Endocrine Abstracts

Scientists have studied the direct effect of Civi19 on the pancreas and thyroid gland, in particular, on the development of subacute thyroiditis de Quervian. Our study describes 9 cases of subacute thyroiditis associated with coronavirus infection. Three patients had a mild form of covid19 (positive PCR test result). Subacute thyroiditis was one of the components of multiple organ lesions. Patients had typical manifestations of thyroiditis neck pain, cough, signs of hyperthyroidism. Palpation of the neck revealed local soreness and thickening in the thyroid gland. Laboratory parameters corresponded to the activity of the process (ESR -28,17,35 (respectively), CRP -9,13, 17 (respectively), Ig M level: 4,2, 3,8 and 5,9 (respectively). The main method of examination was ultrasound (separate hypoechoic heterogeneous areas in the thyroid without clear contours). In 4 patients with covid19 of moderate severity, subacute thyroiditis was detected at the rehabilitation stage (all had a negative PCR test, Ig M – 2.2; 1.4; 2.3 and 1.7 (respectively), IgG -34, 121, 231 and 33 (respectively)). It is possible that the disease began at the peak of coronavirus infection. Clinical and laboratory indicators did not indicate a generalized infectious process. The thyroid gland lesions were revealed on the basis of complaints (neck pain) and a specific ultrasound picture (characteristic heterogeneity, hypoechoic zones without clear boundaries with uneven contours according to the type of geographical map with changes in blood flow activity depending on the phase of the process). Two patients with subacute thyroiditis occurred 4 and 5 months after covid19. Before the appearance of subacute thyroiditis, patients had no other viral diseases. The PCR test at the time of treatment was negative. The clinical picture corresponded to subacute thyroiditis: neck pain during swallowing and movement, subfebrility. According to ultrasound dates, there were extensive hypoechoic hypovascular zones in the thyroid with indistinct uneven contours and pronounced hyperplasia of the cervical lymph nodes). Laboratory studies revealed elevated levels of ESR and CRP, titers Ig G -233 and 76 (respectively), Ig M -0.7 and 1.1 (respectively).

Conclusion: Subacute thyroiditis associated with Covid19 can develop into various phases of viral disease. In the diagnosis of thyroiditis associated with covid19, the main diagnostic marker is ultrasound, which requires an assessment of the clinical status. Clinical and laboratory parameters are labile and depend on the stage of the disease. Therefore, all patients with covid19 should undergo thyroid ultrasound at the stages of treatment in order to exclude thyroid damage.