Impact of COVID-19 on the thyroid gland: an update
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Impact of COVID-19 on the thyroid gland: an update Lorenzo Scappaticcio 1 & Fabián Pitoia 2 & Katherine Esposito 3,4 & Arnoldo Piccardo 5 & Pierpaolo Trimboli 6,7 Accepted: 11 November 2020 # The Author(s) 2020
Abstract Coronavirus disease 2019 (COVID-19) is the pandemic of the new millennium. COVID-19 can cause both pulmonary and systemic inflammation, potentially determining multi-organ dysfunction. Data on the relationship between COVID-19 and thyroid have been emerging, and rapidly increasing since March 2020. The thyroid gland and the virus infection with its associated inflammatory-immune responses are known to be engaged in complex interplay. SARS-CoV-2 uses ACE2 combined with the transmembrane protease serine 2 (TMPRSS2) as the key molecular complex to infect the host cells. Interestingly, ACE2 and TMPRSS2 expression levels are high in the thyroid gland and more than in the lungs. Our literature search provided greater evidence that the thyroid gland and the entire hypothalamic–pituitary–thyroid (HPT) axis could be relevant targets of damage by SARS-CoV-2. Specifically, COVID-19-related thyroid disorders include thyrotoxicosis, hypothyroidism, as well as nonthyroidal illness syndrome. Moreover, we noticed that treatment plans for thyroid cancer are considerably changing in the direction of more teleconsultations and less diagnostic and therapeutical procedures. The current review includes findings that could be changed soon by new results on the topic, considering the rapidity of worldwide research on COVID-19. Keywords Thyroid . COVID-19 . Hyperthyroidism . Hypothyroidism . Thyroid cancer
Abbreviations ACE2 AITD ARDS AT CAT
angiotensin-converting–enzyme 2 autoimmune thyroid diseases acute respiratory distress syndrome atypical thyroiditis chronic autoimmune thyroiditis
* Pierpaolo Trimboli [email protected] 1
Division of Endocrinology and Metabolic Diseases, University Hospital “Luigi Vanvitelli”, University of Campania “L. Vanvitelli”, Naples, Italy
2
Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
3
Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, Naples, Italy
4
Diabetes Unit, University Hospital “Luigi Vanvitelli”, University of Campania “L. Vanvitelli”, Naples, Italy
5
Department of Nuclear Medicine, Galliera Hospital, Genoa, Italy
6
Clinic of Endocrinology and Diabetology, Lugano and Mendrisio Regional Hospital, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
7
Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
COVID-19 CRP EBR FNAB FT3 FT4 HICU HPT MKI NK NSAID NTIS ONFH ORs rh-TSH SARS SARS-CoV-2 SAT SPECT/CT TH TLR TMPRSS2 TPOAb TRAb
Coronavirus disease 2019 C-reactive protein external beam radiation fine-needle aspiration biopsies free T3 free T4 high intensity of care unit hypothalamic–pituitary–thyroid multikinase inhibitors natural killer non-steroidal anti-inflammatory drug nonthyroidal illness syndrome osteonecrosis of the
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