Investigating thyroid dysfunction in the context of COVID-19 infection

Aashna Mehta; Wireko Andrew Awuah; Rohan Yarlagadda; Jacob Kalmanovich; Helen Huang; Mrinmoy Kundu; Esther Patience Nansubuga; Leilani Lopes; Bikona Ghosh; Mohammad Mehedi Hasan

doi:10.1016/j.amsu.2022.104806

Investigating thyroid dysfunction in the context of COVID-19 infection

Ann Med Surg (Lond). 2022 Dec:84:104806. doi: 10.1016/j.amsu.2022.104806. Epub 2022 Oct 31.

Authors

Affiliations

¹ University of Debrecen-Faculty of Medicine, Debrecen, 4032, Hungary.
² Sumy State University, Sumy, Ukraine.
³ Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
⁴ Drexel University, College of Medicine, Philadelphia, PA, USA.
⁵ Royal College of Surgeons in Ireland, University of Medicine and Health Science, Dublin, Ireland.
⁶ Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India.
⁷ Leeds Medical School, University of Leeds, UK.
⁸ Western University of Health Sciences, College of Osteopathic Medicine of the Pacific-Northwest, Lebanon, OR, USA.
⁹ Dhaka Medical College, Dhaka, Bangladesh.
¹⁰ Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh.

Abstract

COVID-19 is a contagious viral infection caused by severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2). One of the key features of COVID-19 infection is inflammation. There is increasing evidence pointing to an association between cytokine storm and autoimmunity. One autoimmune disease of interest in connection to COVID-19 is hyperthyroidism. COVID-19 has been shown to decrease TSH levels and induce thyrotoxicosis, destructive thyroiditis, and de novo Graves' disease. It has also been suggested that the immune response against SARS-CoV-2 antigens following vaccination can cross-react through a mechanism called molecular mimicry which can elicit autoimmune reactivity, potentially leading to potential thyroid disease post vaccine. However, if the COVID-19 vaccine is linked to reduced COVID-19 related serious disease, it could potentially play a protective role against post COVID-19 hyperthyroidism (de novo disease and exacerbations). Further studies investigating the complex interplay between COVID-19 or COVID-19 vaccine and thyroid dysfunction can help provide substantial evidence and potential therapeutic targets that can alter prognosis and improve COVID-19 related outcomes in individuals with or without preexisting thyroid disease.

Publication types

Review