Thyroid disease following SARS- COV-2 vaccination

Enfermedad tiroidea posterior a vacunación contra SARS-COV-2

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Abstract

Introduction: Vaccines have been an essential part of the SARS-CoV-2 pandemic management and control. However, aluminum salts in vaccines, used to enhance the immune response, may be associated with autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This syndrome has been linked to other factors, such as infectious agents, silicone implants, and mineral oil inoculation. Data on autoimmune endocrine disorders and ASIA following SARS-CoV-2 vaccination is scant. Objective: to report cases of thyroid disorders following COVID-19 vaccination, in patients who attended the endocrinology clinic at Clínica Imbanaco, Cali, Colombia, in 2021. Methods: clinical, laboratory and imaging description of 8 patients who attended the endocrinology service. Results and discussion: 87.5% were females, aged 46.8 ± 10 years. Time between vaccine administration and symptoms onset was 13.8 days and the most related vaccine was the Pfizer/BioNTech vaccine followed by Sinovac-CoronaVac and AstraZeneca/AZD1222 vaccines. Subacute thyroiditis presented in 37.5%, Graves´ disease in 37.5%, silent thyroiditis in 12.5% and hypothyroidism in 12.5%. Myalgias and palpitations were the most common symptoms. Subacute thyroiditis was the most common ultrasound finding. Conclusions: our case series evidences a relationship between thyroid disease and SARS-CoV-2 vaccination.  Given controversy remains, further studies will be necessary to establish causality.

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References

Word Health Organization. Coronavirus disease (COVID-19): Vaccines [Internet]. [cited 2021 Dec 6]. Word Health Organization; 2021. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-(covid-19)-vaccines?adgroupsurvey=%7Badgroupsurvey%7D&gclid=Cj0KCQiA47GNBhDrARIsAKfZ2rCEVMlvbm_LadaZ6hQtDqFdfaUmPAi4tIYNl93-UPHARDNWzrlum8kaAphEEALw_wcB

Watad A, Quaresma M, Brown S, Cohen Tervaert JW, Rodríguez-Pint I, Cervera R, Perricone C, Shoenfeld Y. Autoimmune/inflammatory syndrome induced by adjuvants (Shoenfeld's syndrome) - An update. Lupus. 2017;26(7):675-681. https://doi.org/10.1177/0961203316686406. DOI: https://doi.org/10.1177/0961203316686406

Shoenfeld Y, Agmon-Levin N. “ASIA” - autoimmune/inflammatory syndrome induced by adjuvants. J Autoimmun. 2011;36(1):4–8. https://doi.org/10.1016/j.jaut.2010.07.003. DOI: https://doi.org/10.1016/j.jaut.2010.07.003

Plitas G, Rudensky AY. Regulatory T Cells: Differentiation and Function. Cancer Immunol Res. 2016;4(9):721–725. https://doi.org/10.1158/2326-6066.CIR-16-0193. DOI: https://doi.org/10.1158/2326-6066.CIR-16-0193

Bragazzi NL, Hejly A, Watad A, Adawi M, Amital H, Shoenfeld Y. ASIA syndrome and endocrine autoimmune disorders. Best Pract Res Clin Endocrinol Metab. 2020;34(1):101412. https://doi.org/10.1016/j.beem.2020.101412. DOI: https://doi.org/10.1016/j.beem.2020.101412

Ehrenfeld M, Tincani A, Andreoli L, Cattalini M, Greenbaum A, Kanduc D, Alijotas-Reig J, Zinserling V, Semenova N, Amital H, Shoenfeld Y. Covid-19 and autoimmunity. Autoimmun Rev. 2020;19(8):102597. doi: https://doi.org/10.1016/j.autrev.2020.102597. DOI: https://doi.org/10.1016/j.autrev.2020.102597

Vojdani A, Kharrazian D. Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases. Clin Immunol. 2020;217:108480. https://doi.org/10.1016/j.clim.2020.108480. DOI: https://doi.org/10.1016/j.clim.2020.108480

Watad A, David P, Brown S, Shoenfeld Y. Autoimmune/Inflammatory Syndrome Induced by Adjuvants and Thyroid Autoimmunity. Front Endocrinol (Lausanne). 2017;7:150. https://doi.org/10.3389/fendo.2016.00150. DOI: https://doi.org/10.3389/fendo.2016.00150

Iremli BG, Sendur SN, Unluturk U. Three Cases of Subacute Thyroiditis Following SARS-CoV-2 Vaccine: Postvaccination ASIA Syndrome. J Clin Endocrinol Metab. 2021;106(9):2600–2605. https://doi.org/10.1210/clinem/dgab373. DOI: https://doi.org/10.1210/clinem/dgab373

Vera-Lastra O, Navarro AO, Domiguez MPC, Medina G, Valadez TIS, Jara LJ. Two Cases of Graves’ Disease Following SARS-CoV-2 Vaccination: An Autoimmune/Inflammatory Syndrome Induced by Adjuvants. Thyroid. 2021;31(9):1436–1439. https://doi.org/10.1089/thy.2021.0142. DOI: https://doi.org/10.1089/thy.2021.0142

Sriphrapradang C. Aggravation of hyperthyroidism after heterologous prime-boost immunization with inactivated and adenovirus-vectored SARS-CoV-2 vaccine in a patient with Graves’ disease. Endocrine. 2021;74(2):226–227. https://doi.org/10.1007/s12020-021-02879-8. DOI: https://doi.org/10.1007/s12020-021-02879-8

Zettinig G, Krebs M. Two further cases of Graves’ disease following SARS-Cov-2 vaccination. J Endocrinol Invest. 2022;45(1):227228. https://doi.org/10.1007/s40618-021-01650-0. DOI: https://doi.org/10.1007/s40618-021-01650-0

Das L, Bhadada SK, Sood A. Post-COVID-vaccine autoimmune/inflammatory syndrome in response to adjuvants (ASIA syndrome) manifesting as subacute thyroiditis. J Endocrinol Invest. 2022;45(2):465-467. https://doi.org/10.1007/s40618-021-01681-7. DOI: https://doi.org/10.1007/s40618-021-01681-7

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