Table 1.
Reported cases of Graves’ Disease after COVID-19 vaccination.
| Author reference | Age/Sex | Disease history | Presence of COVID-19 history | COVID-19 vaccine name -dose | Pre-vaccination thyroid hormone statusa | Post-vaccination symptom onset (days) |
Laboratory test results at diagnosis |
Antithyroid treatment | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TSH (RR) | fT4 (RR) | fT3 (RR) | Anti-TPO | Anti-Tg | TRAb (RR) | ||||||||
| Relapsed Graves' Disease | |||||||||||||
| Current patient 1 | 44/F | GD in remission (for 12 years) | No | CoronaVac® - 1st | N/A | 7 | <0.01 mIU/L (0.27–4.2) | 2.67 ng/dL (0.93–1.7) | 9.65 ng/L (2–4.4) | + | + | 12.2 IU/L (<1.5) | MMI 20 mg/day |
| Current patient 2 | 49/M | GD in remission (for 1 year) | No | Pfizer-BioNTech® - 2nd | Euthyroid without treatment | 30 | <0.01 mIU/L (0.27–4.2) | 3.86 ng/dL (0.93–1.7) | 13.5 ng/L (2–4.4) | + | + | 3.01 IU/L (<1.5) | MMI 20 mg/day |
| Current patient 3 | 31/F | GD in remission (for 1 year) | No | Pfizer-BioNTech® - 1st | Euthyroid without treatment | 21 | <0.01 mIU/L (0.27–4.2) | >7.77 ng/dL (0.93–1.7) | 21.7 ng/L (2–4.4) | + | – | 19.3 IU/L (<1.5) | MMI 20 mg/day |
| [4] | 30/F | Active GD (for 3 years) | N/A | ChAdOx1 nCoV19 (Oxford-AstraZeneca) - 1st | Euthyroid with MMI 2,5 mg/day | 4 | N/A | N/A | N/A | N/A | N/A | 13.4 IU/L (0–1.75) | MMI switched to 5 mg/day |
| [5] | 34/F | GD in remission (for 11 years) | N/A | Pfizer-BioNTech® -1st | Euthyroid without treatment | 10 | <0.01 mU/L (0.4–2.75) | 2.54 ng/dL (0.75–1.6) | 22.1 pmol/L (3–6.5) | N/A | N/A | 40 IU/L (<0.55) | MMI 40 mg/day |
| [6] | 71/F | GD in remission (for 17 years) | N/A | Pfizer-BioNTech® - 2nd | N/A | 35 | N/A | 3.56 ng/dL (0.7–1.7) | 11.1 pg/mL (2.15–4.1) | N/A | N/A | 4.2 IU/L (<1.5) | N/A |
| Conversion from Hashimoto's thyroiditis to Graves' disease | |||||||||||||
| Current patient 4 | 53/F | Hashimoto's thyroiditis (for 2 years) | Yes | Pfizer-BioNTech® - 2nd | Euthyroid with LT replacement | 7 | <0.01 mIU/L (0.27–4.2) | 4.01 ng/dL (0.93–1.7) | 8.83 ng/L (2–4.4) | + | + | 17.8 IU/L (<1.5) | MMI 15 mg/day |
| [7] | 40/F | Hashimoto's thyroiditis (for 8 years) | No | Pfizer-BioNTech® -2nd | Euthyroid with LT replacement | ∼30 | 0.02 mIU/L (0.47–4.68) | 66.6 pmol/L (10–28.2) | 30.5 pmol/L (2–4.4) | + | + | 420% (<140%) | CMZ |
| Rapidly developing Graves' ophthalmopathy | |||||||||||||
| Current patient 5 | 51/F | DM, HT | No | Pfizer-BioNTech® - 2nd | Euthyroid | 4 | <0.01mIU/L (0.27–4.2) | 3.72 ng/dL (0.93–1.7) | 12.6 ng/L (2–4.4) | – | – | 5.04 IU/L (<1.5) | MMI 15 mg/day |
