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Case Study Reveals Subacute Thyroiditis Linked to COVID-19 in Young Woman

Could novel coronavirus infection lead to subacute thyroiditis? A young woman who seemingly had recovered from COVID-19 reported neck and thyroid pain, fever and an increased heart rate. Find out why clinicians diagnosed her with subacute thyroiditis and linked the case to her previous infection with the novel coronavirus.

PISA, ITALY – Pharmacists might suspect a link to COVID-19 when questioned about symptoms typical of subacute thyroiditis, according to a new report.

A case study published in The Journal of Clinical Endocrinology & Metabolism points out that subacute thyroiditis is an inflammatory thyroid disease characterized by neck pain and is usually preceded by an upper respiratory tract infection. Italian authors point out that the condition can be caused by a viral infection or a post-viral inflammatory reaction.

"We reported the first case of subacute thyroiditis after SARS-CoV-2 infection," said Francesco Latrofa, MD., of the University Hospital of Pisa in Italy. "Physicians should be alerted about the possibility of this additional clinical manifestation related to COVID-19."

Many other viruses also have been linked to the disease, according to the article.

In the case study described, clinicians examined an 18-year-old woman who was infected with COVID-19 after being exposed by her father. She completely recovered from COVID-19, testing negative a few days later, but started experiencing some additional symptoms.

The authors describe how the young woman had neck and thyroid pain, fever and an increased heart rate. Returning to the hospital, where she was diagnosed with subacute thyroiditis, although she had normal thyroid functioning and imaging just one month earlier.

“At physical examination, the patient presented with an increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams FT4 and FT3 were high, TSH undetectable and inflammatory markers and white blood cell count elevated,” the authors note. “Bilateral and diffuse hypoechoic areas were detected at neck ultrasound.”

Clinicals diagnosed subacute thyroiditis, and the patient started prednisone. The authors report that neck pain and fever recovered within two days and the remaining symptoms within a week. Thyroid function and inflammatory markers returned to normal in 40 days.

"Because of the chronological association, SARS-CoV-2 may be considered accountable for the onset of subacute thyroiditis," Latrofa said.