Context: The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods: This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19–related SAT (Cov-SAT), SARS-CoV-2 vaccine–related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. Results: Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. Conclusion: Since there is no difference in terms of follow-up parameters and outcomes, COVID-19– and SARS-CoV-2 vaccine–related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.

The aim of the study was to investigate thyroid function test (TFT) results and anti-thyroid antibody titers in acutely infected COVID-19 patients, as well as the changes in TFT and autoantibody re...

The aim of this study was to investigate changes in heart rate variability (HRV) and QT dispersion (QTd) in patients with differentiated thyroid cancer at different TSH suppression levels. The study included 125 DTC patients, who had been on TSH suppression treatment (TSHST) for at least 1 year. The patients were categorized into three groups: patients with TSH < 0.1 mIU/L (n:30), those with TSH 0.1 to 0.5 mIU/L (n:56), and those with TSH 0.5 to 2 mIU/L (n:39). The first two groups were classified as suppression groups, and the last as replacement (control) group. All patients underwent 12-lead electrocardiogram (ECG) recording and 24-hour rhythm holter echocardiography analysis. The HRV results derived from a 24-hour rhythm holter did not exhibit any significant difference (p < 0.05). In dispersion evaluations, the QTd was significantly longer in the suppression groups (groups 1 and 2), than in the replacement group (group 3) (p < 0.001 and p:0.002, respectively). The same was found for corrected QT dispersion (QTcd) (p < 0.001 and p: 0.008, respectively). In multivariate linear regression analysis, TSH was found to affect QTd (β = -0.299; p = 0.002) and QTcd (β = -0.300; p = 0.002) values independently. In this study, it was shown that in patients with DTC receiving TSHST, QT dispersion prolonged as the TSH suppression level increased. Especially in high-risk DTC patients, evaluation of QTd may be useful in terms of evaluating cardiovascular risk and regulating TSHST level.

Background/aim: To describe Graves’ Disease (GD) associated with COVID-19 infection (COVID) or its vaccines (VAC) and to compare the clinical presentations, laboratory parameters, and short-term clinical course of the disease among different etiology groups (COVID, VAC, and GD control). Materials and methods: Included in this multicenter matched case–control, retrospective cohort study were 239 patients with newly diagnosed (n = 196) or recurrent GD (n = 43) associated with COVID (n = 79) or VAC (n = 160). Each case was matched (1:1) with a control who had been diagnosed with GD prior to COVID. Results: The median age of the entire group was 42 years (female:male = 137:102). Both the COVID (4.6-fold) and VAC (4.1-fold) groups demonstrated higher TSH receptor antibody (TRAb) titers (p < 0.001) compared with the control group (3.5-fold), as well as a higher proportion of recurrent cases. At baseline, the COVID group had higher free triiodothyronine (fT3) levels than the other groups. Graves orbitopathy (GO) was observed in 60 patients (12.6%), with a higher frequency in classical GD (18.4%). At baseline, the variables associated with thyrotoxicosis severity (defined as fT3 levels) were younger age, higher thyroid gland volume (TGV), and etiology, with the COVID and, to a lesser extent, VAC groups presenting with higher fT3 levels. The variables associated with GO were higher TGV, TRAb titers, and smoking, while no association with etiology was identified. Conclusion: The clinical course was similar in all groups other than in some laboratory findings. Although the frequency of GO associated with COVID and VAC was lower, the proportion of cases with a Clinical Activity Score of ≥3 was higher compared to GD. This pattern suggests a potentially stronger immunologic trigger in these cases.

Amaç: Subakut tiroidit (SAT) genellikle orta yaşlı kadınlarda mevsimsel geçiş dönemlerinde görülen, kendisine has trifazik seyri olan ağrılı ve inflamatuvar bir tiroid hastalığıdır. Bu yazımızda hastanemizde SAT tanısıyla takip ettiğimiz hastaların retrospektif analizini yaptık. Gereç ve Yöntem: Hastanemizde Temmuz 2015-Mayıs 2019 yılları arasında SAT tanısı konulan hastaların klinik belirtileri, laboratuvar ve görüntüleme yöntemleri ve hastalık akibetleri retrospektif olarak değerlendirildi. Bulgular: Yirmidörtü (%19.4)’ü erkek, toplam 124 hasta analize dahil edildi. Hastaların yaş ortalaması 41.5 (Min-mak: 20:73) yıl idi. Tiroid lojunda ağrı tüm hastalarda varken, bu belirtiyi %45.9 sıklıkla ateş takip etti. Tanı esnasında tiroid stimülan hormon 0.02 mIU/L (0:0.63), serbest T4 1.98 ng/dL (0.97:4.7), eritrosit sedimantasyon hızı 75.1±24.1 mm/saat ve c-Reaktif Protein 62 mg/L (10.2:361) olarak bulundu. Tiroid uptakesi yapılan 123 hastadan hastadan 104 (%83.9) hasta tiroid uptakesi düşük iken, 23 (%18.6) hastanınki normal saptandı. Yüzdokuz (%87.9) hasta non-steroidal antiinflamatuvar ilaç kullanmışken, 40 (%32.3) hastada kısa süreli steroid kullanımı saptandı. Hastalığın takibinde 66 (53.2) hastada geçici hipotiroidi geliştiği ve L-tiroksin tedavisi başlandığı saptandı. Toplamda 27 (%21.7) hastada kalıcı hipotiroidi saptandı. Sonuç: Subakut tiroiditli olgularımızın yaklaşık beşte birinde kalıcı hipotiroidi gelişti. Bizim kalıcı hipotiroid kabul ettiğimiz bazı olgularda L-tiroksin kullanım süresinin 1 yıldan kısa olması nedeniyle çalışmamızda bu düzeyde yüksek oranlarda kalıcı hipotiroidi saptamamıza sebep olmuş olabilir. Bu nedenle 1 yıl sonra aynı olguların yeniden analiz edilmesi uygun olacakdır.