Endocrine Abstracts

The Sars-COV-2 virus is a recognized endocrine disruptor, which determines the possibility of endocrine dysfunctions associated with COVID 19. One of the endocrine diseases associated with COVID 19 is subacute thyroiditis (STh), which develops regardless of the severity of manifestations of the underlying disease. The aim of the study: to evaluate the clinical manifestations, therapy, and outcomes of STh in unvaccinated COVID 19 patients.

Materials and methods

The diagnosis of STh was established on the basis of generally accepted clinical criteria. As a result 26 patients from April to October 2020 were included in the study: group1 – with STh without COVID 19 in medical history (n = 8); group2 – COVID 19 convalescents who received glucocorticoids (GCs) in complex therapy (in the diagnosis of PT, the daily dose in terms of prednisone was 20 mg) (n = 10); group3 – COVID 19 convalescents who did not use GCs in COVID 19 therapy (n = 8). The levels of erythrocytes (Er), hemoglobin, leukocytes, lymphocytes, erythrocyte sedimentation rate, thyroid-stimulating hormone, free thyroxine, thyroid peroxidase antibodies, C-reactive protein (CRP) in the peripheral blood were determined; ultrasound examination of the thyroid gland, thyroscintigraphy with 99mTc-pertechnetate, with the calculation of the uptake index of the radiopharmaceutical were conducted as well.

Results

Comparison of indicators of the complete blood count revealed differences in the levels of Er, leukocytes, the proportion of lymphocytes, which were associated with the characteristics of treatment (use of GCs). The thyroid status at the time of STh establishment indicated a thyrotoxic phase, confirmed by thyroid status. For the treatment of STh in groups1, 3, a non-steroidal anti-inflammatory drug (NSAID) (nimesulide 200 mg/day) was prescribed. In 50% of patients in group1, 87.5% of patients in group3 required the addition of GCs using the average dose in terms of prednisolone (30 mg/day). Group2 required an increase in the GCc dose to 40 mg/day in terms of prednisone (NSAIDs were’t). Beta-blockers were used to minimize hyperthyroidism’s symptoms in individual doses. The duration of therapy up to resolution in group1 averaged 25 days, in group2 – 51 days, in group3 – 44 days and depended on the relief of symptoms, indicators of complete blood count, CRP. In 3 months hypothyroidism developed in 25% of patients from group1, in group2 – in 90% of the cases, in group3 – in 37.5% of the cases.

Conclusion

The results indicate a higher incidence of hypothyroidism after STh in COVID 19-patients to compare ordinary STh.