Search

BackgroundSubacute thyroiditis (SAT) is a self-limiting thyroid inflammatory disease occurring specifically after upper respiratory tract infections. Since COVID-19 is a respiratory disease leading to multi-organ involvements, we aimed to systematically review the literature regarding SAT secondary to COVID-19.MethodsWe searched Scopus, PubMed/MEDLINE, Cochrane, Web of Science, ProQuest, and LitCovid databases using the terms “subacute thyroiditis” and “COVID-19” and their synonyms from inception to November 3, 2022. We included the original articles of the patients with SAT secondary to COVID-19. Studies reporting SAT secondary to COVID-19 vaccination or SAT symptoms’ manifestation before the COVID-19 infection were not included.ResultsTotally, 820 articles were retained. Having removed the duplicates, 250 articles remained, out of which 43 articles (40 case reports and three case series) with a total of 100 patients, were eventually selected. The patients aged 18–85 years (Mean: 42.70, SD: 11.85) and 68 (68%) were women. The time from the onset of COVID-19 to the onset of SAT symptoms varied from zero to 168 days (Mean: 28.31, SD: 36.92). The most common symptoms of SAT were neck pain in 69 patients (69%), fever in 54 (54%), fatigue and weakness in 34 (34%), and persistent palpitations in 31 (31%). The most common ultrasonographic findings were hypoechoic regions in 73 (79%), enlarged thyroid in 46 (50%), and changes in thyroid vascularity in 14 (15%). Thirty-one patients (31%) were hospitalized, and 68 (68%) were treated as outpatients. Corticosteroids were the preferred treatment in both the inpatient and outpatient settings (25 inpatients (81%) and 44 outpatients (65%)). Other preferred treatments were nonsteroidal anti-inflammatory drugs (nine inpatients (29%) and 17 outpatients (25%)) and beta-blockers (four inpatients (13%) and seven outpatients (10%)). After a mean duration of 61.59 days (SD: 67.07), 21 patients (23%) developed hypothyroidism and thus, levothyroxine-based treatment was used in six of these patients and the rest of these patients did not receive levothyroxine.ConclusionSAT secondary to COVID-19 seems to manifest almost similarly to the conventional SAT. However, except for the case reports and case series, lack of studies has limited the quality of the data at hand.

Supplemental material, sj-docx-1-smo-10.1177_20503121211051573 for Predictors of hospital mortality among patients with COVID-19 in Tehran, Iran by Fatemeh Esfahanian, SeyedAhmad SeyedAlinaghi, Nazanin Janfaza and Marcarious M. Tantuoyir in SAGE Open Medicine

Supplemental material, sj-docx-1-smo-10.1177_20503121211051573 for Predictors of hospital mortality among patients with COVID-19 in Tehran, Iran by Fatemeh Esfahanian, SeyedAhmad SeyedAlinaghi, Nazanin Janfaza and Marcarious M. Tantuoyir in SAGE Open Medicine

Accumulating evidence suggest that in patients with diabetes mellitus, increased rate of lipoprotein oxidation and oxidative stress have important role in diabetic angiopathy, including nephropathy. To evaluate the association of oxidized low- density lipoprotein (ox-LDL) with the development of diabetic nephropathy, plasma level of ox-LDL were measured in 70 diabetic patients with macro and 63 patients with normoalbuminuria. The plasma oxidized- LDL level in patients with macroalbuminuria was higher than those in normoalbuminuric group, (85.72 ± 32.92 mu/L versus 75.07 ± 26.46 u/L, P= 0.041). hemoglobin A1C (HbA1C) levels were similar in diabetic patients with macro (9.0 ± 1.80%) and normoalbuminuria (8.52 ± 1.7%, P= 0.098). There was no significant correlation between the ox-LDL and HbA1C level. The significantly elevated plasma oxidized- LDL in patients with macroalbuminuria suggests that ox-LDL may play an important role in the progression of diabetic nephropathy.