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Thyrotoxicosis occurrence in SARS-CoV-2 infection: A case report
Maria Erika Pranasakti1,2, Nimitta Talirasa2, Henda Ageng Rasena2
1Department of Internal Medicine, Rumah Sakit Nasional Diponegoro, Semarang, Indonesia.
Coronavirus Disease 2019 (COVID-19) can initially manifest as a thyroid crisis, affecting thyroid function through ACE2 and viral replication. Early recognition and treatment are crucial for managing this extrapulmonary COVID-19 complication.
Area of Science:
- Endocrinology
- Infectious Diseases
- Internal Medicine
Background:
- Coronavirus Disease 2019 (COVID-19) primarily affects the respiratory system but has extrapulmonary manifestations.
- The virus interacts with thyroid function via Angiotensin-converting enzyme 2 (ACE2) and direct viral replication.
Observation:
- A 26-year-old woman presented with palpitations and abdominal pain, later diagnosed with COVID-19.
- Physical examination revealed tachycardia, tremor, and hyperreflexia; thyroid tests showed elevated fT4 and suppressed TSH.
- Electrocardiography indicated supraventricular tachycardia, requiring cardioversion.
Findings:
- The patient's presentation mimicked a thyroid crisis, with laboratory results indicating hyperthyroidism.
- COVID-19 infection was confirmed via rapid antigen and PCR testing.
- Treatment included remdesivir, anti-thyroid medication, and supportive care, leading to clinical improvement.
Implications:
- COVID-19 can present as a thyroid crisis in patients without prior endocrine disease.
- Awareness of this presentation is vital for emergency clinicians.
- Prompt diagnosis, anti-hyperthyroid therapy, and isolation protocols are essential for managing thyroid crisis in COVID-19 patients.
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