Along with our case, all 3 previously reported cases were female (ages
ranged from 28 to 53 years). No patients had been previously diagnosed
with thyroid disease. All patients had had COVID-19 infection with
respiratory symptoms. The interval between diagnosis of hyperthyroidism
and COVID-19 infection ranged from 0 to 84 days. Like our case, most of
these patients manifested a goitre and palpitations. Thyroid function
tests showed overt hyperthyroidism. TSH levels were undetectable
(<0.01 U/L) and FT4 were 2-3 times higher than upper limit of
the normal level (NR27 – 36.5 pmol/L). Thyroid autoantibodies were
measured and showed increased TRAb in all cases. Anti -Tg andAnti -TPO were significantly elevated in our case and in that
reported by Mateu-Salat [15]. Thyroid ultrasound examinations
of these patients were typical for Graves’ disease, with
hypervascularity and mild thyromegaly. Iodine uptakes were done in two
patients to confirm the diagnosis of hyperthyroidism. Patients were all
treated with anti-thyroid medication and clinical improvement resulted.
The major limitation of our case report review is the paucity of
published cases (only 3 other patients reported so far). Nevertheless,
these reports are likely to be of benefit to clinicians who encounter
cases of new-onset hyperthyroidism after COVID-19 infection. From our
review, the hyperthyroidism is mild, responds well to methimazole and
beta blockers in combination and has a low incidence post COVID-19
infection. A larger case series might confirm these findings Moreover,
additional follow-up data are necessary to assess long term outcomes in
these cases.