Purpose

Thyroid dysfunction, including thyroiditis, is well recognized in COVID-19 patients. We evaluated thyroid ultrasonographic features among COVID-19 survivors, which are less well known.

Methods

Adult COVID-19 survivors without known thyroid disorders who attended dedicated COVID-19 clinic underwent thyroid ultrasonography and assessment of thyroid function and autoimmunity. Adults admitted for acute non-thyroidal surgical problems and negative for COVID-19 were recruited as control. SARS-CoV-2 viral load (VL) was presented as the inverse of cycle threshold values from the real-time reverse transcription-polymerase chain reaction of the respiratory specimen on admission.

Results

In total, 79 COVID-19 patients and 44 non-COVID-19 controls were included. All abnormal thyroid function tests during acute COVID-19 recovered upon follow-up. Thyroid ultrasonography was performed at a median of 67 days after acute COVID-19. The median thyroid volume was 9.73 mL (IQR: 7.87–13.70). In multivariable linear regression, SARS-CoV-2 VL on presentation (standardized beta −0.206, p = 0.042) inversely correlated with thyroid volume, in addition to body mass index at the time of ultrasonography (p < 0.001). Sex-specific analysis revealed similar results among men but not women. Eleven COVID-19 patients (13.9%) had ultrasonographic changes suggestive of thyroiditis, comparable to non-COVID-19 patients (p = 0.375). None of these 11 patients had isolated low thyroid-stimulating hormone levels suggestive of thyroiditis at initial admission or the time of ultrasonography.

Conclusions

Higher SARS-CoV-2 VL on presentation were associated with smaller thyroid volumes, especially in men. Further research is suggested to investigate this possible direct viral effect of SARS-CoV-2 on the thyroid gland. There was no increased rate of ultrasonographic features suggestive of thyroiditis in COVID-19 survivors.

中文翻译：

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在男性 COVID-19 幸存者中，较高的 SARS-CoV-2 病毒载量与较小的甲状腺体积相关

目的

甲状腺功能障碍，包括甲状腺炎，在 COVID-19 患者中得到广泛认可。我们评估了鲜为人知的 COVID-19 幸存者的甲状腺超声特征。

方法

没有已知甲状腺疾病的成年 COVID-19 幸存者在专门的 COVID-19 诊所接受了甲状腺超声检查，并评估了甲状腺功能和自身免疫。招募因急性非甲状腺手术问题而入院且对 COVID-19 呈阴性的成年人作为对照。SARS-CoV-2 病毒载量 (VL) 表示为入院时呼吸道标本实时逆转录聚合酶链反应的循环阈值的倒数。

结果

总共包括 79 名 COVID-19 患者和 44 名非 COVID-19 对照。急性 COVID-19 期间的所有异常甲状腺功能测试均在随访后恢复。在急性 COVID-19 后的中位 67 天进行甲状腺超声检查。中位甲状腺体积为 9.73 mL（IQR：7.87–13.70）。 在多变量线性回归中，除了超声检查时的体重指数外，SARS-CoV-2 VL（标准化 β -0.206，p = 0.042）与甲状腺体积呈负相关（ p  < 0.001）。性别特异性分析显示男性的结果相似，但女性没有。11 名 COVID-19 患者（13.9%）的超声检查提示甲状腺炎，与非 COVID-19 患者相当（p = 0.375）。这 11 名患者在入院时或超声检查时均未出现提示甲状腺炎的低促甲状腺激素水平。

结论

较高的 SARS-CoV-2 VL 与较小的甲状腺体积相关，尤其是在男性中。建议进一步研究以调查 SARS-CoV-2 对甲状腺的这种可能的直接病毒作用。在 COVID-19 幸存者中，提示甲状腺炎的超声特征的发生率没有增加。