Pathophysiological and clinical aspects of interaction between coronavirus disease 2019 and thyroid

Abstract

In patients who were not previously diagnosed with any thyroid conditions, the scenario of COVID-19 related anomalies of the thyroid may include either: a process of central thyroid-stimulating hormone disturbances via virus‑related hypophysitis; an atypical type of subacute thyroiditis which is connected to the virus spread or to excessive cytokine production including a destructive process with irreversible damage to the gland or low triiodothyronine syndrome (non-thyroidal illness syndrome) which is not specifically related to the COVID‑19 infection, but which is associated with a very severe illness status. This review aimed to investigate thyroid changes resulted from the COVID-19 infection. Ongoing assessment of the effects of the COVID-19 pandemic will reveal more information on coronavirus-induced thyroid conditions. Routine thyroid assays performed in patients with severe infection/acute phase of COVID-19 are encouraged to detect thyrotoxicosis. After recovery, thyroid function should be assessed to identify potential hypothyroidism. There remain unanswered questions related to the predictive value of interleukin-6 in infected patients, especially in cases of cytokine storm, and the necessity of thyroid hormone replacement in subjects with hypophysitis-related central hypothyroidism.