Risk of developing thyroid eye disease in patients with thyroid dysfunction that received a COVID-19 vaccination

Area of Science:

• Endocrinology
• Ophthalmology
• Immunology

Background:

• Thyroid eye disease (TED) is an autoimmune condition affecting the eyes, often associated with thyroid dysfunction.
• mRNA COVID-19 vaccines have been widely administered, necessitating an understanding of their potential side effects, particularly in vulnerable populations.

Purpose of the Study:

• To evaluate the association between mRNA COVID-19 vaccination and the incidence of thyroid eye disease (TED) in patients diagnosed with hyperthyroidism.
• To compare the risk of TED following COVID-19 vaccination with that of other common vaccines like influenza and Tdap.

Main Methods:

• A retrospective cohort study utilizing the TriNetX network.
• Inclusion criteria: patients with hyperthyroidism, no prior TED or orbital inflammatory disease before March 2021.
• Propensity score matching (PSM) was employed to control for confounding demographic and comorbidity variables.

Main Results:

• The study identified 373,909 patients with hyperthyroidism; 69,378 were included after PSM.
• COVID-19 vaccination was associated with a 49% increased risk of developing TED compared to no COVID-19 vaccination (RR=1.49).
• The risk of TED was also elevated following Tdap (RR=1.80) and influenza (RR=1.68) vaccinations compared to no COVID-19 vaccination.

Conclusions:

• Patients with hyperthyroidism exhibit an elevated risk of developing TED after receiving mRNA COVID-19 vaccination.
• Further research is warranted to confirm these findings.
• Individuals with autoimmune thyroid disease should be educated about TED symptoms and monitored post-vaccination.