Auto-immune thyroiditis in SARS-CoV-2 exposed twins

In the coronavirus disease 2019 (COVID-19) pandemic, a spectrum of sequelae affecting different organs has been reported. Of these, the ones affecting the thyroid gland have been reported, especially in the adults.

We present previously healthy twin adolescents with no history of thyroid disease, presenting with signs and symptoms of hypothyroidism after recovery from mild COVID-19 infection. Their investigations were consistent with auto-immune thyroiditis with primary hypothyroidism, showing markedly elevated thyroid-stimulating hormone (TSH), suppressed FT4 levels, positive anti-thyroid peroxidase antibody and anti-thyroglobulin antibody titres. They were treated accordingly and showed quick clinical improvement in symptoms.

This case report demonstrates that COVID-19 infection can be temporally associated with primary hypothyroidism in genetically predisposed children adding more to the growing list of sequelae especially in children.