SARS-CoV-2: a potential trigger for subacute thyroiditis? Insights from a case report

We report the case of a 69- year old woman with nodular goitre, hospitalized in dedicated area for a pneumonia due to Sars-Cov2 after recent back-surgery. In the 5th day she developed overt thyrotoxicosis initially treated with methimazole with no biochemical and clinical response . Thyroid ultrasound showed an enlarged hypoechoic thyroid, decreased vascularity and a known 30-mm isoechoic nodule. Thyroid autoantibodies was absent and serum thyroglobulin was elevated. At thyroid scan using Tc 99-m, there was no uptake . These data indicated a thyroid-destructive process compatible with a subacute thyroiditis, possibly triggered by SARS-CoV-2. Methimazole was discontinued and steroids were given, with clinical and biochemical improvement in a few days. To our knowledge, this and another case report of destructive thyroiditis associated with SARS-CoV-2 infection were almost simultaneously described.