Subacute Granulomatous Thyroiditis Occurring after SARS-CoV-2 Infection: A Case Report

Abstract

Subacute thyroiditis is a rare self-limited thyroid inflammatory condition characterized in the majority of cases by sudden onset of neck pain. It seems to be mostly linked, directly or indirectly, to viral infections. During the COVID-19 pandemic, several cases of thyroiditis were reported in the literature, occurring during or after infection by the SARS-CoV-2, suggesting that this virus is also linked to subacute thyroiditis. Therefore, knowledge of a possible association between these two entities is of the most importance. Several hypotheses explaining the mechanism of action of SARS-CoV-2 on the thyroid gland have been put forward. Clinical symptoms do not appear to be very typical, and thyroid hormonal dysfunction may not be present. Treatment is essentially based on corticosteroids and NSAIDs. The prognosis remains favorable. We report the case of a 46-year-old woman who presented with subacute thyroiditis 25 days after SARS-CoV-2 infection. Her workup showed elevated CRP, multinodular goiter, normal thyroid function and negative antibodies. She was treated with corticosteroids that resulted in improvement of her symptoms.