Zarkesh Maryam, Sanoie Maryam, Heydarzadeh Shabnam, Abooshahab Raziyeh, Daneshafrooz Afsoon, Hosseinpanah Farhad, Hedayati Mehdi
Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Curtin Medical School, Curtin University, Bentley, Australia.
Int J Endocrinol Metab. 2024 Oct 27;22(3):e146857. doi: 10.5812/ijem-146857. eCollection 2024 Jul.
This systematic review sought to address three key questions: (1) what differences in abnormal thyroid function test results are observed between COVID-19 patients and healthy individuals? (2) How does the severity of COVID-19 infection influence the development of thyroid dysfunction? (3) What impact do COVID-19 vaccines have on thyroid function and autoimmune processes?
A literature search was conducted in PubMed, Web of Science, and Scopus from December 2019 to April 2023 to identify studies on thyroid dysfunction in COVID-19 patients without pre-existing thyroid conditions. The search focused on observational and case-control studies.
The literature search yielded 329 reports, from which duplicates and unrelated publications were excluded. Ultimately, 21 studies met the inclusion criteria and were selected for review. A second literature search yielded 605 reports, from which 5 studies were selected for inclusion in the systematic review.
The findings suggest that SARS-CoV-2 infection can induce transient and reversible thyroid dysfunction, possibly through direct viral effects on the thyroid gland or via indirect immune-mediated mechanisms. Clinicians should be mindful of the potential, albeit rare, thyroid-related adverse effects of COVID-19 vaccines and monitor thyroid function, particularly in high-risk individuals.
本系统评价旨在解决三个关键问题：（1）新冠病毒疾病（COVID-19）患者与健康个体在甲状腺功能检查异常结果方面有哪些差异？（2）COVID-19感染的严重程度如何影响甲状腺功能障碍的发生？（3）COVID-19疫苗对甲状腺功能和自身免疫过程有何影响？
于2019年12月至2023年4月在PubMed、科学网和Scopus数据库中进行文献检索，以识别无既往甲状腺疾病的COVID-19患者甲状腺功能障碍的研究。检索重点为观察性研究和病例对照研究。
文献检索得到329篇报告，从中排除重复和不相关的出版物。最终，21项研究符合纳入标准并被选入综述。第二次文献检索得到605篇报告，从中选取5项研究纳入系统评价。
研究结果表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可能通过病毒对甲状腺的直接作用或间接免疫介导机制诱导短暂且可逆的甲状腺功能障碍。临床医生应注意COVID-19疫苗潜在的、尽管罕见的甲状腺相关不良反应，并监测甲状腺功能，尤其是在高危个体中。
