JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v3i3.2242 jpsim.v3i3.2242 Original Research COVID-19 and Thyroid Illness Latif Hina hinalatif2011@gmail.com * Iqbal Adil Farooq Nasir Rathore Rabia Department of Medicine, KEMU, Lahore *Correspondence: Hina Latif (hinalatif2011@gmail.com) 12 09 2022 2022 3 3 216 219 09 04 2022 04 07 2022 Copyright © 2022 The Author(s) 2022 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

We present a case series of three cases of thyroid dysfunction such as Hashimoto thyroiditis, Graves’ disease and sub acute thyroiditis presenting in few weeks after resolution of acute phase of COVID -19 infection in patients with no prior thyroid disease. Physicians should be acquainted with possible relationship of COVID-19 and thyroid dysfunction.

 Methodology

We discuss clinical manifestation, diagnostic evaluation and ensuing management and follow-up in each patient having thyroid dysfunction after getting positive for covid-19.

 Conclusion

The temporal relationship highlights the association of different forms of thyroid dysfunction with COVID-19 calling for further research to clarify the connections and answers to many questions.

 Keywords COVID-19 thyroid dysfunction various non-thyroidal illness syndrome subacute thyroiditis Graves' disease hashimoto thyroiditis References Caron P. Thyroid disorders and SARS-CoV-2 infection: from pathophysiological mechanism to patient management. Ann Endocrinol (Paris). 2020;81(5):507-10. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 382(18):1708-20. Pal R, Banerjee M. COVID-19 and the endocrine system: exploring the unexplored. J Endocrinol Invest 2020; 43(7):1027-31. Ding Y, He L, Zhang Q, Huang Z, Che X, Hou J, et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: Implications for pathogenesis and virus transmission pathways. J Pathol 2004;203(2):622-30. Desailloud R, Hober D. Viruses and thyroiditis: An update. Virol J. 2009;6(1):5. Dworakowska D, Grossman AB. Thyroid disease in the time of COVID-19. Endocrine 2020; doi: 10.1007/s12020-020-02364-8. Bellastella G, Maiorino MI, Esposito K. Endocrine complications of COVID-19: what happens to the thyroid and adrenal glands? J Endocrinol Invest 2020:1–2. https:// doi.org/10.1007/s40618-020-013118. Pal R, Banerjee M. COVID-19 and the endocrine system: exploring the unexplored. J Endocrinol Invest. 2020;doi: 10.1007/s40618-020-01276-8. Li MY, Li L, Zhang Y, Wang XS. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty.2020;9(1):45. Ding Y, He L, Zhang Q, Huang Z, Che X, Hou J, et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: Implications for pathogenesis and virus transmission pathways. J Pathol 2004;203(2):622-30. Barton LM, Duval EJ, Stroberg E, Ghosh S, Mukhopadhyay S. COVID-19 autopsies, Oklahoma, USA. Am J Clin Pathol 2020;153(6):725-33. Bradley BT, Maioli H, Johnston R, Chaudhry I, Fink SL, Xu H, et al. Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: a case series. Lancet 2020;396(10247):320-32. Rotondi M, Coperchini F, Ricci G, Denegri M, Croce L, Ngnitejeu ST, et al. Detection of SARS-COV-2 receptor ACE- 2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis. J Endocrinol Invest. 2021;44(5):1085-90. Lania A, Sandri MT, Cellini M, et al. Thyrotoxicosis in patients with COVID-19: the THYRCOV study. Eur J Endocrinol. 2020;183(4):381-7. Idrose AM. Acute and emergency care for thyrotoxicosis and thyroid storm. Acute Med Surg. 2015;2(3):147-57. Guan WJ, Ni ZY, Hu Y, et al. China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. Muller I, Cannavaro D, Dazzi D, et al. SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrinol. 2020;8(9):739-41. Scappaticcio L, Pitoia F, Esposito K, Piccardo A, Trimboli P. Impact of COVID-19 on the thyroid gland: an update. Rev Endocr Metab Disord. 2020; doi: 10.1007/s1115. Bellastella G, Maiorino MI, Esposito K. Endocrine complications of COVID-19: what happens to the thyroid and adrenal glands? J Endocrinol Invest. 2020;43(8):1169-1170. Croce L, Gangemi D, Ancona G, Liboà F, Bendotti G, Minelli L, et al. The cytokine storm and thyroid hormone changes in COVID-19. J Endocrinol Invest 2021;44(5):891- 904. Lania A, Sandri MT, Cellini M, Mirani M, Lavezzi E, Mazziotti G. Thyrotoxicosis in patients with COVID-19: THE THYRCOV STUDY. Eur J Endocrinol 2020;183(4):381-7. Chen M, Zhou W, Xu W. TThyroid function analysis in 50 patients with COVID-19: A retrospective study. Thyroid 2021; 31(1):8-11. Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Fong CHY, et al. Thyroid dysfunction in relation to immune profile, disease status, and outcome in 191 patients with COVID-19. J Clin Endocrinol Metab 2021;106(10):e926–35. Mateu-Salat M, Urgell E, Chico A. SARS-COV-2 as a trigger for autoimmune disease: report of two cases of Graves’ disease after COVID-19. J Endocrinol Invest 2020;43(12):1527–8. Nishihara E, Ohye H, Amino N, Takata K, Arishima T, Kudo T, et al. Clinical Characteristics of 852 Patients With Subacute Thyroiditis Before Treatment. Intern Med. 2008; 47(8):725–9. Benbassat CA, Olchovsky D, Tsvetov G, Shimon I. Subacute Thyroiditis: Clinical Characteristics and Treatment Outcome in Fifty-Six Consecutive Patients Diagnosed Between 1999 and 2005. J Endocrinol Invest. 2007;30(8):631–5.