Nuclear Pollution

Effects of COVID-19 contamination on the thyr

European Society of Endocrinology
Starling House, 1600 Bristol Parkway North, Bristol, BS34 8YU, UK Tel +44 1454 642247 info@euro-endo.org www.ese-hormones.org
President Martin Reincke Munich, Germany. President-elect Jérôme Bertherat Paris, France. Secretary Mónica Marazuela Madrid, Spain. Treasurer Djuro Macut Belgrade, Serbia. Executive Committee members:
Philippe Chanson Paris, France. Mirjam Christ-Crain Basel, Switzerland. Martin Fassnacht Würzburg, Germany. Simona Glasberg Jerusalem, Israel. Riccarda Granata Torino, Italy. Robin Peeters Rotterdam, The
Netherlands. Ex-Officio members: EYES Representative Eva Coopmans, Rotterdam, Netherlands. Nurse Representative Sherwin Criseno West Bromwich, UK. ECAS Representative Anton Luger Vienna, Austria.
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PRESS RELEASE
Contact: Valens Izere
Media Office European Society of Endocrinology
Phone: +32 (0) 489 89 62 15
ESE-Media@hkstrategies.com
Under embargo until 21 May 2022 12:00 CEST
Press release – European Congress of Endocrinology 2022 Abstract RC11.1: Impact of COVID-19 disease on
thyroid function: longitudinal study.
Effects of COVID-19 contamination on the thyroid gland are still present after one year, study finds
Severe COVID-19 disease affects thyroid function through a variety of mechanisms according to a new study
from Dr. Ilaria Muller and colleagues from the University of Milan, Italy. The study followed patients with
thyroid dysfunction correlated to COVID-19 disease for one year, to better characterize such thyroid
meddling and to follow its evolution over time. During moderate-to-severe COVID-19 disease the
occurrence of thyroiditis (inflammation of the thyroid gland) plays an important role in thyroid dysfunction,
In addition to other well-known mechanisms mainly acting on the hypothalamus-pituitary-thyroid axis. The
hormone imbalance is usually mild but increases in severe cases of COVID-19. Their study will be presented
during the 24th European Congress of Endocrinology on 23 May 2022 in Milan, Italy.
The thyroid function is crucial to the human body’s metabolism, growth, and development. By continually
releasing a stable amount of thyroid hormones into the bloodstream, it aids in the regulation of numerous
body functions. The thyroid gland generates extra hormones when the body needs more energy in particular
situations, such as when it is growing, cold, or pregnant.
The study looked at more than 100 patients admitted to hospital with severe COVID-19, analysing their
thyroid stimulating hormone (TSH) and other indicators. Thyroiditis occurred frequently in the COVID-19
The patient population and the thyroid function, as well as inflammatory indicators, returned to normal in nearly
All instances shortly after the end of their COVID-19 illness. However, after 12 months thyroiditis regions
remained visible at thyroid ultrasound in half of the individuals, even if reduced in size. The thyroid uptake
of technetium or iodine, an indicator of thyroid function, was still reduced in four out of six individuals at
nine months, although it had mostly recovered after 12 months. The long-term clinical consequences, if any,
are unknown.
European Society of Endocrinology
Starling House, 1600 Bristol Parkway North, Bristol, BS34 8YU, UK Tel +44 1454 642247 info@euro-endo.org www.ese-hormones.org
President Martin Reincke Munich, Germany. President-elect Jérôme Bertherat Paris, France. Secretary Mónica Marazuela Madrid, Spain. Treasurer Djuro Macut Belgrade, Serbia. Executive Committee members:
Philippe Chanson Paris, France. Mirjam Christ-Crain Basel, Switzerland. Martin Fassnacht Würzburg, Germany. Simona Glasberg Jerusalem, Israel. Riccarda Granata Torino, Italy. Robin Peeters Rotterdam, The
Netherlands. Ex-Officio members: EYES Representative Eva Coopmans, Rotterdam, Netherlands. Nurse Representative Sherwin Criseno West Bromwich, UK. ECAS Representative Anton Luger Vienna, Austria.
