Table 1.
Clinical characteristics, laboratory results and imaging findings of patients with SARS-CoV-2 vaccine-induced subacute thyroiditis
| N° | Author (Ref) | Gender | Age | Type of vaccine | Dose | Time (days) | Neck pain | TSH | FT4 | ESR | CRP | Thyroid ultrasound, Colour flow Doppler | Thyroid scintigraphy | Treatment | Follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Iremli [1] | F | 35 | Inactivated virus | 2nd | 4 | Y | 0.47 | 14.1 | 53 | 100.5 | Bilateral focal hypoechoic area, decreased blood flow | ND | Methylprednisolone, propanolol | Disappeared within 1 day, recovery 4 weeks |
| 2 | Iremli [1] | F | 34 | Inactivated virus | 1st | 4 | Y | 0.01 | 5.2 | 19 | 6 | Bilateral focal hypoechoic area, decreased blood flow | ND | Methylprednisolone, propanolol | Myalgia, neck pain during taperring methylprednisolone, recovery 10 weeks |
| 3 | Iremli [1] | F | 37 | Inactivated virus | 2nd | 7 | Y | 0.9 | 13.85 | 25 | 2.4 | Bilateral focal hypoechoic area, decreased blood flow | ND | Rarely paracetamol | No treatment, recovery 8 weeks |
| 4 | Oyibo [2] | F | 55 | Adenovirus vectored | 1st | 21 | Y | 0.09 | 25.2 | 51 | 87 | Enlarged, heterogenous thyroid gland | Propanolol, ibuprofen, paracetamol | Hypothyroidism at 6 weeks treated by LT4, recovery 12 weeks | |
| 5 | Franquemont [3] | F | 42 | mRNA | 1st | 5 | Y | <0.01 | 58.95 | 62 | NA | Prednisone, propanolol | |||
| 6 | Schimmel [4] | F | 57 | mRNA | 2nd | 1 | Y | 0.008 | 24.7 | NA | NA | Enlarged, heterogenous, hypervascular right lobe thyroid | Ibuprofen, propanolol, prednisone | ||
| 7 | Saygili [5] | F | 38 | Inactivated virus | 2nd | 14 | Y | 0.008 | 59.8 | 78 | 87.6 | Increased size, hypoechoic area | Naprozen sodium, propanolol | Hypothyroidism at 1 month, levothyroxine treatment | |
| 8 | Sigstad [6] | F | 30 | mRNA | 1st | 6 | Normal | 13 | NA | NA | Thyroiditis, hypoechoic nodule | ||||
| 9 | Jeeyavudeen [7] | F | NA | mRNA | 2nd | 14 | Y | <0.01 | 27 | NA | 23 | Minimal isotope uptake | NSAID | Resolution symptoms 6 weeks, euthyroid 8 weeks | |
| 10 | Soltanpoor [8] | F | 34 | Inactivated virus | 1st | 5 | Y | 0.05 | 60 | 9.8 | Heterogeneity, decreased vascularity | Moderate to severely decreased uptake | Prednisone, propanolol | Euthyroid state at 7 weeks | |
| 11 | Ratnayake [9] | M | 75 | Adenovirus vectored | 1st | 14 | Y | 0.01 | 28.2 | NA | NA | Marked reduction of uptake | Ibuprofen | Normal thyroid function at 1 month | |
| 12 | Sozen [10] | M | 41 | mRNA | 2nd | 3 | Y | 0.01 | 40.9 | 32 | 124 | Heterogeneous, hypoechogenicity, decreased blood flow | Acetylsalicylic acid, propanolol | Transient hypothyroiidsm, complete remission, eythyroid | |
| 13 | Sozen [10] | F | 40 | mRNA | 2nd | 6 | Y | 0.18 | 20.34 | 80 | 34 | Heterogeneity, hypoechoic areas, decreased blood flow | Acetylsalicylic acid, propanolol | Control at 1 month | |
| 14 | Sozen [10] | M | 40 | mRNA | 1st | 4 | Y | 1.1 | 19.95 | 28 | 15 | Heterogenous, hypoechoic areas | Ibuprofen | Control at 2 weeks | |
| 15 | Sozen [10] | F | 26 | mRNA | 1st | 20 | Y | 0.01 | 26 | 34 | 27 | Heterogeneous, hypoechogenicity, decreased blood flow | Suppressed thyroid gland | Acetylsalicylic acid, propanolol | Control at 1 month, euthyroid |
| 16 | Sozen [10] | F | 44 | mRNA | 2nd | 9 | Y | 0.24 | 20.33 | 44 | 18 | Heterogeneity, hypoechoic areas, decreased blood flow | Ibuprofen | Control at 1 month | |
