Thyroiditis associated with COVID-19: Is there a difference between subacute thyroiditis the other viral etiology?
https://doi.org/10.62751/2713-0177-2025-6-4-09
Abstract
Subacute thyroiditis (ST; synonyms: granulomatous thyroiditis, De Kerven’s thyroiditis, viral thyroiditis, giant cell thyroiditis) is a inflammatory disease of thyroid gland (TG), presumably viral etiology, lasting from one week to several months, аt the height of the disease most often manifested by a pronounced pain in the area of TG and fever, sometimes with attachment of symptoms of thyrotoxicosis; having a tendency to reccurence. The COVID-19 pandemic has changed established perceptions about epidemiology, pathogenesis, clinical characteristics of thyroid infections associated with viral infections. Clinical symptoms and laboratory signs that were previously considered pathognetic for ST (neck pain, fever, pronounced increase in erythrocyte sedimentation rate) can no longer be considered as such. Despite the availability of instrumental and laboratory methods of investigation, there are currently some difficulties in the diagnosis and differential diagnosis of ST. Thus, the objective of this review is to synthesize new data on the diagnosis of ST, its clinical course and approaches to patient management.
Supporting agencies: This work was carried out within the framework of the State Contract “Hormonal-metabolic and molecular-cellular characteristics of thyroid diseases as a basis for the development of innovative methods of diagnosis, treatment, and prevention” (Research Project No. 123021300097-0).
About the Authors
E. A. Troshina
Endocrinology Research Centre
Russian Federation
Russian Federation
Ekaterina А. Troshina – D. Sci. (Med.), Corresponding Member of the Russian Academy of Sciences, Prof., Director of the Institute of Clinical Endocrinology
Moscow
V. D. Ankina
Endocrinology Research Centre
Russian Federation
Russian Federation
Vlada A. Denisovna – Clinical Resident
Moscow
N. V. Mazurina
Endocrinology Research Centre
Russian Federation
Russian Federation
Natalia V. Mazurina – D. Sci. (Med.), Senior Researcher at Department of Therapeutic Endocrinology
Researcher ID: S-2312-2016
Moscow
N. M. Platonova
Endocrinology Research Centre
Russian Federation
Russian Federation
Nadezhda M. Platonova – D. Sci. (Med.), Head of the Department of Therapeutic Endocrinology, Scientific Research Center
Moscow
References
1. Трошина Е.А., Панфилова Е.А., Михина М.С., Ким И.В., Сенюшкина Е.С., Глибка А.А. с соавт. Клинические рекомендации «Острые и хронические тиреоидиты (исключая аутоиммунный тиреоидит)». Проблемы эндокринологии. 2021;67(2):57–83. doi: 10.14341/probl12747.
2. Stasiak M, Lewinski A. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021;22(4):1027–39. doi: 10.1007/s11154-021-09648-y.
3. Brancatella A, Ricci D, Viola N, Sgro D, Santini F, Latrofa F. Subacute thyroiditis after SARS-CoV-2 infection. J Clin Endocrinol Metab. 2020;105(7):dgaa276. doi: 10.1210/clinem/dgaa2768.
4. Aemaz Ur Rehman M, Farooq H, Ali MM, Ebaad Ur Rehman M, Dar QA, Hussain A. The association of subacute thyroiditis with COVID-19: A systematic review. SN Compr Clin Med.2021;3(7):1515–27. doi: 10.1007/s42399-021-00912-5.
5. Ippolito S, Dentali F, Tanda ML. SARS-CoV-2: A potential trigger for subacute thyroiditis? Insights from a case report. J Endocrinol Invest. 2020;43(8):1171–72. doi: 10.1007/s40618-020-01312-7.
6. Meftah E, Rahmati R, Zari Meidani F, Khodadadi S, Chitzan-Zadeh K, Esfahanian F, Afshar S. Subacute thyroiditis following COVID-19: A systematic review. Front Endocrinol (Lausanne). 2023;14:1126637. doi: 10.3389/fendo.2023.1126637.
7. San Juan MDJ, Florencio MQV, Joven MH. Subacute thyroiditis in a patient with coronavirus disease 2019. AACE Clin Case Rep. 2020;6(6):361–64. doi: 10.4158/ACCR-2020-0524.
8. Ruggeri RM, Campennì A, Siracusa M, Frazzetto G, Gulloet D. Subacute thyroiditis in a patient infected with SARS-CoV-2: An endocrine complication linked to the COVID-19 pandemic. Hormones (Athens). 2020;20(1):219–21. doi: 10.1007/s42000-020-00230-w.
9. Muller I, Cannavaro D, Dazzi D, Covelli D, Mantovani G, Muscatello A et al. SARSCoV-2-related atypical thyroiditis. Lancet Diabet Endocrinol. 2020;8(9):739–41. doi: 10.1016/S2213-8587(20)30266-7.
10. Lania A, Sandri MT, Cellini M, Mirani M, Lavezzi E, Mazziotti G et al. Thyrotoxicosis in patients with COVID-19: The THYRCOV study. Eur J Endocrinol. 2020;183(4):381–87. doi: 10.1530/EJE-20-0335.
11. Dolkar T, Jitidhar F, Patel MJ, Hamad AM, Salauddin F, Shiferaw-Deribe Z et al. Painless subacute thyroiditis in a patient with acute COVID-19 infection: A transient event. Cureus. 2022;14(7):e26924. doi: 10.7759/cureus.26924.
12. Mondal S, DasGupta R, Lodh M, Ganguly A. Subacute thyroiditis following recovery from COVID-19 infection: Novel clinical findings from an Eastern Indian cohort. Postgraduate Med J. 2023;99(1172):558–65. doi: 10.1136/postgradmedj-2021-141429.
