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Multicenter Study
. 2023 Sep 18;108(10):e1013-e1026.
doi: 10.1210/clinem/dgad235.

Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study

Adnan Batman  1 , Dilek Yazıcı  1 , Oğuz Dikbaş  2 , Kemal Ağbaht  3 , Emre Sedar Saygılı  4 , İbrahim Demirci  5 , Nurbanu Bursa  6 , Görkem Ayas  7 , Cüneyd Anıl  8 , Mustafa Cesur  8 , Fatma Nur Korkmaz  9 , Adile Begüm Bahçecioglu  9 , Demet Çorapçıoğlu  9 , Murat Faik Erdoğan  9 , Hayri Bostan  10 , Murat Calapkulu  10 , Sema Hepşen  10 , Bekir Uçan  10 , Erman Çakal  10 , Bağdagül Yüksel Güler  5 , Cem Haymana  5 , Süleyman Hilmi İpekçi  11 , Selami Aydın  12 , Havva Sezer  1 , Seçil Özışık  1 , Oğuzhan Deyneli  1 , Faruk Alagöl  13 , Refik Tanakol  13 , Mustafa Eroğlu  14 , Ümmü Mutlu  15 , Hülya Hacışahinoğulları  15 , Ayşe Kubat Üzüm  15 , Canan Demir  16 , Gönül Koç  17 , Sevde Nur Fırat  17 , Tülay Omma  18 , Nurcan İnce  19 , Şefika Burçak Polat  19 , Oya Topaloğlu  19 , Cevdet Aydın  19 , Bekir Çakır  19 , Çiğdem Tura Bahadır  20 , Mehmet Güven  21 , Mehmet Sözen  22 , Alev Selek  22 , Zeynep Cantürk  22 , Berrin Çetinarslan  22 , Mustafa Aydemir  23 , Işılay Taşkaldıran  24 , Yusuf Bozkuş  24 , Özlem Turhan İyidir  24 , Filiz Ekşi Haydardedeoğlu  25 , Seda Erem Basmaz  26 , Mehmet Çağrı Ünal  27 , Tevfik Demir  27 , Ayten Oğuz  28 , Özlem Çelik  29 , Merve Yilmaz  30 , Aykut Cimsir  10 , Serdar Kayıhan  10 , Ziynet Alphan Uc  31 , Sakin Tekin  32 , Ömercan Topaloğlu  33 , Başak Özgen Saydam  34 , Yasemin Aydoğan Ünsal  34 , Özge Özer  35 , Göknur Yorulmaz  35 , Kader Uğur  36 , Sezin Doğan Çakır  37 , Mehmet Aşık  38 , Mustafa Unubol  39 , Selin Genc  40 , Burak Andac  41 , Mine Okur  41 , Ozlem Dogan  42 , Ersen Karakiliç  4 , Gokcen Unal Kocabas  43 , Cem Onur Kirac  44 , Güven Barış Cansu  45 , Meliha Melin Uygur  46 , Zafer Pekkolay  47 , Sadettin Öztürk  48 , Aşkın Güngüneş  49 , Eren Gürkan  50 , Lezzan Keskin  51 , Kenan Çağlayan  52 , Yasemin Emur Günay  53 , Eren İmre  54 , Selcuk Yusuf Şener  55 , Ahmet Toygar Kalkan  56 , Deniz Engin Gök  57 , Mustafa Şahin  9
Affiliations
Multicenter Study

Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study

Adnan Batman et al. J Clin Endocrinol Metab. .

Abstract

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.

Keywords: COVID-19; SARS-CoV-2 vaccine; subacute thyroiditis.

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