Endocrine Abstracts

SAT due to viral infections is a cause of thyrotoxicosis, neck pain and tenderness on palpation. In the COVID-19 era, SAT seems to be a manifestation of the disease which occurs during SARS-CoV-2 infection. In 2021, some SAT cases were reported after COVID-19 vaccination. We reviewed the incidence of SAT from 2000 to 2021. In the Savona district vaccination of the general population started in February 2021 and progressively involved fragile, healthy elderly, adult and young-adult subjects. By the end of 2021, about 80% of adults in the Savona district had received at least two doses of COVID-19 vaccines. Electronic records from June to December in each year from 2000 to 2020 were searched. From 8115 medical files, 51 diagnoses of SAT were retrieved (35 females). In the corresponding period in 2021, SAT was diagnosed in 7 females after COVID-19 vaccination. From 2020 to 2021, 0.6% of patients in our centre had SAT and SAT occurred at the median age of 45 years (IQR 38-52) with an incidence of 2 cases/year (1-3). The long-term evolution of the disease was known in 25 cases and full thyroid recovery or chronic thyroiditis/hypothyroidism were observed in 72% and 28% of cases, respectively. From June to December 2021, the percentage of SAT in files was 1.5%. SAT diagnoses increased (P=0.03) in 2021 in comparison with the 2000-2020 period. The median age of SAT patients in 2021 (54 years; 50-61) was higher (P=0.05) than in the 2000-2020 period. To date, 6 women have been followed up for 2-4 months. In 2 women, a decrease in thyroid volume was noted, while in 4, TSH was suppressed or increased; in the remaining 2, L-T4 was ongoing. Pain, palpitation, fatigue and sweating disappeared after prednisone/NSAIDs discontinuation. To date, 19 cases (91% females; median age 40 years) of SAT after COVID-19 vaccinations have been described in the literature, with sub-clinical, normal or increased thyroid function in about 29%, 53% and 12% of cases, respectively, during follow-up. Our findings and the literature data indicate that SAT after COVID-19 vaccination is more frequent in females and at greater age than that occurs in other virus-related SAT cases. In our experience, thyroid function remains undefined after 2-4 months. Our observation of a local increase in SAT during the 2021 COVID-19 vaccination campaign indicates that physicians should be aware of this infrequent side effect, which must be considered and monitored after COVID-19 vaccination.