| [8] | 50/F | GD in remission (for 11 years) | N/A | Pfizer-BioNTech® - 2nd | Euthyroid with LT replacement | 3 | Normal | Normal | Normal | N/A | N/A | 2.29 IU/L (<0.55) | – |
| Newly diagnosed Graves' Disease | |||||||||||||
| Current patient 6 | 47/F | Obesity | No | Pfizer-BioNTech®-1st | Euthyroid | 5 | <0.01 mIU/L (0.27–4.2) | 3.32 ng/dL (0.93–1.7) | 11.0 ng/L (2–4.4) | – | + | 22.7 IU/L (<1.5) | MMI 15 mg/day |
| Current patient 7 | 46/M | – | No | Pfizer-BioNTech®-2nd | N/A | 21 | <0.01 mIU/L (0.27–4.2) | >7.77 ng/dL (0.93–1.7) | 25.3 ng/L (2–4.4) | + | + | 9.1 IU/L (<1.5) | MMI 25 mg/day |
| [6] | 46/M | – | N/A | Pfizer-BioNTech® - 1st | Euthyroid | 15 | N/A | 1.63 ng/dL (0.7–1.7) | 5.2 pg/mL (2.15–4.1) | N/A | N/A | 2.9 IU/L (<1.5) | N/A |
| [9] | 32/M | – | N/A | Vaxzevria® (Oxford-AstraZeneca) - 2nd | N/A | 10 | 0.005 uIU/mL (N/A) | 2.96 ng/dL (0.6–1.12) | 7.9 pg/mL (2–4.4) | N/A | N/A | 7.98 IU/L (<2.9) | MMI 15 mg/day |
| [9] | 35/M | – | N/A | Vaxzevria® (Oxford-AstraZeneca) - 1st | N/A | 5 | 0.004 uIU/mL (N/A) | 4.96 ng/dL (0.6–1.12) | N/A | N/A | N/A | 3.2 IU/L (<2.9) | MMI 15 mg/day |
| [10] | 52/M | Vitiligo, DM | No | Pfizer-BioNTech® - 2nd | N/A | 30 | 0.004 mIU/L (0.4–4) | 5.56 ng/dL (0.7–1.7) | 15.0 ng/L (2.7–5.7) | + | + | 6.48 IU/L (0–1.49) | MMI |
| [11] | 38/F | – | N/A | Pfizer-BioNTech® - 1st | N/A | 12 | 0.008 uIU/mL (0.35–4.95) | 2.01 ng/dL (0.7–1.48) | 7.46 pg/mL (1.58–3.9) | + | + | 12.5 IU/L (<0.7) | MMI |
| [12] | 70/M | N/A | No | ChAdOx1 nCoV19 (Oxford-AstraZeneca) – 2nd | Euthyroid | 2 | 0.003 mIU/L (0.35–4.94) | 3.19 ng/dL(0.7–1.48) | 20.0 pg/mL (2.04–4.4) | N/A | N/A | 3.23 IU/L (<1.75) | MMI 15 mg/day |
| [13] | 40/F | HT | Yes | Pfizer-BioNTech® - 1st | N/A | 2 | <0.001 mIU/L (0.27–4.4) | 3.57 ng/dL (0.93–1.71) | 10.5 pg/mL (2.04–4.4) | + | + | 16.6 IU/L (<1.75) | N/A |
| [13] | 28/F | – | No | Pfizer-BioNTech® - 1st | N/A | 3 | <0.001 mIU/L (0.27–4.4) | 1.84 ng/dL (0.93–1.71) | 9.2 pg/mL (2.04–4.4) | + | + | 5.85 IU/L (<1.75) | N/A |
COVID-19: Coronavirus disease-2019; GD: Graves' disease; DM: Diabetes Mellitus; HT: Hypertension; TSH: thyroid-stimulating hormone; fT4: free thyroxine; fT3: free triiodothyronine; Anti-TPO: anti-thyroid peroxidase; Anti-Tg: anti-thyroglobuline; TRAb: TSH receptor antibody; MMI: methimazole; CMZ: carbimazole; LT: levothyroxine; N/A: not available.
a
Indicates the thyroid hormone status in the period 6 months before vaccination.