Thyroid-associated orbitopathy following COVID-19: a case report

Studies have shown a link between COVID-19 vaccination and the development of Graves' disease (GD) and Graves' orbitopathy (GO). However, to the best of our knowledge, this is only the second reported case of clinically overt GO following COVID-19 infection. Herein, we report a 48-year-old female patient who was initially treated in 2017 with radioactive iodine therapy for a toxic thyroid adenoma. In 2021, the patient was diagnosed with COVID-19. Ten days later, she developed bilateral, active, moderate-to-severe GO, accompanied by elevated thyrotropin receptor antibody (TRAb) levels. She was treated with intravenous methylprednisolone followed by oral prednisone and later underwent orbital decompression surgery, followed by strabismus surgery due to worsening diplopia. No complications occurred postoperatively, and her symptoms improved significantly. This case contributes to the literature by suggesting a potential association between COVID-19 infection and the onset of autoimmune diseases, including GO.