Analysis of the functional state of the thyroid gland in children who underwent COVID-19

Abstract

Introduction. Extrapulmonary manifestations of COVID-19 may include endocrine forms, including diseases of the pancreas, pituitary gland, gonads, and thyroid gland. The direct cytopathic effect of the virus lies in its ability to enter cells through the ACE-2 receptor located on the epithelial and endothelial cells of the endocrine glands, followed by expression, which creates the possibility of the development and progression of damage to the endocrine system, both inflammatory and autoimmune. Until now, it has not been fully studied what changes in the state of health await children and teenagers in the post-COVID period, the dynamics of changes in the functional state of the thyroid gland in children and adolescents living in the region of endemic goiter (Far Eastern Federal District) has not been assessed. Aim. To assess of thyroid dysfunction in children who have had COVID-19. Materials and methods. The clinic performed a clinical and laboratory examination of 41 children aged 5-17 years who had a new coronavirus infection. Hormones were determined using the test systems of “AlkorBio” (St. Petersburg) on a microplate reader Stat-Fax 2100 (USA): thyroid stimulating hormone (µU/mL), free thyroxine (pmol/L), thyroid peroxidase antibodies. Results. It was determined that some children had clinical symptoms that may be associated with a possible involvement of the thyroid system: severe fatigue (61.0%), drowsiness (48.8%), memory loss (26.8%), depressed mood (14.6%), hair loss (14.6%), chilliness (4.9%), dry skin (4.9%). Ultrasound of the thyroid gland revealed a decrease in the volume of the gland in 46.3% and a diffuse enlargement of the thyroid gland in 9.8% of patients. In 33.3% of patients, the level of thyroid stimulating hormone in blood serum exceeded 3.4 mcU/mL, with a normal level of free thyroxine, which corresponds to subclinical hypothyroidism. Conclusion. The obtained data suggest the possibility of subclinical dysfunction of the thyroid gland in children who have had a coronavirus infection. Based on the pathophysiology of SARS-CoV-2 infection, with the presence of clinical complaints, it is necessary to conduct a routine assessment of thyroid function in patients in the recovery and convalescence phase after COVID-19. Future prospective studies are needed to improve epidemiological and clinical knowledge and optimize the management of endocrine diseases in patients with COVID-19.