1 Introduction
2 Materials and methods
2.1 Review conduction
2.2 Search strategy
2.3 Data extraction
3 Results
3.1 Reviews retrieved
First author [ref] | Country | Last literature search | Date of publication | Journal | Type of review | Topic (thyroid/endocrinology) |
---|---|---|---|---|---|---|
Dworakowska [11] | Poland, UK | N.A | June 7th 2020 | Endocrine | NR | Thyroid |
Gorini [12] | Italy | N.A | September 11th 2020 | International Journal of Environmental Research and Public Health | NR | Thyroid |
Caron [13] | France | N.A | September 18th 2020 | Annales d’endocrinologie | NR | Thyroid |
Scappaticcio [7] | Italy, Switzerland, Argentina | September 5th, 2020 | November 25th 2020 | Reviews in Endocrine and Metabolic Disorders | SR | Thyroid |
Kumari [14] | India | N.A | December 10th 2020 | Heliyon | NR | Thyroid |
Chen [15] | China | December 23th 2020 | January 11th 2021 | Endocrinology | NR | Thyroid |
Speer [16] | Hungary | N.A | January 19th 2021 | Endocrine Journal | NR | Thyroid |
Croce [17] | Italy | N.A | February 13th 2021 | Journal of Endocrinological Investigation | NR | Thyroid |
Piticchio [18] | Italy | November 18th 2020 | February 13th 2021 | Journal of Endocrinological Investigation | SR | Endocrinology |
3.2 Findings of the reviews included
First author [ref] | Aim | Main conclusions |
---|---|---|
Dworakowska [11] | To explore COVID-19 risks in patients with preexisting thyroid problems. To review current literature on thyroid diseases (excluding cancer) and COVID-19, including data from the previous coronavirus pandemic caused by the SARS-CoV | There are no data suggesting that thyroid patients are at higher risk of COVID-19. In patients severely affected by COVID-19, changes in thyroid function may relate to a ‘sick euthyroid’ syndrome, but there may be specific thyroid-related damage which requires further investigation |
Gorini [12] | To summarize the main findings on thyroid and COVID-19 and define research lines aimed at patient care and effective public health measures | Thyroid disease is not a risk factor for the development of COVID-19, and a higher prevalence of thyroid disease has not been found in patients with COVID-19. Questioning patients about the presence of thyroid disease at the time of hospitalization with subsequent follow-up might be useful in patients with multiple diseases to avoid thyrotoxicosis first and hypothyroidism later resulting from SAT |
Caron [13] | To discuss the diagnosis and the management of patients presenting with thyrotoxicosis, thyroid-associated orbitopathy and hypothyroidism in the context of SARS-CoV-2 infection | Routine assessment of thyroid function in the acute phase for COVID-19 patients requiring intensive care is useful, as they frequently present thyrotoxicosis related to SARS-CoV-2, and during convalescence to diagnose and adapt levothyroxine replacement treatment in patients with primary or central hypothyroidism |
Scappaticcio [7] | To explore the impact of COVID-19 on the thyroid gland | SAT mainly occurs during or soon after mild COVID-19. Thyrotoxicosis without neck pain (possibly in the context of the nonthyroidal illness syndrome) could characterize more severe and critical cases of COVID-19 pneumonia. Some clues of the hormonal changes (i.e., low T3 and TSH concentrations) and overt thyrotoxicosis to be regarded as predictors of poor outcome of COVID-19 are already emerging |
Kumari [14] | To explore the potential role of prevailing thyroid disorders in SARS-CoV-2 infection | Thyroid dysfunction may have considerable risk in aggravating the infection and spread of SARS-CoV-2, and it is closely associated with aging |
Chen [15] | To review the potential interaction between COVID-19 and the thyroid gland, including thyroid pathology, function and diseases. To explore the potential harmful effects of COVID-19 drugs on the thyroid | SAT caused by SARS-CoV-2 has been reported. The alteration of thyroid tests is common among COVID-19 patients. However, there is no pathological evidence of thyroid injury caused by SARS-CoV-2. Some anti–COVID-19 agents may cause thyroid injury or affect its function |
Speer [16] | To explore and compare the impact of SARS-CoV and SARS-CoV-2 on the thyroid gland | No increase of prevalence of pre-existing thyroid disorder in SARS-CoV and SARS-CoV-2 patients was found. However, routine screening of thyroid function at least in COVID-19 patients requiring hospitalization is suggested, because subacute thyroiditis might be a late complication |
Croce [17] | To summarize studies regarding thyroid function alterations in patients with COVID-19 | Non-thyroid illness syndrome is the most consistently observed alteration of thyroid function parameters. SARS-CoV-2 may also infect the thyroid producing typical (painful) or atypical (painless) subacute thyroiditis |
Piticchio [18] | To discuss the relationship between COVID-19 infection and the endocrine glands and compare it with SARS-CoV | A possible damage of endocrine system in COVID-19 patients should be investigated in both COVID-19 acute phase and recovery to identify both early and late endocrine complications that may be important for patient’s prognosis and well-being after infection |
Question of the present systematic review | Conclusion | References supporting these findings |
---|---|---|
Which impact on thyroid can be expected in COVID-19 patients? | COVID-19-related thyroid dysfunctions include thyrotoxicosis, hypothyroidism, nonthyroidal illness syndrome. It is difficult to distinguish whether altered thyroid function is a result of direct or indirect effects of viral infection. Low-T3 as well as thyrotoxicosis should be predictors of poor outcome of hospitalized COVID-19 patients. SAT occurrence in patients with COVID-19 has been reported | |
Is there a higher risk for SARS-CoV-2 infection among thyroid patients? | Thyroid disease should not be considered a risk factor for SARS-CoV-2 infection | |
Has the management of thyroid patients to be adapted in presence of SARS-CoV-2 infection? | Data on the indication for monitoring thyroid patients when infected by SARS-CoV-2 are unclear and the need of thyroid follow-up is not supported |