FUNCTIONAL AND STRUKTURAL CHANGES OF THE THYROID IN PATIENTS WITH AUTOIMMUNE THYROIDITIS WITH HYPOTHYROIDISM IN THE POST-COVID PERIOD

Abstract

COVID-19 is a severe immunosuppressive disease that may exacerbate existing autoimmune diseases. Autoimmune thyroiditis (AIT) is no exception, the progression of which can lead to changes in the structure and function of the thyroid. The issue of studying the peculiarities of the clinical course of existing AIT in the post-COVID period is relevant.

The aim of the study – to investigate changes in the structure and function of the thyroid gland in patients with AIT with subclinical and manifest compensated hypothyroidism, who had moderate COVID-19.

Patients and methods. We examined 35 people aged 21–49 with AIT who had moderate COVID-19. The duration of AIT was from 4 to 10 years. Thyroid function and compensation of hypothyroidism in terms of thyroid-stimulating hormone (TSH), the structure of the gland – according to the results of ultrasound were studied in all patients 2 and 6 months after COVID-19.

Results and Discussion. It was found that in all patients with AIT COVID-19 caused an increase in structural changes in the thyroid gland and a decrease in its hormone-producing function. Structural changes in the parenchyma of the gland progressed within one of the two variants of the ultrasound picture (hypoechoic heterogeneous or pseudomicrous). Manifest hypothyroidism developed in half of patients with subclinical hypothyroidism in the post-COVID period. They showed a significant decrease in hormone synthesis, which required an increase in the dose of replacement therapy.

Conclusion. There is a progression of lymphocytic infiltration of the parenchyma of the thyroid gland, exacerbation of structural changes and reduction of its hormonal and synthetic function in the post-COVID period in patients with AIT.