Table 2.
Adverse events of the endocrine system after SARS-CoV-2 vaccination
| Author reference | Type of vaccine | Time of symptoms onset | Main symptoms | Complications | Treatment |
|---|---|---|---|---|---|
| Thyroid-Subacute Thyroiditis (SAT) | |||||
| Sözen et al. [51] | BNT162b2 (Pfizer-BioNTech) | mainly 4–20 days after 1st dose | neck pain, fatigue, palpitation | None | Acetylsalicylic acid, propranolol, and Ibuprofen |
| Bornemann et al. [52] | Spikevax (Moderna Biotech, Spain) and Vaxzevria (AstraZeneca, Sweden) | mainly 14 days after 1st dose | cervical pain that radiated to both ears, fever chills, and headache | None | Ibuprofen diclofenac, prednisolone |
| Oyibo et al. [41] | ChAdOx1 nCoV-19 (Oxford-AstraZeneca) | 21 days after 1st dose | neck pain and swelling, headache, sore throat, generalized aches and palpitations | None | Propranolol, ibuprofen and paracetamol |
| Thyroid- Graves’ disease (GD) | |||||
| Vera-Lastra et al. [43] | BNT162b2 (Pfizer-BioNTech) | mainly 2–3 days after 1st dose | nausea, vomiting, fatigue, anxiety, insomnia, palpitations, and a distal tremor | sinus tachycardia and episodes of paroxysmal atrial fibrillation | Propranolol, diltiazem, ivabradine, and thiamazole |
| Sriphrapradang et al. [53] | ChAdOx1 nCoV-19 (Oxford-AstraZeneca) | 4 days after the booster dose | palpitations and loss weight | hyperthyroidism | Methimazole and propranolol |
| Bostan et al. [54] | inactivated COVID-19 vaccine (CoronaVac®; BNT162b2 (Pfizer-BioNTech) | mainly 4–30 days after 2nd dose | excessive sweating, palpitation, and fatigue hand tremors | rapidly developing Graves’ ophthalmopathy was detected in one patient. | Methimazole and propranolol |
| Thyroid-Painless thyroiditis (PT) | |||||
| Siolos et al. [27] | ChAdOx1 nCoV-19 (Oxford-AstraZeneca) | 21 days after 1st dose | None | None | No specific treatment |
| Pancreas-Hyperosmolar hyperglycemic state (HHS) | |||||
| Abu-Rumaileh et al. [31] | BNT162b2 (Pfizer-BioNTech) | 2 days after 2nd dose | increased nocturia, polyuria, polydipsia, worsening mental status, and weight loss | new-onset T2DM | Intravenous fluids with insulin drip |
| Lee et al. [32] | BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) | mainly 2 days after 1st dose | fatigue, blurry vision, polyuria and polydipsia | one patient was diagnosed with T2DM and nonketotic HHS without coma | Intravenous hydration and an insulin infusion, and metformin |
| Pancreas-Diabetic ketoacidosis (DKA) | |||||
| Lee et al. [32] | mRNA-1273 (Moderna) | 10 days after 1st dose | weakness and altered mental status, fatigue and myalgias | aspiration pneumonia and a lower extremity deep | Normal saline hydration, continuous insulin infusion, antibiotics and enoxaparin |
| Edwards et al. [30] | ChAdOx1 nCoV-19 (Oxford-AstraZeneca) | 20 days after 1st dose | subacute onset of osmotic symptoms | pre-diabetes | Amlodipine, indapamide |
| Pancreas-High glucose (HG) | |||||
| Mishra et al. [28] | Covishield (ChAdOx1 nCoV-19) | mainly 1–6 days after 1st dose | higher SMBG values | T2DM | Metformin or without intervention |
| Pituitary- Hypophysitis | |||||
| Murvelashvili et al. [33] | mRNA-1273 (Moderna) | 3 days after 2nd dose | headache, nausea, vomiting, malaise, and diffuse arthralgias | low libido and erectile dysfunction | Steroids and thyroid hormone |
| Adrenal-Hemorrhage | |||||
| Taylor et al. [34] | ChAdOx1 nCoV-19 (Oxford-AstraZeneca) | 8 days after 1st dose | severe abdominal pain and vomiting | VITT | Hydrocortisone, Plasma exchange, fludrocortisone |
| Adrenal-Primary adrenal insufficiency | |||||
| Varona et al. [35] | ChAdOx1 nCoV-19 (Oxford-AstraZeneca) | 10 days after 1st dose | headache, somnolence, mild confusion, and progressive abdominal discomfort | VITT | Hydrocortisone |
VITT vaccine‐induced thrombosis and thrombocytopaenia