July - September 2021, Volume 17, Issue 3

Urbanovych AM, Laniush F, Borovets M, Kozlovska K

Coronavirus as a Trigger of Graves’ Disease

Acta Endo (Buc) 2021, 17 (3): 413-415
doi: 10.4183/aeb.2021.413

Context. SARS-CoV-2 infection was declared a pandemic in 2020 and affected millions of people worldwide. Angiotensin-converting enzyme-2 receptors, through which coronavirus enters the cells of different organs, have been detected in the thyroid gland. The most common cause of thyrotoxicosis is Graves’ disease in which thyroid-receptors antibodies (TRAb) stimulate the TSH receptor, increasing thyroid hormone production and release. Case presentation. A 22-year-old woman had symptoms of palpitation, tremor, muscle weakness, anxiety and sleep disturbance. 3 weeks before the onset of these symptoms, the patient suffered from COVID-19, which lasted 14 days and was characterized by a course of moderate severity with fever up to 38˚C, general weakness without shortness of breath. The patient had no pre-existing thyroid problems. Her TSH was <0.01 mU/L, FT4, FT3 and TRAb were increased. Antithyroid drugs, glucocorticosteroids and β-blockers were prescribed. During 3 months of treatment doses of methimazole, methylprednisolone and bisoprolol were gradually reduced due to the improvement of the patient’s condition and thyroid tests normalization. Conclusions. COVID-19 infection can cause Graves’ disease and thyrotoxicosis. The onset of this disease after SARS-CoV-2 does not depend on the presence of preexisting thyroid pathology and requires the appointment of glucocortisteroids.

Keywords: Graves’ disease, SARS-CoV-2, thyrotoxicosis, ACE2.

Correspondence: Alina M. Urbanovych MD, PhD, “Danylo Halytsky” Lviv National Medical University, Dept. of Endocrinology, Pekarska str. 69, Lviv, 79010, Ukraine, E-mail: alinaur@dr.com