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Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic

Purpose: This study aimed to evaluate various therapeutic approaches, identify potential predictive factors for the recurrence and development of hypothyroidism, and examine specific clinical and laboratory characteristics of patients with subacute thyroiditis (SAT) due to SARS-CoV-2 infection. Meth...

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Autores principales: Angelopoulos, Nikolaos, Askitis, Dimitrios P., Androulakis, Ioannis, Valvis, Nicolas, Paparodis, Rodis, Petkova, Valentina, Boniakos, Anastasios, Zianni, Dimitra, Perogamvros, Ilias, Toulis, Konstantinos, Livadas, Sarantis, Iakovou, Ioannis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10671895/
https://www.ncbi.nlm.nih.gov/pubmed/38002783
http://dx.doi.org/10.3390/jcm12227171
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author Angelopoulos, Nikolaos
Askitis, Dimitrios P.
Androulakis, Ioannis
Valvis, Nicolas
Paparodis, Rodis
Petkova, Valentina
Boniakos, Anastasios
Zianni, Dimitra
Perogamvros, Ilias
Toulis, Konstantinos
Livadas, Sarantis
Iakovou, Ioannis
author_facet Angelopoulos, Nikolaos
Askitis, Dimitrios P.
Androulakis, Ioannis
Valvis, Nicolas
Paparodis, Rodis
Petkova, Valentina
Boniakos, Anastasios
Zianni, Dimitra
Perogamvros, Ilias
Toulis, Konstantinos
Livadas, Sarantis
Iakovou, Ioannis
author_sort Angelopoulos, Nikolaos
collection PubMed
description Purpose: This study aimed to evaluate various therapeutic approaches, identify potential predictive factors for the recurrence and development of hypothyroidism, and examine specific clinical and laboratory characteristics of patients with subacute thyroiditis (SAT) due to SARS-CoV-2 infection. Methods: We retrospectively analyzed the medical records of 226 patients with confirmed SAT diagnosed from January 2020 to November 2022. Results: The mean age was 48.01 ± 0.75 years, and the F/M ratio was 2.3/1. At the end of the follow-up period, 69 patients (32.1%) had developed hypothyroidism. Treatment duration was significantly shorter with nonsteroidal anti-inflammatory drugs (NSAIDs) (17.40 ± 2.56 days), while time-to-symptom relief was shorter with glucocorticoids (CGs). Recurrence was observed only in those treated with corticosteroid preparations (14.1%). C-reactive protein levels at treatment discontinuation were higher in patients who experienced SAT recurrence, while the coexistence of Hashimoto’s thyroiditis was a significant predictive factor for the development of hypothyroidism. The TSH value at the time of treatment withdrawal >4.12 μIU/mL showed optimal sensitivity and specificity for the prediction of permanent hypothyroidism. Regarding COVID-19, 34 patients (15%) experienced related SAT, with similar clinical manifestations of the disease but a higher BMI and shorter time-to-symptom relief. Conclusion: In conclusion, GCs administration alleviated acute symptoms earlier during the onset of SAT, whereas NSAIDs had a shorter treatment duration, and both regimens could not prevent the development of delayed hypothyroidism. The clinical characteristics of SAT due to COVID-19 infections were similar to those of typical SAT disease.
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spelling pubmed-106718952023-11-18 Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic Angelopoulos, Nikolaos Askitis, Dimitrios P. Androulakis, Ioannis Valvis, Nicolas Paparodis, Rodis Petkova, Valentina Boniakos, Anastasios Zianni, Dimitra Perogamvros, Ilias Toulis, Konstantinos Livadas, Sarantis Iakovou, Ioannis J Clin Med Article Purpose: This study aimed to evaluate various therapeutic approaches, identify potential predictive factors for the recurrence and development of hypothyroidism, and examine specific clinical and laboratory characteristics of patients with subacute thyroiditis (SAT) due to SARS-CoV-2 infection. Methods: We retrospectively analyzed the medical records of 226 patients with confirmed SAT diagnosed from January 2020 to November 2022. Results: The mean age was 48.01 ± 0.75 years, and the F/M ratio was 2.3/1. At the end of the follow-up period, 69 patients (32.1%) had developed hypothyroidism. Treatment duration was significantly shorter with nonsteroidal anti-inflammatory drugs (NSAIDs) (17.40 ± 2.56 days), while time-to-symptom relief was shorter with glucocorticoids (CGs). Recurrence was observed only in those treated with corticosteroid preparations (14.1%). C-reactive protein levels at treatment discontinuation were higher in patients who experienced SAT recurrence, while the coexistence of Hashimoto’s thyroiditis was a significant predictive factor for the development of hypothyroidism. The TSH value at the time of treatment withdrawal >4.12 μIU/mL showed optimal sensitivity and specificity for the prediction of permanent hypothyroidism. Regarding COVID-19, 34 patients (15%) experienced related SAT, with similar clinical manifestations of the disease but a higher BMI and shorter time-to-symptom relief. Conclusion: In conclusion, GCs administration alleviated acute symptoms earlier during the onset of SAT, whereas NSAIDs had a shorter treatment duration, and both regimens could not prevent the development of delayed hypothyroidism. The clinical characteristics of SAT due to COVID-19 infections were similar to those of typical SAT disease. MDPI 2023-11-18 /pmc/articles/PMC10671895/ /pubmed/38002783 http://dx.doi.org/10.3390/jcm12227171 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Angelopoulos, Nikolaos
Askitis, Dimitrios P.
Androulakis, Ioannis
Valvis, Nicolas
Paparodis, Rodis
Petkova, Valentina
Boniakos, Anastasios
Zianni, Dimitra
Perogamvros, Ilias
Toulis, Konstantinos
Livadas, Sarantis
Iakovou, Ioannis
Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic
title Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic
title_full Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic
title_fullStr Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic
title_full_unstemmed Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic
title_short Clinical Aspects in Subacute Thyroiditis: A Real-Life Study on 226 Cases in Greece Amid the COVID-19 Pandemic
title_sort clinical aspects in subacute thyroiditis: a real-life study on 226 cases in greece amid the covid-19 pandemic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10671895/
https://www.ncbi.nlm.nih.gov/pubmed/38002783
http://dx.doi.org/10.3390/jcm12227171
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