The Coronaviruses Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), is the second most serious threat to human health after the Spanish flu in 1918, causing systemic devastating effects, high morbidity, and mortality.
Detrimental effects of COVID-19 on thyroid function have been reported to affect patients with and without pre-existing thyroid disease. Low T3 syndrome, destructive and atypical subacute thyroiditis, autoimmune-associated thyroiditis, central hypothyroidism, Hashimoto’s thyroiditis, and Graves’ disease have been the most frequent thyroid abnormalities associated with Covid-19. A direct virus attack on the follicular cell or indirect effects associated with a hyperinflammatory state or cytokine storm are among the hypothesized mechanisms of thyroid insult in Covid-19.
However, data on thyroid involvement in SARS-CoV-2 infection are still scarce, and it is necessary to increase our understanding of this complex interaction, from the triggering pathophysiological mechanisms to the clinical outcomes and its proper management.
The connection between these entities is not yet clarified, and many questions need to be answered. Should we screen thyroid dysfunction during Covid-19? Is Covid-19 more frequent or are its consequences larger in patients with thyroid dysfunctions? Can Covid-19 induce thyroid dysfunctions or thyroid autoimmunity? Can pre-existing thyroid disease or low T3 syndrome affect the Covid-19 prognosis? Does levothyroxine dose need to be checked or adjusted after Covid-19? Can Covid-19 vaccines affect thyroid function? What would be the best clinical management for an affected patient?
Moreover, several authoritative guidelines have recommended withholding invasive diagnostic procedures and surgery in patients with nodular thyroid disease. Since pandemics have elapsed more than previously planned, compliance to these recommendations weakened and the individual criteria prevailed in terms of decisions. It is not yet known if patients with thyroid cancer were safe under these new policies. How long can thyroid surgery be deferred due to pandemics?
The current Research Topic aims to cover recent research in the field of the Covid-19 and thyroid diseases. We are interested in original research, reviews, and mini reviews covering translational, epidemiological, and clinical studies on pathophysiological aspects, diagnosis, clinical significance, and management. The potential areas to be covered in this Research Topic include, but are not limited to Covid-19 in relation to:
• Non-thyroidal illness syndrome;
• Destructive and atypical subacute thyroiditis;
• Autoimmune thyroid disease;
• Hypothyroidism and thyrotoxicosis;
• Thyroid nodules and cancer;
• Covid-19 vaccination and thyroid diseases
Cover image provided by Prof. Célia Nogueira and her students.
*For articles relating to other aspects of Covid-19 and endocrine research, please see our related Research Topics
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