Associate Professor of Medicine and Endocrinology, Department of Clinical Science, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
J Int Med Res. 2022 Feb;50(2):3000605221082898. doi: 10.1177/03000605221082898.
In this review, I aim to provide a complete overview of recent advances in knowledge regarding severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2)-induced thyroid dysfunction. I discuss the findings regarding the role of SARS-CoV-2 in the development of thyroid dysfunction, including subacute thyroiditis, Graves' disease, non-thyroidal illness, thyrotoxicosis and Hashimoto's thyroiditis during and subsequent to coronavirus disease 2019 (COVID-19). The thyroid gland and the entire hypothalamic-pituitary-thyroid (HPT) axis may represent key targets of SARS-CoV-2. Thyroid dysfunction during and subsequent to COVID-19 has been documented in clinical studies and is usually reversible. Most of the thyroid disorders, including Graves' disease, euthyroid sick syndrome, Hashimoto's thyroiditis and subacute thyroiditis, have been documented as sequelae to COVID-19, and the SARS-CoV-2 virus has been implicated in the aetiology of each. COVID-19 has been suggested to trigger the activation of pre-existing thyroid disease or autoimmunity. Furthermore, patients with uncontrolled thyrotoxicosis are at risk of SARS-CoV-2 infection-related consequences. Because of the neutropenia caused by antithyroid medications, which may obscure the signs of COVID-19, this group of patients should receive special attention. It is suggested that thyroid dysfunction during COVID-19 is caused by direct infection of the thyroid or "cytokine storm"-mediated autoimmune effects on the thyroid.
在这篇综述中，我旨在全面概述关于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的甲状腺功能障碍的最新知识进展。我讨论了 SARS-CoV-2 在甲状腺功能障碍发展中的作用的发现，包括亚急性甲状腺炎、格雷夫斯病、非甲状腺疾病、甲状腺毒症和 COVID-19 期间和之后的桥本甲状腺炎。甲状腺和整个下丘脑-垂体-甲状腺（HPT）轴可能是 SARS-CoV-2 的关键靶标。在 COVID-19 期间和之后已经在临床研究中记录到甲状腺功能障碍，并且通常是可逆的。大多数甲状腺疾病，包括格雷夫斯病、甲状腺机能正常的病态综合征、桥本甲状腺炎和亚急性甲状腺炎，都被记录为 COVID-19 的后遗症，而 SARS-CoV-2 病毒被认为与每种疾病的病因有关。COVID-19 被认为会引发先前存在的甲状腺疾病或自身免疫的激活。此外，患有未经控制的甲状腺毒症的患者有感染 SARS-CoV-2 相关后果的风险。由于抗甲状腺药物引起的中性粒细胞减少症可能掩盖 COVID-19 的迹象，因此应特别关注这群患者。有人建议，COVID-19 期间的甲状腺功能障碍是由甲状腺的直接感染或“细胞因子风暴”对甲状腺的自身免疫作用引起的。
