Affiliation:
1. Department of Endocrinology, Farhikhtegan Hospital, Faculty of Medicine, Tehran Medical Sciences Islamic Azad
University, Tehran, Iran
Abstract
Abstract:
Coronavirus disease 2019 (COVID-19) affects thyroid function. These changes are due to
the direct impact of the virus on thyroid cells via angiotensin-converting–enzyme 2 (ACE2) receptors,
inflammatory reaction, apoptosis in thyroid follicular cells, suppression of hypothalamus-pituitarythyroid
axis, an increase in activity of adrenocortical axis, and excess cortisol release due to cytokine
storm of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Euthyroid sick syndrome
(ESS), thyroiditis, clinical and subclinical hypothyroidism, central hypothyroidism, exacerbation of
underlying autoimmune thyroid disease, and clinical and subclinical hyperthyroidism can be associated
with coronavirus. Adjuvants in coronavirus vaccines induce autoimmune/inflammatory syndrome
known as vaccine adjuvants (ASIA) syndrome. Thyroiditis and Graves’ disease have been reported to
be associated with ASIA syndrome after some coronavirus vaccinations. Some coronavirus medications,
such as hydroxychloroquine, monoclonal antibodies, lopinavir/ritonavir, remdesivir, naproxen,
anticoagulants, and glucocorticoids can also affect thyroid tests, and correct diagnosis of thyroid disorders
will be more difficult. Changes in thyroid tests may be one of the most important manifestations
of COVID-19. These changes can be confusing for clinicians and can lead to inappropriate diagnoses
and decisions. Prospective studies should be conducted in the future to increase epidemiological
and clinical data and optimize the management of thyroid dysfunctions in patients with COVID-19.
Publisher
Bentham Science Publishers Ltd.
Subject
Drug Discovery,Pharmacology,General Medicine