Endocrine Abstracts

The impact of novel coronavirus (COVID-19) infection in adult patients with endocrine diseases is well established, with the evidence showing a link between endocrine pathology and disease severity (A. Badawi, S.G. Ryoo, 2016, J. Yang et al, 2020, S. Cianfarani, A. Brancatella, 2020). The thyroid gland and the virus infection with its associated inflammatory-immune responses are known to be engaged in complex interplay (L. Scappaticcio, et al, 2020). To date, no study has reported data on the interaction between novel coronavirus infection and endocrine diseases (for example, thyroiditis) in children (BTA/SFE, 2020).

Aim

To study impact of COVID-19 on the thyroid in children with Hashimoto’s thyroiditis.

Patients and methods

We observed 7 clinical cases of the disease in children after COVID-19. We studied retrospectively seven cases (6 girls and 1 boy, aged 10–18 y.o.) of Hashimoto’s thyroiditis in children enrolled in the pediatrics department. A clinical examination, hormonal analysis (free thyroxine, T4f, thyroid-stimulating hormone, TSH, thyroid peroxidase antibody, TPO and thyroglobulin antibodies, ATG) and thyroid ultrasound examination (USE) were conducted.

Results

COVID-19 had been mild in all children. Before the COVID-19 (6 months earlier) all children had a normal thyroid volume (WHO) and function both were normal, TPO level was was within 100–600 E/ml (ref: < 5.6 E/ml), ATG level was within 50–200 IE/ml (ref: < 18 IE/ml). In the treatment of COVID-19, human recombinant interferon alpha-2b preparations were used. After COVID-19 all cases showed an increase in thyroid volume by 20–30% at thyroid USE. At laboratory exams in all children were found to have elevated TPO (to 1000 E/l and more), in one patient was found to had elevated ATG (to 500 IE/ml and more), in one girl developed subclinical hypothyroidism and another patient presented with hypothyroidism.

Conclusions

A clinical case study showed that novel coronavirus infection aggravates the thyroid in children with Hashimoto’s thyroiditis. There is required careful thyroid monitoring in patients with Hashimoto’s thyroiditis during the pandemic of COVID-19.