New-Onset Graves' Disease Induced by COVID-19: A Case Report and Literature Review

We present a case of new-onset Graves' disease in a 40-year-old woman following COVID-19 infection. The patient experienced hand tremors, palpitations, shortness of breath with minimal exertion, and excessive sweating one week after recovering from COVID-19. Thyroid function tests revealed thyrotoxicosis, elevated free thyroxine, free triiodothyronine, and suppressed thyroid-stimulating hormone levels. Positive antithyroid peroxidase and thyroid-stimulating hormone (TSH) receptor antibodies, along with ultrasonography findings of diffuse thyroid enlargement and hypervascularization, confirmed the diagnosis of Graves' disease. Scintigraphy was omitted per the patient's request. This case contributes to the growing evidence suggesting SARS-CoV-2 may trigger autoimmune responses leading to thyroid disorders. We discuss the epidemiology, clinical characteristics, and potential mechanisms of Graves' disease following COVID-19, reviewing 28 similar cases reported from 2020 to early 2024. Our analysis reveals varied onset times and severity of thyroid dysfunction post-COVID-19, with some cases progressing to thyroid storm. Our findings highlight the importance of vigilant post-COVID-19 follow-up and contribute to understanding SARS-CoV-2's long-term consequences. From a cost-benefit perspective, a targeted screening approach might be needed for patients with persistent symptoms suggestive of thyroid dysfunction. This strategy could facilitate early detection and treatment, potentially preventing complications and reducing long-term healthcare costs.