A Prospective Observational Study of 42 Patients with COVID-19 infection and a History of Hepatitis C Virus Infection and Thyroid Disease with Follow-Up Thyroid Function and Autoantibody Testing

Med Sci Monit. 2021 Dec 31:27:e935075. doi: 10.12659/MSM.935075.

Abstract

BACKGROUND Thyroiditis is an important extrahepatic association in chronic hepatitis C virus (HCV) infection. There have been reports of an association between SARS-CoV-2 infection and the onset or re-activation of autoimmune hypothyroidism. Therefore, we performed this prospective observational study of 42 patients with COVID-19 infection and a history of hepatitis C virus infection and thyroid disease with follow-up thyroid function and autoantibody testing. MATERIAL AND METHODS From April 2020 to October 2020, we performed a prospective observational study of patients with cured hepatitis C virus (HCV) infection and documented thyroid disease who became infected with SARS-CoV-2 (confirmed by SARS-CoV-2 RNA detection via reverse-transcription polymerase chain reaction [RT-PCT] from the upper respiratory tract, both nasal and pharyngeal swabs). Evaluation at 1 and 3 months after SARS-CoV-2 infection included serum determination of antithyroid antibodies (anti-thyroglobulin [anti-Tg] and antithyroid peroxidase [ATPO]), thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and evaluation of thyroid medication, with dose adjustment if required. RESULTS One-month follow-up showed that both patients with autoimmune thyroiditis as well as patients without antibodies had increased ATPO levels. Also, levels of TSH, fT3, and fT4 were significantly decreased. At 3-month follow-up, levels of ATPO were decreased in all patient groups and the levels of thyroid hormones increased to normal values. CONCLUSIONS This study supports previous reports of an association between SARS-CoV-2 infection and thyroid dysfunction associated with thyroid autoantibodies. Thyroid function tests may be considered as part of the laboratory work-up in patients with COVID-19.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • COVID-19 / complications*
  • COVID-19 / virology
  • Female
  • Follow-Up Studies
  • Hepacivirus / pathogenicity
  • Hepatitis C / complications*
  • Hepatitis C / virology
  • Humans
  • Hypothyroidism / etiology*
  • Hypothyroidism / physiopathology
  • Hypothyroidism / virology
  • Male
  • Middle Aged
  • Prospective Studies
  • RNA, Viral
  • Romania / epidemiology
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / pathogenicity
  • Thyroid Diseases / physiopathology
  • Thyroid Function Tests
  • Thyroid Gland / physiology
  • Thyroiditis, Autoimmune / blood
  • Thyroiditis, Autoimmune / immunology
  • Thyrotropin / blood
  • Thyroxine / blood
  • Triiodothyronine / blood

Substances

  • RNA, Viral
  • Triiodothyronine
  • Thyrotropin
  • Thyroxine