Deciphering the Thyroid Enigma: Exploring the Global Impact of COVID-19on Autoimmune Pathways and Euthyroid Patients

Authors

DOI:

https://doi.org/10.56294/piii2024328

Keywords:

Autoimmune thyroiditis, SARS-CoV-2, covid-19, Hashimoto's disease, Graves' disease, Quervain's thyroiditis, SAT, Secondary Hemophagocytic lymphocytosis, cytokin strom, hypothyroidism

Abstract

Introduction: This research delves into the complex interaction between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and thyroid disorders. With the growing body of evidence suggesting a connection between COVID-19 infection and the onset of autoimmune thyroid diseases (AITD) and non-thyroidal illness syndrome (NTIS), this study aims to unravel the underlying mechanisms, identify risk factors, and explore the geographic prevalence of these conditions. The research addresses the critical need to understand the long-term implications of SARS-CoV-2 infection on thyroid health and its relationship with the phenomenon known as "long COVID". Summary: The study focuses on autoimmune manifestations, particularly AITDs, examining the relationship between COVID-19 and thyroid disorders such as Hashimoto's thyroiditis and Graves' disease. Subacute granulomatous thyroiditis (TGSA) induced by the virus and the persistence of thyroid symptoms beyond the acute phase of infection are explored. The importance of factors such as glandular trophism, pathophysiology, and the presence of symptoms in "long COVID" is emphasized. Materials and Methods: The research methodology is based on a comprehensive review of scientific literature, spanning studies from 2021 to 2023. Recognized databases such as NIH, PubMed, Cochrane, and Elsevier were utilized, prioritizing  systematic reviews, meta-analyses, and relevant case reports. The search focused on risk factors, thyroid manifestations in COVID-19 patients.  Results: The findings address the correlation between thyroid dysfunction and the severity of COVID-19, the impact of fT3 hormone as a predictor, and the relationship between thyroid disorders and "long COVID" syndrome. Results from various researchers are presented, including diagnostic methods, treatment modalities, and potential interventions. Conclusion: The thesis concludes that SARS-CoV-2 infection can trigger thyroid disorders, especially AITDs and NTIS, highlighting immune dysregulation as a central factor. Diagnostic strategies are proposed, modifiable and non-modifiable risk factors are discussed, and the importance of addressing persistent symptoms in "long COVID" is emphasized. The research significantly contributes to the understanding of this complex interaction, providing crucial insights for future investigations and clinical practice

References

Yazdanpanah N, Rezaei N. Autoimmune complications of COVID‐19. J Med Virol. enero de 2022;94(1):54-62.

Trinh A, Nguyen KH, Nguyen D. Thyroid disease post COVID-19 infection: Report of a case with new-onset autoimmune thyroid disease [Internet]. Preprints; 2022 nov [citado 24 de octubre de 2023]. Disponible en: https://www.authorea.com/users/521512/articles/594364-thyroiddisease-post-covid-19-infectionreport-of-a-case-with-new-onsetautoimmune-thyroiddisease?commit=be4eb8158c2ed9a a64ab4ca8ac389c67a026266c

Brancatella A, Viola N, Santini F, Latrofa F. COVID-induced thyroid autoimmunity. Best Pract Res Clin Endocrinol Metab. marzo de; 37(2):101742.

Barahona San Millán R, Tantinyà Daura M, Hurtado Ganoza A, Recasens Sala M. Tiroiditis indolora en infección por SARS-CoV-2. Endocrinol Diabetes Nutr. diciembre de 2021;68(10):757-8.

Yoshikawa N, Arreaza G, Morita T, Mukuta T, Resetkova E, Miller N, et al. Studies of Human Peripheral Blood Mononuclear Cells (PBMC) from Patients with Subacute Thyroiditis in Severe Combined Immunodeficient (SCID) Mice: Less Production of Human Interferon Gamma than that Seen for Graves’ Disease. Horm Metab Res. septiembre de 1994;26(09):419-23.

Álvarez Martín MC, Del Peso Gilsanz C, Hernández López A. Subacute De Quervain thyroiditis after SARSCoV-2 infection. Endocrinol Diabetes Nutr Engl Ed. diciembre de 2021;68(10):754-5.