13. Trimboli P, Cappelli C, Croce L, Scappaticcio L, Chiovato L, Rotondi M. COVID-19- associated subacute thyroiditis: Evidence-based data from a systematic review. Front Endocrinol (Lausanne). 2021;12:707726. doi: 10.3389/fendo.2021.707726.
14. Popescu M, Ghemigian A, Vasile CM, Costache A, Carsote M, Ghenea AE. The new entity of subacute thyroiditis amid the COVID-19 pandemic: From infection to vaccine. Diagnostics.2022;12(4):960. doi: 10.3390/diagnostics12040960.
15. Dhakal BP, Sweitzer NK, Indik JH, Acharya D, William P. SARS-CoV-2 infection and cardiovascular disease: COVID-19 heart. Heart Lung Circ. 2020;29(7):973–87. doi: 10.1016/j.hlc.2020.05.101.
16. Viola N, Brancatella A, Sgro D, Santini F, Latrofa F. Clinical, biochemical features and functional outcome of patients with SARS-CoV-2-related subacute thyroiditis: A review. Endocrine. 2023;79(3):448–54. doi: 10.1007/s12020-022-03247-w.
17. Ray I, D’Souza B, Sarker P, Agarwal P. Management of subacute thyroiditis – a systematic review of current treatment protocols. Int J Gen Med. 2022:15:6425–39. doi: 10.2147/IJGM.S366784.
18. Scappaticcio L, Pitoia F, Esposito K, Piccardo A, Trimboli P. Impact of COVID-19 on the thyroid gland: An update. Rev Endocr Metab Disord. 2021;22(4):803–15. doi: 10.1007/s11154-020-09615-z.
19. Poma A, Bonuccelli D, Giannini R, Macerola E, Vignali P, Ugolini C et al. COVID-19 autopsy cases: Detection of virus in endocrine tissues. J Endocrinol Invest. 2022;45(1):209–14. doi: 10.1007/s40618-021-01628-y.
20. Turkmen Sarıyıldız G, Cicek C, Arslan AI, Demir ME. COVID-19 and COVID-19 vaccines-related subacute thyroiditis: Analysis of a case series. Anatolian Curr Med J. 2022;4(2):138–45. doi: 10.38053/acmj.1061185.
21. Stasiak M, Tymoniuk B, Michalak R, Stasiak B, Kowalski ML, Lewinski A. Subacute thyroiditis is associated with HLA-b*18:01, – DRB1*01 and – c*04:01 – the significance of the new molecular background. J Clin Med. 2020;9(2):534. doi: 10.3390/jcm9020534.
22. Korkmaz FN, Gokcay Canpolat A, Dalva K, Sahin M, Corapcıoglu D, Demir O. Common human leucocyte antigen sassociated with the development of subacute thyroiditis and COVID-19. Hum Immunol. 2024;85(4):110834. doi:10.1016/j.humimm.2024.110834.
23. Yorulmaz G, Sahin Tekin M. SARS-CoV-2 vaccine-associated subacute thyroiditis. J Endocrinol Invest. 2022;45(7):1341–47. doi: 10.1007/s40618-022-01767-w.
24. Lampropoulou E, Benz C, Kahaly GJ, Fuhrer D. Thyroid inflammation and immunity during the COVID-19 pandemic: A comprehensive review and case study. Horm Metab Res. 2024;56(2):111–17. doi: 10.1055/a-2222-6300.
25. Lui DTW, Lee CH, Woo YC, Hung IFN, Lam KSL. Thyroid dysfunction in COVID-19. Nat Rev Endocrinol. 2024;20(6):336–48. doi: 10.1038/s41574-023-00946-w.
26. Patrizio A, Ferrari SM, Elia G, Ragusa F, Paparo SR, Mazzi V et al. Graves' disease following SARS-CoV-2 vaccination: A systematic review. Vaccines (Basel). 2022;10(9):1445. doi: 10.3390/vaccines10091445.
27. Lanzo N, Patera B, Fazzino GFM, Gallo D, Lai A, Piantanida E et al. The old and the new in subacute thyroiditis: An integrative review. Endocrines.2022;3(3):391–410. doi: 10.3390/endocrines3030031.
28. Sahin Tekin M, Yorulmaz G, Yantir E, Gunduz E, Colak E. A Novel finding of an HLA Allele's and a haplotype's relationship with SARS-CoV-2 vaccine-associated subacute thyroiditis. Vaccines (Basel). 2022;10(12):1986. doi: 10.3390/vaccines10121986.
29. Sendur SN, Ozmen F, Oguz SH, Iremli BG, Malkan UY, Gurlek A et al. Association of human leukocyte antigen genotypes with severe acute respiratory syndrome coronavirus 2 vaccine-induced subacute thyroiditis. Thyroid. 2022;32(6):640–47. doi: 10.1089/thy.2022.0010.
30. Stasiak M, Zawadzka-Starczewska K, Lewinski A. Significance of HLA haplotypes in two patients with subacute thyroiditis triggered by mRNA-based COVID-19 vaccine. Vaccines (Basel). 2022;10(2):280. doi: 10.3390/vaccines10020280.
Review
For citations:
Troshina E.A., Ankina V.D., Mazurina N.V., Platonova N.M. Thyroiditis associated with COVID-19: Is there a difference between subacute thyroiditis the other viral etiology? FOCUS. Endocrinology. 2025;6(4):71-76. (In Russ.) https://doi.org/10.62751/2713-0177-2025-6-4-09
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