced Graves' disease as a differential diagnosis in patients with compatible symptoms.
This case underscores the importance of recognizing potential autoimmune sequelae of COVID-19 and the need for further research into the underlying mechanisms.