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新冠病毒感染患者中的亚急性甲状腺炎

Subacute Thyroiditis in COVID-19 Patients.

作者信息

Sohrabpour Saeed, Heidari Farrokh, Karimi Ebrahim, Ansari Reza, Tajdini Ardavan, Heidari Firouzeh

机构信息

Otorhinolaryngology Research Center, Amir-Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Eur Thyroid J. 2021 Feb;9(6):321-323. doi: 10.1159/000511707. Epub 2020 Oct 30.

Abstract

INTRODUCTION

Since December 2019, novel coronavirus (COVID-19) infection has been identified as the cause of an outbreak of respiratory illness in Wuhan, China. The classic presentation of COVID-19 infection was described as fever, myalgia, cough, and fatigue. Whether coronavirus can directly attack the endocrine glands is unclear.

OBJECTIVE

Post-viral subacute thyroiditis (SAT, de Quervain thyroiditis) has been reported following other viral infection. A limited number of SAT after COVID-19 infection have been reported up to now.

METHODS

Here, we reported 6 patients with SAT and positive COVID-19 serology tests. Demographic, clinical, biochemical, and imaging data were presented.

RESULTS

In this study, 6 patients (4 women and 2 men) with clinician manifestations and physical examination in favor of SAT were described. Cervical ultrasonography showed bilateral hypoechoic areas in the thyroid gland which was suggestive of SAT. Elevated C-reactive protein, erythrocyte sedimentation rate, free thyroxine, free tri-iodothyronine, and undetectable thyrotropin were found in laboratory evaluations. Both IgM and IgG were positive for COVID-19 infection, but the PCR tests were negative in all patients. Patients had history of working in a COVID center and/or family member hospitalized due to COVID-19 pneumonia. Patients were followed up for 1 month and were treated effectively with steroids.

CONCLUSION

This report may help physicians to identify lesser-known manifestations and complications of COVID-19. Early diagnosis of COVID-19 infection results in the prevention of further transmission.

摘要

引言

自2019年12月以来,新型冠状病毒(COVID-19)感染已被确认为中国武汉呼吸道疾病暴发的病因。COVID-19感染的典型表现被描述为发热、肌痛、咳嗽和疲劳。冠状病毒是否能直接攻击内分泌腺尚不清楚。

目的

其他病毒感染后曾有过病毒性亚急性甲状腺炎(SAT,德奎尔万甲状腺炎)的报道。截至目前,COVID-19感染后发生SAT的病例报道较少。

方法

在此,我们报告了6例SAT且COVID-19血清学检测呈阳性的患者。呈现了人口统计学、临床、生化和影像学数据。

结果

在本研究中,描述了6例具有支持SAT的临床表现和体格检查结果的患者(4名女性和2名男性)。颈部超声显示甲状腺双侧低回声区,提示为SAT。实验室评估发现C反应蛋白、红细胞沉降率、游离甲状腺素、游离三碘甲状腺原氨酸升高,促甲状腺激素未检测到。COVID-19感染的IgM和IgG均呈阳性,但所有患者的PCR检测均为阴性。患者有在COVID中心工作的经历和/或有因COVID-19肺炎住院的家庭成员。对患者进行了1个月的随访,并用类固醇进行了有效治疗。

结论

本报告可能有助于医生识别COVID-19鲜为人知的表现和并发症。COVID-19感染的早期诊断有助于预防进一步传播。

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