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| | Age/sex | Time between positive COVID-19 PCR and onset of SAT symptoms | Clinical features | COVID-19 PCR testing on admission | Inflammatory markers | TFT on admission | Findings of thyroid USG | Treatment | Reference |
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| Patient 1 | 55/male | 15 days | A painful tender thyroid gland with pain radiating to the jaw, fever, tachycardia severe and frequent cough, and flushing | Not available | ESR = 121 mm/h
CRP = 92.6 mg/l | Thyrotoxic | Complete heterogeneous echotexture suggestive of goiter was observed in the right thyroid lobe with ring calcification in the superior part of the left lobe | (1) Aspirin (discontinued after one week)
(2) Prednisolone after aspirin | Current case |
| Patient 2 | 56/male | 28 days | Anterior neck pain, myalgia, and fatigue | Not available | ESR = 78 mm/h
CRP = 45 mg/l | Thyrotoxic TSH (µIU/mL) = 0.139
Free T4 (ng/dl) = 1.39 | Heterogenous thyroid, hypoechoic areas, decreased vascularity (unilateral, right lobe) | Naproxen sodium (NSAID) | [5] |
| Patient 3 | 38/female | 28 days | Anterior neck pain, myalgia, fatigue, back pain, and headache | Not available | ESR = 68 mm/h
CRP = 18.4 mg/l | Thyrotoxic
TSH (µIU/mL) = 0.99
Free T4 (ng/dl) = 1.02 | Heterogenous thyroid, hypoechoic areas, decreased vascularity (bilateral) | Naproxen sodium (NSAID) | [5] |
| Patient 4 | 41/female | 28 days | Tender neck swelling, fevers, neck pain, odynophagia, fatigue, hand tremors, and palpitations | (−) | CRP = 36.4 mg/l
ESR = 107 mm/h | Thyrotoxic normal T3up
TPOAb (+)
TSI (−)
TSHrAb (−) | (1) Heterogenous thyroid gland
(2) Bilateral patchy ill-defined hypoechoic areas | (1) Ibuprofen 600 mg PO q6h
(2) Prednisone 40 mg/d PO (followed by taper) | [6] |
| Patient 5 | 18/female | 19 days | Anterior neck pain radiating to the jaw, fatigue, fevers, and palpitations | (−) | ESR = 90 mm/h
CRP = 69 mg/l | Thyrotoxic/sTg detected (low level)
TPOAb (−)
TSHrAb (−)
TgAb (+) | Multiple diffuse hypoechoic areas | Prednisone 25 mg/d PO (followed by taper) | [7] |
| Patient 6 | 41/female | Concurrent illness | A painful tender thyroid gland, fevers, left TMJ tenderness, and pharyngitis | (+) | CRP = 101 mg/l
ESR = 134 mm/h | Thyrotoxic
TPOAb (−)
TSHrAb (−)
TgAb (−) | (1) Heterogenous thyroid parenchyma
(2) Relative diffuse decrease of vascularity | (1) HCQ 200 mg PO q12 h × 5 days
(2) Prednisolone 16 mg/d PO (followed by taper) | [8] |
| Patient 7 | 69/female | Concurrent illness | Cough, fever, dyspnea, insomnia, agitation, and palpitations | (+) | Not available | Thyrotoxic
High sTg
TSHrAb (−)
TPOAb (−)
TgAb (−) | (1) Enlarged hypoechoic thyroid
(2) Decreased vascularity
(3) Known 30 mm homogenous nodule in the right lobe (with peripheral vascularization) | (1) HCQ
(2) Methimazole(later discontinued)
(3) Methylprednisolone IV × 3 days
(4) Prednisone 25 mg/d PO (followed by taper) | [9] |
| Patient 8 | 43/female | 6 weeks | Tenderness anterior neck, fever, tremors, fatigue, and palpitations | Not available | Not available | Thyrotoxic
High sTg
TPOAb (−)
TSHrAb (−)
TgAb (−) | Diffusely enlarged and hypoechogenic thyroid gland (thyroid scintigraphy showed markedly reduced 99mTc-pertechnetate uptake) | (1) Prednisone 25 mg/d PO (followed by taper) | [10] |
| Patient 9 | 38/female | 16 days | Anterior neck pain radiating to the jaw, asthenia, fever, palpitation, and anorexia | (−) | ESR = 47 mm/h
CRP = 11.2 mg/l | Thyrotoxic
TgAb <30 IU/mL
TPOAb <10 IU/mL
TRAb <1.5 IU/mL | Enlarged thyroid gland with multiple hypoechoic areas and absent vascularization at color Doppler | Prednisone 25 mg/d (followed by taper) | [11] |
| Patient 10 | 29/female | 30 days after starting quarantine (a PCR test is not available) | Anterior neck pain radiating to the jaw, asthenia, fever, palpitation, and sweating | Not available (negative at the end of quarantine) | ESR 110 mm/h
CRP 7.9 mg/l | Thyrotoxic
Tg 80 mg/l
TgAb 38 IU/mL
TPOAb <10 IU/mL
TRAb <1.5 IU/mL | Multiple diffuse hypoechoic areas and low vascularization at color Doppler | (1) Prednisone 25 mg/d (followed by taper)
(2) Propranolol 40 mg/d | [11] |
| Patient 11 | 29/female | 36 days after onset of COVID-19 symptoms (a PCR test is not available) | Anterior neck pain radiating to the jaw, palpitation, and sweating | Not available | Not available | Not available | Diffuse enlarged gland, with multiple hypoechoic areas and absent vascularization at color Doppler | (1) Ibuprofen 600 mg/d
