Evaluation of the diagnostic features and clinical course of COVID-19 vaccine-associated subacute thyroiditis

Hormones (Athens). 2022 Sep;21(3):447-455. doi: 10.1007/s42000-022-00380-z. Epub 2022 Jun 16.

Abstract

Objective: This study aimed to identify cases of coronavirus disease 2019 (COVID-19) vaccine-associated subacute thyroiditis (SAT) during the active vaccination period of the pandemic, analyze the characteristics of these cases, and compare them with cases of non-vaccine associated SAT diagnosed in the same period.

Methods: A total of 55 patients diagnosed with SAT in our outpatient clinic between February and October, 2021, were included in this retrospective single-center study.

Results: Of the study population, 16 (29.1%) were diagnosed with COVID-19 vaccine-associated SAT (10 with CoronaVac® and six with Pfizer-BioNTech® vaccine), with a median time to onset of symptoms after vaccination of 6.5 (range, 2-20) days. There was no statistically significant difference between the vaccine-associated (VA) and non-vaccine associated (NVA) groups in terms of age, gender, time to diagnosis, thyroid volumes, thyroid function tests, and acute phase reactants. Seven (43.8%) and 25 (64.1%) patients were treated with methylprednisolone in the VA group and NVA group, respectively (p = 0.16). Follow-up data of 45 patients (16/16 for VA and 29/39 for NVA) were available. The mean follow-up of these patients was 47.4 ± 19.4 days, and the follow-up periods of the VA group and NVA group were comparable (p = 0.24). There was no difference between the two groups in terms of the frequency of euthyroidism at the follow-up visit (12/16 vs.14/29, p = 0.08).

Conclusion: With the increase in COVID-19 vaccination rates during the current pandemic, VA SAT cases are seen more frequently. The present study demonstrated that these cases have similar diagnostic features and clinical course to that of classic forms of SAT. In addition, most patients with VA SAT had a mild clinical course that improved with non-steroidal anti-inflammatory drugs.

Keywords: COVID-19; Inactivated COVID-19 vaccine; Neck pain; Thyroiditis; Thyrotoxicosis; mRNA vaccine.

MeSH terms

  • COVID-19 Testing
  • COVID-19 Vaccines* / adverse effects
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Humans
  • Retrospective Studies
  • Thyroiditis, Subacute* / diagnosis
  • Thyroiditis, Subacute* / epidemiology
  • Thyroiditis, Subacute* / etiology

Substances

  • COVID-19 Vaccines