Lee ZC, Wong YJE, Ti LL, Shrikant DP, Tay TL, Santosa A. Hashimoto’s thyroiditis-related myopathy in a patient with SARS-CoV-2 infection: A case report and systematic literature review. Medicine (Baltimore). 20 de octubre de 2023;102(42):e35720.

Bostan H, Ucan B, Kizilgul M, Calapkulu M, Hepsen S, Gul U, et al. Relapsed and newly diagnosed Graves’ disease due to immunization against COVID-19: A case series and review of the literature. J Autoimmun. abril de 2022;128:102809.

Duntas LH, Jonklaas J. COVID-19 and Thyroid Diseases: A Bidirectional Impact. J Endocr Soc. 1 de agosto de 2021;5(8):bvab076.

Sahin Tekin M, Kocaturk E, Gurcu S, Kayadibi H, Dibeklioglu B, Yorulmaz G. Cellular immunity in subacute thyroiditis: a new perspective through neopterin. Clin Exp Immunol. 22 de julio de 2022;209(1):109-14.

Saad MA, Alfishawy M, Nassar M, Mohamed M, Esene IN, Elbendary A. COVID-19 and Autoimmune Diseases: A Systematic Review of Reported Cases. Curr Rheumatol Rev. 19 de mayo de 2021;17(2):193204.

Jafarzadeh A, Nemati M, Jafarzadeh S, Nozari P, Mortazavi SMJ. Thyroid dysfunction following vaccination with COVID-19 vaccines: a basic review of the preliminary evidence. J Endocrinol Invest. 26 de marzo de 2022;45(10):1835-63.

Speer G, Somogyi P. Thyroid complications of SARS and coronavirus disease 2019 (COVID19). Endocr J. 2021;68(2):129-36.

Muller I, Cannavaro D, Dazzi D, Covelli D, Mantovani G, Muscatello A, et al. SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrinol. septiembre de 2020;8(9):739-41.

Tutal E, Ozaras R, Leblebicioglu H. Systematic review of COVID-19 and autoimmune thyroiditis. Travel Med Infect Dis. mayo de ;47:102314.

Sunada N, Honda H, Nakano Y, Yamamoto K, Tokumasu K, Sakurada Y, et al. Hormonal trends in patients suffering from long COVID symptoms. Endocr J. 2022;69(10):1173-81.

Nakano Y, Kurihara H, Sasaki J. Graves’ Disease Following Subacute Thyroiditis. Tohoku J Exp Med. 2011;225(4):301-9.

Rotondi M, Coperchini F, Ricci G, Denegri M, Croce L, Ngnitejeu ST, et al. Detection of SARS-COV-2 receptor ACE-2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis. J Endocrinol Invest. 1 de mayo de 2021;44(5):1085-90.

Zhang Z, Fang T, Lv Y. Causal associations between thyroid dysfunction and COVID-19 susceptibility and severity: A bidirectional Mendelian randomization study. Front Endocrinol. 6 de septiembre de 2022;13:961717.

Rafael Silvestre Knack, Taliê Hanada, Renata Silvestre Knack, Kamilla Mayr. Hashimoto’s thyroiditis following SARS-CoV-2 infection. BMJ Case Rep. 1 de agosto de 2021;14(8):e244909.

Rossetti CL, Cazarin J, Hecht F, Beltrão FEDL, Ferreira ACF, Fortunato RS, et al. COVID-19 and thyroid function: What do we know so far? Front Endocrinol. 19 de diciembre de 2022;13:1041676.

Lisco G, De Tullio A, Jirillo E, Giagulli VA, De Pergola G, Guastamacchia E, et al. Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects. J Endocrinol Invest. 2021;44(9):180114.

Rojas M, Rodríguez Y, AcostaAmpudia Y, Monsalve DM, Zhu C, Li QZ, et al. Autoimmunity is a hallmark of post-COVID syndrome. J Transl Med. diciembre de 2022;20(1):129.

Naguib R. Potential relationships between COVID-19 and the thyroid gland: an update. J Int Med Res. febrero de 2022;50(2):030006052210828.

Kojima M, Nakamura S, Oyama T, Sugihara S, Sakata N, Masawa N. Cellular Composition of Subacute Thyroiditis. An Immunohistochemical Study of Six Cases. Pathol - Res Pract. enero de 2002;198(12):833-7.

Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Fong CHY, et al. Thyroid Dysfunction in Relation to Immune Profile, Disease Status, and Outcome in 191 Patients with COVID-19. J Clin Endocrinol Metab. 23 de enero de 2021;106(2):e926-35.

