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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Thyroid dysfunction in COVID-19.

David Tak Wai Lui1, Chi Ho Lee1, Yu Cho Woo1

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COVID-19 can cause thyroid dysfunction through direct and indirect effects on the thyroid axis. This review summarizes evidence on thyroid issues in acute infection, long COVID, and vaccination, offering testing recommendations.

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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.