| 17 | Kyriacou [11] | F | 40 | mRNA | 2nd | 1 | Y | 0.11 | 33.74 | 67 | 174.3 | Heterogeneity, hypoechoic areas, decreased blood flow | Prednisone, propanolol | Resolution symptoms in 2 days, euthyroid TSH 2,74 1 month | |
| 18 | Patel [12] | M | 48 | 2nd | 7 | Y | 0.01 | 46.34 | Increased | Increased | Heterogeneous, hypoechogenicity, goiter | NSAID, prednisone during 1 week | Resolution symptoms in 1 day | ||
| 19 | Sahin tekin [13] | M | 67 | Inactivated virus | 2nd | 17 | Y | 0.005 | 36.9 | 67 | 5.9 | Hypoechogenicity, heterogenous, pseudonodular areas | Ibuprofen | Relief of symptoms in few days | |
| 20 | Bornemann [14] | F | 26 | Adenovirus vectored | 1st | 16 | Y | 1.75 | 11.97 | NA | 29.4 | Heterogenous, hypoechoic areas, decreased blood flow | Ibuprofen, prednisolone | Resolution symptoms 2 weeks, euthyroid 6 weeks TSH 0,83 | |
| 21 | Bornemann [14] | F | 49 | mRNA | 1st | 14 | Y | 0.01 | 12.1 | NA | 21.9 | Normal size, hypoechoic areas, decreased vascularity | Ibuprofen, prednisolone | Symptoms improved in 2 weeks | |
| 22 | Lee [15] | F | 39 | Adenovirus vectored | 2nd | 4 | Y | 0.113 | 31.4 | 63 | 28.6 | Ill defined, hypoechoic lesion | Decreased uptake | ||
| 23 | Lee [15] | F | 73 | Adenovirus vectored | 1st | 11 | Y | 0.012 | 94.7 | 85 | 34.6 | Ill defined, hypoechoic lesion | |||
| 24 | Lee [15] | M | 39 | Adenovirus vectored | 1st | 14 | Y | 0.012 | 36.98 | 74 | 36.5 | Ill defined, hypoechoic lesion | Thyroid scan uptake increased | ||
| 25 | Siolos [16] | F | 51 | mRNA | 1st | 4 | Y | 0.08 | 24.84 | 103 | 135 | Markedly decreased thyroid uptake | Prednisolone | Resolution fever and neck pain in 2 days | |
| 26 | Pujol [17] | F | 38 | mRNA | 1st | 8 | Y | <0.008 | 23.94 | NA | NA | Enlarged right lobe, diffuse hypoechogenicity | Very low uptake | Ibuprofen, propanolol, prednisone | Improvement of symptoms in 1 week |
| 27 | Pandya [18] | M | 37 | mRNA | 1st | 15 | Y | <0.01 | 89.58 | 51 | NA | Enlarged and heterogenous thyroid gland | Decreased uptake at 4 and 24 hr | Ibuprofen, propanolol, prednisone | |
| 28 | Pandya [18] | M | 35 | mRNA | 1st | 10 | Y | 0.07 | 39.13 | NA | NA | Enlarged and heterogenous thyroid gland | Ibuprofen, propanolol | ||
| 29 | Pandya [18] | F | 41 | mRNA | 2nd | 20 | 0.019 | 32.43 | NA | NA | Enlarged and heterogenous thyroid gland | Decreased uptake | Ibuprofen, diltiazen | ||
| 30 | Pla Pleris [19] | M | 57 | mRNA | 1st | <14 | No | <0.005 | 64.36 | 30 | 88 | Heterogeneous echogenicity, diffuse hypoechoic area, decreased vascularity | NA | NSAID | Improvement in 2 weeks, subclinical hypothyroidism |
| 31 | Pla Pleris [19] | M | 67 | mRNA | 1st | <14 | Y | <0.005 | 45.05 | 60 | 120 | Unstructured thyroid, diffuse hypoechoic area, decreased vascularity | Decreased uptake | NSAID | Improvement in 2 weeks, subclinical hypothyroidism at 4 weeks |
| 32 | Pla Pleris [19] | M | 47 | mRNA | 1st | <14 | Y | 0.005 | 33.46 | 70 | 92 | Unstructured thyroid, diffuse hypoechoic area, decreased vascularity | Decreased uptake | NSAID | Improvement of symptoms in 2 weeks, normal thyroid function at 5 weeks |
| 33 | Pla Pleris [19] | F | 69 | mRNA | 1st | <14 | Y | <0.005 | 23.17 | 75 | 120 | Enlarged thyroid gland, heterogeneous echogenecity, diffuse hypoechoic pattern | NA | Methylprednisolone, NSAID | |
| 34 | Das [20] | F | 47 | Adenovirus vectored | 1st | 14 | Y | 0.06 | NA | NA | Bulky thyroid with bilateral hypoechoic nodules | No tracer uptake | Propanolol, | Improvement and complete rsolution and normal TSH at 8 weeks | |
