Based on the chronological relationship observed in patients aged 18 years, doctors from the hospital suggested SARS-CoV-2 could be held responsible for the onset of subacute thyroiditis in patients.
“We report the first case of subacute thyroiditis after SARS-CoV-2 infection,” said lead researcher Francesco Latrofa, MD, of the University Hospital of Pisa in Pisa, Italy, in a statement. “Physicians must be vigilant about the possibility of these additional clinical manifestations related to COVID-19.”
Published in Journal of Clinical Endocrinology & Metabolism, this 12-page study outlines what researchers suggest as the first example of subacute thyroiditis caused by COVID-19. An 18-year-old woman who underwent an oropharyngeal swab for SARS-CoV-2 on February 28, 2020 – only 2 days after her father, who lived with her, was hospitalized with COVID-19.
Over the next few days, patients suffered from rhinorrhea and coughing, which according to the researchers was mild. This was left untreated and the patient completely recovered in 4 days. The patient then underwent 2 additional swabs for SARS-CoV-2 on March 13 and March 14 — both of these swabs returned negative.
After negative swabs, the patient suddenly develops 99.5 ° F fever, fatigue, palpitations, and anterior neck pain radiating to the jaw. Because of this pain, the patient was referred to the University of Pisa Hospital on March 19.
Physical examination at the hospital showed a heart rate of 90 beats per minute and, on palpation, the thyroid gland was enlarged, slightly soft, and very painful. Laboratory test results show high levels of free thyroxine (FT4) and triiodothyronine (FT3), TSH not detected, and markers of increased inflammation and white blood cell counts. Hospital ultrasonography performed at the hospital indicates bilateral and diffuse hypoechoic areas.
Of note, examination from 20 February 2020 showed normal thyroid function and imaging. After treatment with prednisone 25 mg / day, the patient’s fever and neck pain subside in 2 days and the remaining symptoms disappear within a week. A follow-up visit conducted on April 27 returned a normal thyroid function test and inflammation marker.
“To our knowledge, this is the first SAT case related to SARS-CoV-2. Because of the chronological relationship, SARS-CoV-2 can be held responsible for the emergence of subacute thyroiditis, “the researchers concluded.
This study, “Subacute Thyroiditis After SARS-CoV-2 Infection,” published in Journal of Clinical Endocrinology & Metabolism.
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