Skip to main content
Top
Published in: Journal of Endocrinological Investigation 5/2021

Open Access 01-05-2021 | COVID-19 | Review

The cytokine storm and thyroid hormone changes in COVID-19

Authors: L. Croce, D. Gangemi, G. Ancona, F. Liboà, G. Bendotti, L. Minelli, L. Chiovato

Published in: Journal of Endocrinological Investigation | Issue 5/2021

Login to get access

Abstract

Background

COVID-19 is now a worldwide pandemic. Among the many extra-pulmonary manifestations of COVID-19, recent evidence suggested a possible occurrence of thyroid dysfunction.

Purpose

The Aim of the present review is to summarize available studies regarding thyroid function alterations in patients with COVID-19 and to overview the possible physio-pathological explanations.

Conclusions

The repercussions of the thyroid of COVID-19 seem to be related, in part, with the occurrence of a “cytokine storm” that would, in turn, induce a “non-thyroidal illness”. Some specific cytokines and chemokines appear to have a direct role on the hypothalamus–pituitary–thyroid axis. On the other hand, some authors have observed an increased incidence of a destructive thyroiditis, either subacute or painless, in patients with COVID-19. The hypothesis of a direct infection of the thyroid by SARS-Cov-2 stems from the observation that its receptor, ACE2, is strongly expressed in thyroid tissue. Lastly, it is highly probable that some pharmaceutical agents largely used for the treatment of COVID-19 can act as confounding factors in the laboratory evaluation of thyroid function parameters.
Literature
5.
go back to reference Jl F, Abhyankar S, Dg G (1993) Cytokine storm of graft-versus-host disease: a critical effector role for interleukin-1. Transplant Proc 25(1 Pt 2):1216–1217 Jl F, Abhyankar S, Dg G (1993) Cytokine storm of graft-versus-host disease: a critical effector role for interleukin-1. Transplant Proc 25(1 Pt 2):1216–1217
6.
go back to reference Yuen KY, Wong SS (2005) Human infection by avian influenza A H5n1. Hong Kong Med J 11(3):189–199PubMed Yuen KY, Wong SS (2005) Human infection by avian influenza A H5n1. Hong Kong Med J 11(3):189–199PubMed
38.
go back to reference Borges Do Nascimento IJ, Von Groote TC, O'mathúna DP et al (2020) Clinical, laboratory and radiological characteristics and outcomes of novel coronavirus (Sars-Cov-2) infection in humans: a systematic review and series of meta-analyses. Plos One 15(9):E0239235https://doi.org/10.1371/Journal.Pone.0239235 Borges Do Nascimento IJ, Von Groote TC, O'mathúna DP et al (2020) Clinical, laboratory and radiological characteristics and outcomes of novel coronavirus (Sars-Cov-2) infection in humans: a systematic review and series of meta-analyses. Plos One 15(9):E0239235https://​doi.​org/​10.​1371/​Journal.​Pone.​0239235
83.
go back to reference Ramadori G, Van Damme J, Rieder H, Meyer Zum Büschenfelde KH (1988) Interleukin 6, the third mediator of acute-phase reaction, modulates hepatic protein synthesis in human and mouse. Comparison with interleukin 1 beta and tumor necrosis factor-alpha. Eur J Immunol 18(8):1259–1264. https://doi.org/10.1002/Eji.1830180817 Ramadori G, Van Damme J, Rieder H, Meyer Zum Büschenfelde KH (1988) Interleukin 6, the third mediator of acute-phase reaction, modulates hepatic protein synthesis in human and mouse. Comparison with interleukin 1 beta and tumor necrosis factor-alpha. Eur J Immunol 18(8):1259–1264. https://​doi.​org/​10.​1002/​Eji.​1830180817
91.
go back to reference Kraiem Z, Sobel E, Sadeh O, Kinarty A, Lahat N (1990) Effects of gamma-interferon on DR antigen expression, growth, 3,5,3′-triiodothyronine secretion, iodide uptake, and cyclic adenosine 3′,5′-monophosphate accumulation in cultured human thyroid cells. J Clin Endocrinol Metab 71(4):817–824. https://doi.org/10.1210/Jcem-71-4-817CrossRefPubMed Kraiem Z, Sobel E, Sadeh O, Kinarty A, Lahat N (1990) Effects of gamma-interferon on DR antigen expression, growth, 3,5,3′-triiodothyronine secretion, iodide uptake, and cyclic adenosine 3′,5′-monophosphate accumulation in cultured human thyroid cells. J Clin Endocrinol Metab 71(4):817–824. https://​doi.​org/​10.​1210/​Jcem-71-4-817CrossRefPubMed
93.
99.
go back to reference Carella C, Mazziotti G, Morisco F et al (2002) The addition of ribavirin to interferon-alpha therapy in patients with hepatitis C virus-related chronic hepatitis does not modify the thyroid autoantibody pattern but increases the risk of developing hypothyroidism. Eur J Endocrinol 146(6):743–749. https://doi.org/10.1530/Eje.0.1460743CrossRefPubMed Carella C, Mazziotti G, Morisco F et al (2002) The addition of ribavirin to interferon-alpha therapy in patients with hepatitis C virus-related chronic hepatitis does not modify the thyroid autoantibody pattern but increases the risk of developing hypothyroidism. Eur J Endocrinol 146(6):743–749. https://​doi.​org/​10.​1530/​Eje.​0.​1460743CrossRefPubMed
136.
go back to reference Stevenson HP, Archbold GP, Johnston P, Young IS, Sheridan B (1998) Misleading serum free thyroxine results during low molecular weight heparin treatment. Clin Chem 44(5):1002–1007CrossRefPubMed Stevenson HP, Archbold GP, Johnston P, Young IS, Sheridan B (1998) Misleading serum free thyroxine results during low molecular weight heparin treatment. Clin Chem 44(5):1002–1007CrossRefPubMed
138.
go back to reference Sapin R, Jl S, Gasser F et al (2000) Intermethod discordant free thyroxine measurements in bone marrow-transplanted patients. Clin Chem 46(3):418–422CrossRefPubMed Sapin R, Jl S, Gasser F et al (2000) Intermethod discordant free thyroxine measurements in bone marrow-transplanted patients. Clin Chem 46(3):418–422CrossRefPubMed
Metadata
Title
The cytokine storm and thyroid hormone changes in COVID-19
Authors
L. Croce
D. Gangemi
G. Ancona
F. Liboà
G. Bendotti
L. Minelli
L. Chiovato
Publication date
01-05-2021
Publisher
Springer International Publishing
Published in
Journal of Endocrinological Investigation / Issue 5/2021
Electronic ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-021-01506-7

Other articles of this Issue 5/2021

Journal of Endocrinological Investigation 5/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine