CHANGES IN THYROID NODULES CAUSED BY COVID-19, ACCORDING TO ULTRASOUND. FIRST OBSERVATIONS.

OBJECTIVES: The COVID-19 pandemic has posed a number of issues of medical and social significance to doctors of various specialties. In particular, the issue of the impact of COVID-19 on the course of chronic diseases and conditions is relevant and little studied. The aim of the work is to study changes in the structure of thyroid nodules after COVID-19 according to ultrasound data. MATERIALS: Dynamic ultrasound examinations was performed in 39 patients with verified benign thyroid nodules and pseudonodular changes in autoimmune thyroiditis. The duration of follow-up before COVID-19 disease was 0.5-10 years, after the disease - 2-6 months. RESULTS: In 8 (42%) of 19 patients with autoimmune thyroiditis, an increase in pseudonodes in size and the fusion of several small pseudonodes into large ones were noted without significant changes in echographic characteristics. Enlargement and fusion of pseudonodes can be caused by the intensification of lymphoid infiltration due to the activation of autoimmune processes determined by the COVID-19. In 11 (55%) of 20 patients with benign nodules, a change in their echostructure in the form of microcalcifications was noted, in 6 of them the nodule size increased. A possible cause of such changes may be the destruction of small blood vessels with pinpoint hemorrhages because of COVID-19, followed by their calcification. A fine-needle biopsy of the altered nodes was performed, in one case precancerous proliferation was detected. CONCLUSIONS: Postponed COVID-19 causes multidirectional changes in benign thyroid nodules, determined by ultrasound. Further studies are needed to assess their nature and impact on the course of the disease.