Endocrine Abstracts

Introduction: The SARS-CoV-2 virus has severely affected humanity. The disease causes pneumonia which may be severe. In many cases, patients, especially if there are comorbidities, may have a fatal outcome. The disease affects all organs and the variability of its manifestations has attracted intense scientific interest.

Aim: The aim of the study was to describe the case of a patient who developed subacute thyroiditis after infection with the SARS-CoV-2 virus.

Case description: A patient, female, aged 52 years, developed signs of respiratory infection with a mild clinical picture and fatigue. Hospitalization was not necessary. Sixty days later, she developed signs of subacute thyroiditis with pain in the area of the thyroid gland radiating to the ears, hyperidrosis, tachycardia and intense fatigue. Laboratory investigations revealed IgG Ab COVID-19 31.9 (normal values <1) (ELISA), IgM Ab COVID-19 0.6 (normal values <1) (ELISA), CRP 4.27 mg/dl (normal values <0.5 mg/dl), ESR 85 mm/h and TSH 0.03 μIU/ml. A thyroid ultrasonogram was performed which revealed hypoechoic areas. Non-steroidal-anti-inflammatory drugs were administered which led to pain relief. A month later the patient presented with tachycardia, pain in the area of the thyroid and fatigue. Methylprednisolone was administered 16 mgx2 daily and propranolol 20 mgx2 daily and the patient improved. However, a month later the patient presented with disease relapse. Methylprednisolone 16 mgx2 was administered and the patient improved and is now asymptomatic.

Conclusions: The disease caused by the SARS-CoV-2 virus affects all organ systems. The virus enters cells by attaching to the ACE2 (angiotensin converting enzyme 2) which acts as a receptor for the virus. It has been observed that thyroid cells express the ACE2. It appears that the SARS-CoV-2 virus infects thyroid cells via the ACE2. Cases of subacute thyroiditis, a post-inflammatory disease, have been described mainly in female patients after SARS-CoV-2 infection. In conclusion, it appears that the SARS-CoV-2 virus may affect the thyroid gland.