Thyroid dysfunction in COVID-19

Area of Science:

• Endocrinology
• Infectious Diseases
• Public Health

Background:

• The COVID-19 pandemic has impacted global health, with significant morbidity and mortality primarily linked to lung damage.
• Emerging evidence indicates SARS-CoV-2 (the virus causing COVID-19) affects multiple organs, including endocrine glands.
• Thyroid dysfunction following COVID-19 has been increasingly documented since May 2020.

Purpose of the Study:

• To provide an updated review of scientific evidence on the relationship between COVID-19 and thyroid dysfunction.
• To incorporate recent advances, particularly concerning long COVID and COVID-19 vaccination.
• To propose evidence-based recommendations for thyroid function testing.

Main Methods:

• Systematic review of epidemiological, radiological, molecular, and histological evidence.
• Analysis of data on thyroid dysfunction in acute COVID-19, long COVID, and post-vaccination.
• Examination of the effects on the hypothalamic-pituitary-thyroid axis.

Main Results:

• Thyroid dysfunction is a recognized complication of COVID-19, affecting the hypothalamic-pituitary-thyroid axis.
• Evidence supports thyroid involvement in acute infection, long COVID, and potentially following vaccination.
• Subacute thyroiditis is one reported manifestation of COVID-19-associated thyroid dysfunction.

Conclusions:

• COVID-19 poses a significant risk for developing thyroid dysfunction, impacting a broad spectrum of patients.
• Understanding thyroid implications in long COVID is crucial given the large number of survivors.
• Guidelines for thyroid function testing are needed during and after COVID-19 infection and vaccination.