The COVID-19 lockdown clearly affected the lifestyle of the population and entailed changes in their daily habits, which involved potential health consequences, especially on patients with Type 2 Diabetes Mellitus (T2DM). We aimed to examine the impact of the lockdown caused by COVID-19 pandemic on both nutrition and exercise habits, as well as the psychological effects in patients with T2DM, compared to their usual diet and physical activity level previous to the complete home confinement. We also intended to analyse any potential variables that may have influenced these lifestyle modifications. A Food Frequency Questionnaire (FFQ), Physical Activity Questionnaire (IPAQ), Food Craving Questionnaire-State (FCQ-S) and Food Craving Questionnaire-Trait (FCQ-T) were used. Our results showed an increase in vegetable, sugary food and snack consumption. An association between levels of foods cravings and snack consumption was also found. Data also showed a high percentage of physical inactivity before the COVID-19 lockdown, which was exacerbated during the home confinement. These findings emphasise the great importance to do further research with larger study samples to analyse and explore dietary habits and to develop public health policies to promote a healthy lifestyle in terms of diet and physical activity in these patients, especially after this strict period of lockdown.

To the Editor Although recent evidence suggests that COVID-19 can affect practically all organs, data on the impact of SARS-CoV-2 on the thyroid gland are very scarce. Two patients with Graves' disease (GD) and COVID-19 have been recently published [1], and we would like to provide more evidence with two more cases. Patient 1 was a 45-year-old woman with a 12-year medical history of GD. She had 2 previous episodes of hyperthyroidism that were treated with antithyroid drugs (ATD), first in 2008 after diagnosis (ATD for 22 months) and then at a relapse in 2015 (ATD for 25 months). She also had Graves' ophthalmopathy that was treated with corticosteroids for 3 months in 2018. At the beginning of March 2020, her thyroid function was normal, with free thyroxine levels (FT4) of 1.36 ng/dL (normal range, 0.93-1.7 ng/dL) and serum thyroid-stimulating hormone levels (TSH) of 0.75 µIU/ mL (normal range, 0.27-4.2 µIU/mL), although anti-TSH receptor antibodies (anti-TSHR-Ab) were slightly elevated (1.9 mIU/mL; normal range < 1.5 mIU/mL). In May 2020, she developed bilateral pneumonia and was diagnosed with SARS-CoV-2 infection. This patient also presented palpitations and nervousness. Her blood test results showed a TSH of < 0.005 µIU/mL, a FT4 of > 7.7 ng/dL and an anti-TSHR-Ab of 28.7 mIU/mL. Thyroid ultrasound showed hypervascularization. She started methimazole (MMI) at a daily dose of 40 mg, which resulted in a rapid normalization of her thyroid function. No deterioration of her ophthalmopathy was observed. The MMI dosage of 40 mg/day was reduced to 5 mg/day during follow-up and she shows improvement in her condition after 3 months of treatment.