Registered in England and Wales No. 5540866. Registered Office: Redwood House, Brotherswood Court, Great Park Road, Almondsbury Business Park, Bradley Stoke, Bristol, BS32 4QW, UK. Company Limited by
Guarantee. Registered Charity No. 1123492.
“There is a clear link between thyroid dysfunction and COVID-19 disease”, said Dr. Muller
thyroid hormones correlate with the disease severity is important, and the fact that the thyroid gland seems
directly involved in SARS-CoV-2 (COVID-19) viral infection needs to be taken into account.”
-ENDNotes
for Editors
1. The presentation “Impact of COVID-19 disease on thyroid function: longitudinal study.” will be
presented on Saturday 21 May at 12:00 CEST.
2. ECE 2022 will be held in Milan on the 21-24 May 2022. You can access more information about the
congress here.
3. The European Society of Endocrinology was created to promote research, education, and clinical
practice in endocrinology by the organization of conferences, training courses and publications, by
raising public awareness, liaison with national and international legislators and by any other
appropriate means.
About the European Society of Endocrinology
The European Society of Endocrinology (ESE) provides a platform to develop and share leading research
and best knowledge in endocrine science and medicine. By uniting and representing every part of the
endocrine community, we are best placed to improve the lives of patients. Through the 54 National
Societies involved with the ESE Council of Affiliated Societies (ECAS) ESE represents a community of over
20,000 European endocrinologists. We inform policy makers on health decisions at the highest level
through advocacy efforts across Europe.
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European Society of Endocrinology
Starling House, 1600 Bristol Parkway North, Bristol, BS34 8YU, UK Tel +44 1454 642247 info@euro-endo.org www.ese-hormones.org
President Martin Reincke Munich, Germany. President-elect Jérôme Bertherat Paris, France. Secretary Mónica Marazuela Madrid, Spain. Treasurer Djuro Macut Belgrade, Serbia. Executive Committee members:
Philippe Chanson Paris, France. Mirjam Christ-Crain Basel, Switzerland. Martin Fassnacht Würzburg, Germany. Simona Glasberg Jerusalem, Israel. Riccarda Granata Torino, Italy. Robin Peeters Rotterdam, The
Netherlands. Ex-Officio members: EYES Representative Eva Coopmans, Rotterdam, Netherlands. Nurse Representative Sherwin Criseno West Bromwich, UK. ECAS Representative Anton Luger Vienna, Austria.
Registered in England and Wales No. 5540866. Registered Office: Redwood House, Brotherswood Court, Great Park Road, Almondsbury Business Park, Bradley Stoke, Bristol, BS32 4QW, UK. Company Limited by
Guarantee. Registered Charity No. 1123492.
Abstract
RC11.1
Impact of COVID-19 disease on thyroid function: longitudinal study.
Ilaria Muller1,2, Matteo Varallo3, Anita Daturi3, Tiziana E Re4, Davide Dazzi5, Virgilio Longari6, Andrea Gori7,8,
Giovanna Mantovani1,2, Maura Arosio1,2, Mario Salvi2
1University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy; 2Fondazione
IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Endocrinology, Milan, Italy; 3University of Milan,
Milan,; 4Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Department of Medicine –
Acute Medical Unit, Milan, Italy; 5Casa di Cura Val Parma SRL; 6Fondazione IRCCS Ca’ Granda Ospedale
Maggiore Policlinico di Milano, Nuclear Medicine; 7University of Milan, Department of Pathophysiology and
Transplantation; 8Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Infectious
Diseases, Milan,
BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic disease
(COVID-19) affects thyroid function with different mechanisms: non-thyroidal illness syndrome (NTIS), direct
infection of thyroid gland and cytokine storm. We provided the first description of painless atypical thyroiditis
coexisting with NTIS in patients hospitalized for moderate-to-severe COVID-19 disease. We aimed at: 1)
correlate thyroid dysfunction with COVID-19 disease severity; 2) follow the evolution of thyroid function over
time.
