BACKGROUND: The occurrence of Graves' disease and Hashimoto thyroiditis after coronavirus disease 2019 (COVID-19) raised concerns that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger thyroid autoimmunity. We aimed to address the current uncertainties regarding incident thyroid dysfunction and autoimmunity among COVID-19 survivors. METHODS: We included consecutive adult COVID-19 patients without known thyroid disorders, who were admitted to Queen Mary Hospital from July 21 to September 21, 2020 and had serum levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine (fT3), and anti-thyroid antibodies measured both on admission and at 3 months. RESULTS: In total, 122 patients were included. Among 20 patients with abnormal thyroid function tests (TFTs) on admission (mostly low fT3), 15 recovered. Among 102 patients with initial normal TFTs, two had new-onset abnormalities that could represent different phases of thyroiditis. Among 104 patients whose anti-thyroid antibody titers were reassessed, we observed increases in anti-thyroid peroxidase (TPO) (P<0.001) and anti-thyroglobulin (P<0.001), but not anti-thyroid stimulating hormone receptor titers (P=0.486). Of 82 patients with negative anti-TPO findings at baseline, 16 had a significant interval increase in anti-TPO titer by >12 U, and four became anti-TPO-positive. Worse baseline clinical severity (P=0.018), elevated C-reactive protein during hospitalization (P=0.033), and higher baseline anti-TPO titer (P=0.005) were associated with a significant increase in anti-TPO titer. CONCLUSION: Most patients with thyroid dysfunction on admission recovered during convalescence. Abnormal TFTs suggestive of thyroiditis occurred during convalescence, but infrequently. Importantly, our novel observation of an increase in anti-thyroid antibody titers post-COVID-19 warrants further follow-up for incident thyroid dysfunction among COVID-19 survivors.
BACKGROUND: The occurrence of Graves' disease and Hashimoto thyroiditis after coronavirus disease 2019 (COVID-19) raised concerns that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger thyroid autoimmunity. We aimed to address the current uncertainties regarding incident thyroid dysfunction and autoimmunity among COVID-19 survivors. METHODS: We included consecutive adult COVID-19patients without known thyroid disorders, who were admitted to Queen Mary Hospital from July 21 to September 21, 2020 and had serum levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine (fT3), and anti-thyroid antibodies measured both on admission and at 3 months. RESULTS: In total, 122 patients were included. Among 20 patients with abnormal thyroid function tests (TFTs) on admission (mostly low fT3), 15 recovered. Among 102 patients with initial normal TFTs, two had new-onset abnormalities that could represent different phases of thyroiditis. Among 104 patients whose anti-thyroid antibody titers were reassessed, we observed increases in anti-thyroid peroxidase (TPO) (P<0.001) and anti-thyroglobulin (P<0.001), but not anti-thyroid stimulating hormone receptor titers (P=0.486). Of 82 patients with negative anti-TPO findings at baseline, 16 had a significant interval increase in anti-TPO titer by >12 U, and four became anti-TPO-positive. Worse baseline clinical severity (P=0.018), elevated C-reactive protein during hospitalization (P=0.033), and higher baseline anti-TPO titer (P=0.005) were associated with a significant increase in anti-TPO titer. CONCLUSION: Most patients with thyroid dysfunction on admission recovered during convalescence. Abnormal TFTs suggestive of thyroiditis occurred during convalescence, but infrequently. Importantly, our novel observation of an increase in anti-thyroid antibody titers post-COVID-19 warrants further follow-up for incident thyroid dysfunction among COVID-19 survivors.
Authors: Mihaela Popescu; Adina Ghemigian; Corina Maria Vasile; Andrei Costache; Mara Carsote; Alice Elena Ghenea Journal: Diagnostics (Basel) Date: 2022-04-12
Authors: David Tak Wai Lui; Chi Ho Lee; Wing Sun Chow; Alan Chun Hong Lee; Anthony Raymond Tam; Polly Pang; Tip Yin Ho; Chloe Yu Yan Cheung; Carol Ho Yi Fong; Chun Yiu Law; Kelvin Kai Wang To; Ching Wan Lam; Kathryn Choon Beng Tan; Yu Cho Woo; Ivan Fan Ngai Hung; Karen Siu Ling Lam Journal: Front Endocrinol (Lausanne) Date: 2022-01-13 Impact factor: 5.555
Authors: David Tak Wai Lui; Matrix Man Him Fung; Keith Wan Hang Chiu; Chi Ho Lee; Wing Sun Chow; Alan Chun Hong Lee; Anthony Raymond Tam; Polly Pang; Tip Yin Ho; Carol Ho Yi Fong; Connie Hong Nin Loong; Wade Wei Wong; Cassandra Yuen Yan Lee; Chun Yiu Law; Kelvin Kai Wang To; Ching Wan Lam; Kathryn Choon Beng Tan; Yu Cho Woo; Ivan Fan Ngai Hung; Karen Siu Ling Lam; Brian Hung Hin Lang Journal: Endocrine Date: 2021-09-01 Impact factor: 3.633
Authors: D T W Lui; C H Lee; W S Chow; A C H Lee; A R Tam; C Y Y Cheung; C H Y Fong; S T M Kwok; C Y Law; K K W To; C W Lam; K C B Tan; Y C Woo; I F N Hung; K S L Lam Journal: J Endocrinol Invest Date: 2022-07-13 Impact factor: 5.467