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评价 COVID-19 疫苗相关性亚急性甲状腺炎的诊断特征和临床病程。

Evaluation of the diagnostic features and clinical course of COVID-19 vaccine-associated subacute thyroiditis.

机构信息

Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ziraat Mahallesi, Şht. Ömer Halisdemir Blv No. 1, 06110, AltindagAnkara, Turkey.

出版信息

Hormones (Athens). 2022 Sep;21(3):447-455. doi: 10.1007/s42000-022-00380-z. Epub 2022 Jun 16.

Abstract

OBJECTIVE

This study aimed to identify cases of coronavirus disease 2019 (COVID-19) vaccine-associated subacute thyroiditis (SAT) during the active vaccination period of the pandemic, analyze the characteristics of these cases, and compare them with cases of non-vaccine associated SAT diagnosed in the same period.

METHODS

A total of 55 patients diagnosed with SAT in our outpatient clinic between February and October, 2021, were included in this retrospective single-center study.

RESULTS

Of the study population, 16 (29.1%) were diagnosed with COVID-19 vaccine-associated SAT (10 with CoronaVac® and six with Pfizer-BioNTech® vaccine), with a median time to onset of symptoms after vaccination of 6.5 (range, 2-20) days. There was no statistically significant difference between the vaccine-associated (VA) and non-vaccine associated (NVA) groups in terms of age, gender, time to diagnosis, thyroid volumes, thyroid function tests, and acute phase reactants. Seven (43.8%) and 25 (64.1%) patients were treated with methylprednisolone in the VA group and NVA group, respectively (p = 0.16). Follow-up data of 45 patients (16/16 for VA and 29/39 for NVA) were available. The mean follow-up of these patients was 47.4 ± 19.4 days, and the follow-up periods of the VA group and NVA group were comparable (p = 0.24). There was no difference between the two groups in terms of the frequency of euthyroidism at the follow-up visit (12/16 vs.14/29, p = 0.08).

CONCLUSION

With the increase in COVID-19 vaccination rates during the current pandemic, VA SAT cases are seen more frequently. The present study demonstrated that these cases have similar diagnostic features and clinical course to that of classic forms of SAT. In addition, most patients with VA SAT had a mild clinical course that improved with non-steroidal anti-inflammatory drugs.

摘要

目的

本研究旨在识别大流行期间 COVID-19 疫苗相关亚急性甲状腺炎(SAT)病例,分析这些病例的特征,并将其与同期诊断的非疫苗相关 SAT 病例进行比较。

方法

本回顾性单中心研究纳入了 2021 年 2 月至 10 月期间在我们门诊确诊的 55 例 SAT 患者。

结果

在研究人群中,有 16 例(29.1%)被诊断为 COVID-19 疫苗相关 SAT(10 例使用科兴疫苗,6 例使用辉瑞疫苗),接种后症状出现的中位时间为 6.5(范围 2-20)天。疫苗相关组(VA 组)和非疫苗相关组(NVA 组)在年龄、性别、诊断时间、甲状腺体积、甲状腺功能检查和急性期反应物方面无统计学差异。VA 组和 NVA 组分别有 7(43.8%)和 25(64.1%)例患者接受了甲泼尼龙治疗(p=0.16)。VA 组和 NVA 组分别有 45 例患者(16/16 和 29/39)的随访数据可用。这些患者的平均随访时间为 47.4±19.4 天,VA 组和 NVA 组的随访时间相当(p=0.24)。两组在随访时甲状腺功能正常的频率无差异(12/16 例 vs. 14/29 例,p=0.08)。

结论

随着当前大流行期间 COVID-19 疫苗接种率的增加,VA SAT 病例更为常见。本研究表明,这些病例具有与经典 SAT 相似的诊断特征和临床病程。此外,大多数 VA SAT 患者的临床病程较轻,用非甾体抗炎药即可改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42da/9203142/fae88caccd16/42000_2022_380_Fig1_HTML.jpg

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