METHODS: Baseline (at hospital admittance) and longitudinal study of patients hospitalized for moderateto-
severe COVID-19 disease, without known history of thyroid disfunction, assessing serum thyroid function
and autoantibodies, inflammatory markers and thyroid ultrasound scan (US). Patients showing at US focal
hypoechoic areas suggestive for thyroiditis (thyroiditis-areas) also underwent thyroid 99mTc or I123 uptake
scan.
RESULTS: 183 COVID-19 patients were studied baseline, of whom 63 (34%) were already on steroid treatment
before hospital admission, thus were not considered for TSH analysis. Decreased serum TSH positively
correlated with albumin (p=0.02) and lymphocyte count (p<0.01) but not with C-reactive-protein (p=0.12)
and interleukin-6 (p=0.10); TSH also progressively and inversely correlated to the need of oxygen support
(p=0.02). Serum FT3 correlated positively with albumin (P<0.01) and inversely with D-dimer (p=0.02).
Baseline thyroid US scan showed thyroiditis-areas in 18/65 (28%) patients, associated with reduced thyroid
uptake at 99mTc/I123 scintigraphy in 14/17 (82%) cases. Thyroiditis-areas were more frequent among patients
with baseline low TSH (6/10, 60%) compared with those with normal TSH (10/40, 25%, p=0.034). The patients
with thyroiditis-areas also had higher baseline FT4 (p=0.018) and IL-6 (p=0.016) compared with those with
European Society of Endocrinology
Starling House, 1600 Bristol Parkway North, Bristol, BS34 8YU, UK Tel +44 1454 642247 info@euro-endo.org www.ese-hormones.org
President Martin Reincke Munich, Germany. President-elect Jérôme Bertherat Paris, France. Secretary Mónica Marazuela Madrid, Spain. Treasurer Djuro Macut Belgrade, Serbia. Executive Committee members:
Philippe Chanson Paris, France. Mirjam Christ-Crain Basel, Switzerland. Martin Fassnacht Würzburg, Germany. Simona Glasberg Jerusalem, Israel. Riccarda Granata Torino, Italy. Robin Peeters Rotterdam, The
Netherlands. Ex-Officio members: EYES Representative Eva Coopmans, Rotterdam, Netherlands. Nurse Representative Sherwin Criseno West Bromwich, UK. ECAS Representative Anton Luger Vienna, Austria.
Registered in England and Wales No. 5540866. Registered Office: Redwood House, Brotherswood Court, Great Park Road, Almondsbury Business Park, Bradley Stoke, Bristol, BS32 4QW, UK. Company Limited by
Guarantee. Registered Charity No. 1123492.
normal thyroid US. Follow-up analysis was conducted in 75/183 (41%) patients; thyroid function and
Inflammatory markers normalized at all time-points in nearly all cases and no increase of thyroid
autoantibodies positivity was observed. The thyroiditis-areas, even if often reduced in size, were still present
after 6 and 12 months in 13/15 (87%) and 6/12 (50%) patients, respectively. After 9 months the thyroid
uptake at 99mTc/I123 scintigraphy was still reduced in 4/6 (67%) patients, even if partially recovered (mean)
+28%) compared with baseline.
CONCLUSIONS: Thyroid dysfunction during moderate-to-severe COVID-19 disease is mild and transient, and
thyroid hormones correlate with disease severity. Thyroiditis-areas at US occur frequently and may persist
after one year, even if reduced in size; long-term consequences are unknown. The association of thyroiditisareas
with low TSH and high FT4 and IL-6 serum concentrations support the hypothesis of direct thyroid gland
involvement in SARS-CoV-2 infection.


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