Șandru Florica, Carsote Mara, Petca Răzvan Cosmin, Gheorghisan-Galateanu Ancuta Augustina, Petca Aida, Valea Ana, Dumitrașcu Mihai Cristian
Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania.
Exp Ther Med. 2021 Jul;22(1):756. doi: 10.3892/etm.2021.10188. Epub 2021 May 13.
In patients who were not previously diagnosed with any thyroid conditions, the scenario of COVID-19-related anomalies of the hypothalamus-pituitary-thyroid axes may include either: A process of central thyroid stimulating hormone (TSH) disturbances via virus-related hypophysitis; an atypical type of subacute thyroiditis which is connected to the virus spread or to excessive cytokine production including a destructive process with irreversible damage of the gland or low T3 (triiodothyronine) syndrome (so called non-thyroid illness syndrome) which is not specifically related to the COVID-19 infection, but which is associated with a very severe illness status. Our objective here was to briefly review thyroid changes due to the COVID-19 infection. Ongoing assessment of the effects of the COVID-19 pandemic will reveal more information on coronavirus-induced thyroid conditions. Routine thyroid assays performed in patients with severe infection/at acute phase of COVID-19 are encouraged in order to detect thyrotoxicosis. After recovery, thyroid function should be assessed to identify potential hypothyroidism. There remain unanswered questions related to the prognostic value of interleukin-6 in infected patients, especially in cases with cytokine storm, and the necessity of thyroid hormone replacement in subjects with hypophysitis-related central hypothyroidism.
在既往未被诊断患有任何甲状腺疾病的患者中，新型冠状病毒肺炎（COVID-19）相关的下丘脑-垂体-甲状腺轴异常情况可能包括以下两种：一是通过病毒相关的垂体炎导致中枢性促甲状腺激素（TSH）紊乱的过程；二是一种非典型的亚急性甲状腺炎，它与病毒传播或细胞因子过度产生有关，包括腺体发生不可逆损伤的破坏性过程或低三碘甲状腺原氨酸（T3）综合征（即所谓的非甲状腺疾病综合征），这种综合征并非与COVID-19感染有特异性关联，而是与非常严重的疾病状态相关。我们在此的目的是简要回顾COVID-19感染导致的甲状腺变化。对COVID-19大流行影响的持续评估将揭示更多关于冠状病毒诱发的甲状腺疾病的信息。鼓励对重症感染患者/处于COVID-19急性期的患者进行常规甲状腺检测，以便检测甲状腺毒症。康复后，应评估甲状腺功能以确定潜在的甲状腺功能减退。关于白细胞介素-6在感染患者中的预后价值，尤其是在细胞因子风暴的情况下，以及垂体炎相关的中枢性甲状腺功能减退患者中甲状腺激素替代的必要性，仍存在未解答的问题。
