A prospective follow-up of thyroid volume and thyroiditis features on ultrasonography among survivors of predominantly mild to moderate COVID-19

Author:

Fung Man Him Matrix1,Lui David Tak Wai2,Chiu Keith Wan Hang3,Lee Sherman Haynam1,Lee Chi Ho2,Chow Wing Sun2,Lee Alan Chun Hong2,Tam Anthony Raymond4,Pang Polly2,Ho Tip Yin2,Fong Carol Ho Yi2,Loong Connie Hong Nin2,Law Chun Yiu5,To Kelvin Kai Wang4,Lam Ching Wan6,Tan Kathryn Choon Beng2,Woo Yu Cho2,Hung Ivan Fan Ngai2,Lam Karen Siu Ling2,Lang Brian1

Affiliation:

1. Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China

2. Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China

3. Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China

4. Department of Microbiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China

5. Division of Chemical Pathology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China

6. Department of Pathology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China

Abstract

Background We previously showed that higher SARS-CoV-2 viral load correlated with smaller thyroid volumes among COVID-19 survivors at 2 months after acute COVID-19. Our current follow-up study evaluated the evolution of thyroid volumes and thyroiditis features within the same group of patients 6 months later. Methods Adult COVID-19 survivors who underwent thyroid ultrasonography 2 months after infection (USG1) were recruited for follow-up USG 6 months later (USG2). The primary outcome was the change in thyroid volume. We also reassessed thyroiditis features on USG, thyroid function and anti-thyroid antibodies. Results Fifty-four patients were recruited (mean age 48.1 years; 63% men). The mean thyroid volume increased from USG1 to USG2 (11.9 ± 4.8 to 14.5 ± 6.2 mL, p < 0.001). Thirty-two patients (59.3%) had significant increase in thyroid volume by ≥15%, and they had a median increase of +33.3% (IQR: +20.0% to +45.0%). Multivariable logistic regression analysis showed that only higher baseline SARS-CoV-2 viral load independently correlated with significant thyroid volume increase on USG2 (p = 0.022). Among the seven patients with thyroiditis features on USG1, six (85.7%) had the features resolved on USG2. None had new thyroiditis features on USG2. All abnormal thyroid function during acute COVID-19 resolved upon USG1 and USG2. Conclusion Most COVID-19 survivors had an increase in thyroid volume from early convalescent phase to later convalescent phase. This increase correlated with high initial SARS-CoV-2 viral load. Together with the resolution of thyroiditis features, these may suggest a transient direct atrophic effect of SARS-CoV-2 on the thyroid gland with subsequent recovery of thyroid volume and thyroiditis features.

Publisher

PeerJ

Subject

General Agricultural and Biological Sciences,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

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