Subacute thyroiditis in the SARS-CoV-2 era: a multicentre prospective study
Author:
De Vincentis Sara12, Loiacono Simona1, Zanni Eleonora1, Sueri Roberta1, Monzani Maria Laura12, Santi Daniele12, Muller Ilaria34ORCID, Di Marco Francesco5, Crivicich Erica5, Armenti Mirco5, Pagotto Uberto67, Tucci Lorenzo67, Cecchetti Carolina67, Trenti Tommaso8, Pecoraro Valentina8, Canu Giulia8, Simoni Manuela12, Brigante Giulia12ORCID
Affiliation:
1. Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy 2. Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy 3. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy 4. Department of Endocrinology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy 5. School of Specialisation in Endocrinology, University of Milan, Milan, Italy 6. Department of Medical and Surgical Sciences, Alma Mater Studiorum - Bologna University, Bologna, Italy 7. Department of Endocrinology and Diabetes Care and Prevention Unit, IRCCS Sant’Orsola-Malpighi Polyclinic, Bologna, Italy 8. Department of Laboratory Medicine and Anatomy Pathology, Azienda USL Modena, Modena, Italy
Abstract
Objective
Many cases of subacute thyroiditis (SAT) have been described related to SARS-CoV-2 infection, but no prospective data about follow-up are known. This prospective, longitudinal, 3-year, multicentre study aims to explore the clinical peculiarities and outcome of SAT in relation to SARS-CoV-2 infection, ascertained with antibody dosage.
Methods
All patients receiving SAT diagnosis from November 2020 to May 2022 were enrolled. Data on anamnesis, physical examination, blood tests (TSH, freeT4, freeT3, thyroglobulin, anti-thyroid antibodies, C-reactive protein, erythrocyte sedimentation rate, complete blood count), and thyroid ultrasound were collected. At baseline, the presence of IgG against the SARS-CoV-2 spike protein or nucleocapsid was investigated. Patients were evaluated after 1, 3, 6, and 12 months.
Results
Sixty-six subjects were enrolled. At baseline, 54 presented with pain, 36 (67%) for at least 15 days. Serum SARS-CoV-2 IgG measurements documented that 7 out of 52 subjects (13.5%) had infection before SAT diagnosis (COVID+). No significant differences between the COVID+ and COVID− groups were found at baseline, except for respiratory symptoms and fever, which were more common in COVID+ (P = 0.039 and P = 0.021, respectively). Among the 41 subjects who completed follow-up, COVID+ and COVID− did not differ for therapeutic approach to SAT or outcome, all having an improvement in neck pain, inflammation parameters, and ultrasound features.
Conclusion
This is the first prospective study investigating any difference both at diagnosis and at follow-up between SAT presentation in patients with previous SARS-CoV-2 infection and those without. Our data demonstrate that SARS-CoV-2 does not impact on SAT onset, evolution, and outcome.
Reference26 articles.
1. An interactive web-based dashboard to track COVID-19 in real time;Dong,2020 2. 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis;Ross,2016 3. Subacute granulomatous (de Quervain) thyroiditis: grayscale and color Doppler sonographic characteristics;Frates,2013 4. Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted County, Minnesota, study;Fatourechi,2003 5. Subacute thyroiditis: clinical characteristics and treatment outcome in fifty-six consecutive patients diagnosed between 1999 and 2005;Benbassat,2007
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