| 35 | Raven [21] | F | 35 | mRNA | 1st | 4 | Y | 2.03 | 11.4 | NA | NA | 11 mm right thyroid nodule | NA | No treatment | Resolution of pain in 2 weeks |
| 36 | Chatzi [22] | F | 35 | mRNA | 1st | 12 | Y | 75 | 498 | Increased gland, heterogeneous appearance, hypoechogenic regions | Low uptake | Prednisolone | |||
| 37 | Chatzi [22] | F | 32 | mRNA | 2nd | 4 | Y | 40 | 10 | Increased gland, heterogeneous appearance, hypoechogenic regions | Low uptake | Prednisolone | |||
| 38 | Oguz [23] | F | 42 | mRNA | 1st | 4 | <0.015 | 51.4 | 74 | 44.4 | Patchy heterogenous hypoechoic areas in right lobe | Partially suppressed thyroid uptake | NSAID | Remission 14 weeks | |
| 39 | Oguz [23] | F | 48 | Inactivated virus | 2nd | 1 | 0.031 | 48 | 58 | Patchy heterogenous, hypoechoic areas | NA | Prednisolone | Remission 5 weeks | ||
| 40 | Oguz [23] | F | 47 | mRNA | 1st | 10 | 0.54 | 13.42 | 55 | 48.5 | Patchy heterogenous, hypoechoic areas | NA | Paracetamol | Remission 13 weeks | |
| 41 | Oguz [23] | F | 72 | mRNA | 2nd | 15 | 11.81 | 10 | 7.7 | Patchy heterogenous, hypoechoic areas in the right lobe | NA | No treatment | Remission 5 weeks | ||
| 42 | Oguz [23] | M | 50 | Inactivated virus | 1st | 1 | 0.127 | 11.4 | 41 | 10.2 | Ill-edged heterogenous hypoechoic area in right lobe | NA | NSAID | Remission 6 weeks | |
| 43 | Oguz [23] | F | 61 | Inactivated virus | 2nd | 15 | 4.44 | 10.99 | 34 | 11.6 | Patchy heterogenous, hypoechoic areas | NA | Methylprednisolone | Remission 20 weeks | |
| 44 | Oguz [23] | F | 36 | Inactivated virus | 2nd | 4 | 0.47 | 19.11 | 53 | 105 | Patchy heterogenous, hypoechoic areas, decreased vascularisation | NA | Methylprednisolone | No remission | |
| 45 | Oguz [23] | F | 38 | Inactivated virus | 2nd | 7 | 0.018 | 26.1 | 44 | 3 | Patchy heterogenous, hypoechoic areas, decreased vascularisation | NA | No treatment | Remission 11 weeks | |
| 46 | Oguz [23] | F | 38 | mRNA | 1st | 10 | <0.01 | 51.48 | 55 | 136.3 | Patchy heterogenous, hypoechoic areas | NA | NSAID | Remission 4 weeks | |
| 47 | Oguz [23] | F | 38 | Inactivated virus | 1st | 13 | 0.032 | 12.23 | 42 | 19 | Patchy heterogenous, hypoechoic areas | NA | Paracetamol, NSAID | Remission 12 weeks | |
| 48 | Oguz [23] | F | 43 | mRNA | 2nd | 7 | 0.01 | 37.7 | 429 | Patchy heterogenous, hypoechoic areas, decreased vascularisation | Low thyroid uptake (24 h RAIU 1%) | Methylprednisolone, NSAID | Remission 11 weeks | ||
| 49 | Oguz [23] | F | 60 | mRNA | 1st | 3 | 0.6 | 14 | 33 | 52 | Patchy heterogenous, hypoechoic area in left lobe | NA | No treatment | Not in remission | |
| 50 | Oguz [23] | F | 46 | mRNA | 1st | 1 | 0.43 | 14.08 | 60 | 17 | Patchy heterogenous, hypoechoic areas | NA | NSAID, methylprednisolone | Remission 18 weeks | |
| 51 | Oguz [23] | F | 34 | Inactivated virus | 1st | 4 | 0.03 | 31.65 | 18 | 6 | Patchy heterogenous, hypoechoic areas, decreased vascularisation | NA | Methylprednisolone and then methimazole after GD diagnosis | Not in remission | |
| 52 | Oguz [23] | M | 71 | mRNA | 1st | 10 | 0.038 | 17.27 | 67 | 36.5 | Patchy heterogenous, hypoechoic areas, decreased vascularisation | NA | Prednisolone | Not in remission | |
Age in years, Time in days, TSH in mU/L, and FT4 in pmol/l
Gender F female, M male, Y yes, N not present, ESR Erythrocyte sedimentation rate (mm/h), CRP C-reactive protein (mg/l), NSAID non-steroidal anti-inflammatory drug, NA Not available