Endocrine Abstracts

Objectives: The number of reported cases COVID-19 associated subacute thyroiditis (ST) in literature is small thus peculiarities of its clinical features remain the subject of interest. The aim of the review is to share our experience of COVID-19 associated ST.

Materials and Methods: We describe 5 cases of COVID-19 associated ST. SARS-CoV-2 diagnosis was based on the presence of its typical symptoms and real-time polymerase chain reaction on nasopharyngeal swab or by positivity of specific IgG.

Results: ST manifested in 15-28 days after COVID-19. General symptomatology (asthenia and malaise) was recorded in all cases. Neck pain and subfebrile temperature presented in 60% cases, one patient described some discomfort in neck but without pain. Thyroid function tests showed mild thyrotoxicosis in three patients (60%) and two patients were euthyroid (40% cases). The median ESR was 28 (18-36). Thyroid ultrasound showed the typical characteristics (hypoechogenic areas with reduced vascularization) in 100 % cases. Steroid therapy with methylprednisolone was the administered in all case. The euthyroid patient with neck discomfort received non-steroidal anti-inflammatory agents firstly, but after 7-12 days they both represented the negative dynamic and treatment with steroids was initiated. The median dose of methylprednisolone was 24 mg. One of the patient had relapse of the process after steroid withdrawal and needed to be cured repeatedly. The time of active cure with glucocorticoids lasted from 3 to 12 month.

Conclusion: Available literature suggests that forms COVID -19 associated ST are mild and sometimes do not require specific treatment. Our experience showed that the disease had more covert clinical symptoms but long period of duration.