Zahran AM, Abdel-Rahim MH, Nasif KA, Hussein S, Hafez R, Ahmad AB, et al. Association of follicular helper T and follicular regulatory T cells with severity and hyperglycemia in hospitalized COVID-19 patients. Virulence. 31 de diciembre de 2022;13(1):569-77.

Bogusławska J, Godlewska M, Gajda E, Piekiełko-Witkowska A. Cellular and molecular basis of thyroid autoimmunity. Eur Thyroid J [Internet]. 1 de febrero de 2022 [citado 22 de diciembre de 2023];11(1). Disponible en: https://etj.bioscientifica.com/view/journals/etj/11/1/ETJ-21-0024.xml

Mobasheri L, Nasirpour MH, Masoumi E, Azarnaminy AF, Jafari M, Esmaeili SA. SARS-CoV-2 triggering autoimmune diseases. Cytokine. junio de 2022;154:155873.

Liu Y, Tang X, Tian J, Zhu C, Peng H, Rui K, et al. Th17/Treg Cells Imbalance and GITRL Profile in

Patients with Hashimoto’s Thyroiditis. Int J Mol Sci. 25 de noviembre de 2014;15(12):21674-86.

Qureshi NK, Bansal SK. Autoimmune Thyroid Disease and Psoriasis Vulgaris after COVID-19 in a Male Teenager. Kasapcopur O, editor. Case Rep Pediatr. 27 de julio de 2021;2021:1-3.

Lee J, Seo GH, Song K. Beyond Acute COVID-19: Investigating the Incidence of Subacute Thyroiditis in Long COVID-19 in Korea. Endocrinol Metab. 31 de agosto de 2023;38(4):455-61.

Marazuela M, Giustina A, PuigDomingo M. Endocrine and metabolic aspects of the COVID-19 pandemic. Rev Endocr Metab Disord. diciembre de 2020;21(4):495-507.

Nakamura S, Kido N, Watanabe M, Ohmachi Y, Inayama Y, Kashitani Y, et al. Analysis of thyroid function in Japanese patients with coronavirus disease 2019. Endocr J. 2022;69(6):643-8.

Chen M, Zhou W, Xu W. Thyroid Function Analysis in 50 Patients with COVID-19: A Retrospective Study. Thyroid. 1 de enero de 2021;31(1):8-11.

Herczeg V, Garai R, Takács J, Kovács F, Luczay A, Hrapka E, et al. Thyroid disturbances after COVID-19 and the effect of vaccination in children: a prospective tri-center registry analysis. Eur J Pediatr. 25 de julio de 2023;182(10):4443-55.

Brancatella A, Ricci D, Viola N, Sgrò D, Santini F, Latrofa F. Subacute Thyroiditis After Sars-COV-2 Infection. J Clin Endocrinol Metab. 1 de julio de 2020;105(7):2367-70.

Lanzo N, Patera B, Fazzino G, Gallo D, Lai A, Piantanida E, et al. The Old and the New in Subacute Thyroiditis: An Integrative Review. Endocrines. 4 de julio de 2022;3(3):391-410.

Churilov LP, Normatov MG, Utekhin VJ. Molecular Mimicry between SARS-CoV-2 and Human Endocrinocytes: A Prerequisite of

Post-COVID-19 Endocrine Autoimmunity? Pathophysiology. 25 de agosto de 2022;29(3):486-94.

Sharma C, Bayry J. High risk of autoimmune diseases after COVID19. Nat Rev Rheumatol. julio de 2023;19(7):399-400.

Ruggeri RM, Giovanellla L, Campennì A. SARS-CoV-2 vaccine may trigger thyroid autoimmunity: real-life experience and review of the literature. J Endocrinol Invest. 2022;45(12):2283-9.

Downloads

Published

2024-06-11

How to Cite

1.
Gimenez Olivieri LJ, Laube GE. Deciphering the Thyroid Enigma: Exploring the Global Impact of COVID-19on Autoimmune Pathways and Euthyroid Patients. SCT Proceedings in Interdisciplinary Insights and Innovations [Internet]. 2024 Jun. 11 [cited 2024 Oct. 7];2:328. Available from: https://proceedings.ageditor.ar/index.php/piii/article/view/295