(2) Low dose of levothyroxine (after 47 days of admission) | [11] |
| Patient 12 | 46/female | 29 days | Anterior neck pain radiating to the jaw, asthenia, fever, palpitation, insomnia, anxiety, and weight loss | (−) | CRP = 8 mg/l | Thyrotoxic
TRAb <1.5 IU/mL | An enlarged thyroid with multiple hypoechoic areas | Prednisone 25 mg/d | [11] |
| Patient 13 | 29/female | 6 weeks after COVID-19 infection (a PCR test is not available) | Fever, odynophagia, exertional tachycardia, shortness of breath, weight loss, front neck tenderness, fine bilateral hand tremors, and palpable left thyroid lobe | (−) | CRP = 44 mg/l
ESR = 88 mm/h | Thyrotoxic
TPOAb (−)
TSI (−) | Heterogeneously enlarged thyroid gland | (1) Prednisone 20 mg/d, then 40 mg/d, and then tapered off
(2) Atenolol 25 mg/d, then 50 mg/d, and then discontinued | [12] |
| Patient 14 | 58/male | Concurrent illness | Anterior neck pain, fever, diffusely enlarged thyroid gland, and tachycardia | (+) | ESR = 110 mm/h
CRP = 16.6 mg/l | Thyrotoxic | Diffuse bilateral enlargement of thyroid with hypoechogenicity and increased vascularity on color Doppler and a solitary nodule in each lobe | (1) Combination of analgesics, favipiravir and azithromycin, along with zinc tablets and vitamin C capsules
(2) Prednisolone 30 mg/d 9 followed by taper)
(3) Propranolol 40 mg/d
(4) Levothyroxine 50 μg/day (after one month of admission) | [13] |
| Patient 15 | 47/female | Concurrent illness | Anterior neck pain radiating to the right submandibular region | (+) | CRP = 50.9 mg/l | Subclinical hyperthyroidism
TPOAb (−)
Anti-TGB Ab (−)
69TRAb (−) | Slightly enlarged right thyroid lobe, with ill-defined hypoechogenicity and normal vascularity in both lobes | (1) Mefenamic acid was started, but was later shifted to celecoxib due to epigastric pains. Oral hydroxychloroquine and intravenous ceftriaxone were initiated
(2) Oral levothyroxine (after 8 weeks of admission) | [14] |
| Patient 16 | 26/female | 30 days after COVID-19 infection (a PCR test is not available) | Fever, fatigue, palpitation, painful, tender, and slightly thyroid gland | (−) | ESR = 70 mm/h
CRP = 28 mg/l | Thyrotoxic | Bilateral hypoechoic areas in the thyroid gland | Prednisolone 25 mg/d (followed by taper) | [15] |
| Patient 17 | 37/female | 30 days after COVID-19 infection (a PCR test is not available) | Fever, fatigue, palpitation, painful, tender, and slightly thyroid gland | (−) | ESR = 56 mm/h
CRP = 38 mg/l | Thyrotoxic | Bilateral hypoechoic areas in the thyroid gland | Prednisolone 25 mg/d (followed by taper) | [15] |
| Patient 18 | 35/male | 30 days after COVID-19 infection (a PCR test is not available) | Fever, fatigue, palpitation, painful, tender, and slightly thyroid gland | (−) | ESR = 45 mm/h
CRP = 18 mg/l | Thyrotoxic | Bilateral hypoechoic areas in the thyroid gland | Prednisolone 25 mg/d (followed by taper) | [15] |
| Patient 19 | 41/female | 30 days after COVID-19 infection (a PCR test is not available) | Fever, fatigue, palpitation, painful, tender, and slightly thyroid gland | (−) | ESR = 83 mm/h
CRP = 43 mg/l | Thyrotoxic | Bilateral hypoechoic areas in the thyroid gland | Prednisolone 25 mg/d (followed by taper) | [15] |
| Patient 20 | 52/male | 30 days after COVID-19 infection (a PCR test is not available) | Fever, fatigue, palpitation, painful, tender, and slightly thyroid gland | (−) | ESR = 76 mm/h
CRP = 51 mg/l | Thyrotoxic | Bilateral hypoechoic areas in the thyroid gland | Prednisolone 25 mg/d (followed by taper) | [15] |
| Patient 21 | 34/female | 30 days after COVID-19 infection (a PCR test is not available) | Fever, fatigue, palpitation, painful, tender, and slightly thyroid gland | (−) | ESR = 39 mm/h
CRP = 23 mg/l | Thyrotoxic | Bilateral hypoechoic areas in the thyroid gland | Prednisolone 25 mg/d (followed by taper) | [15] |
| Patient 22 | 28/female | 13 days | Fever, anterior neck pain radiating to the jaw, palpitation, sore throat, and severe asthenia | (−) | ESR = 116 mm/h
CRP = 173 mg/l | Thyrotoxic
TgAb (−)
TPOAb (−)
TRAb (−) | Not available (thyroid scintigraphy with 5.73 mCi of 99mTc-pertechnetate was performed on May 26th, which showed absence of uptake in the gland) | (1) Aspirin 500 mg q6h
(2) Propranolol 40 mg q6h | [16] |
| Patient 23 | 37/female | 30 days | Severe neck pain radiating to the right ear and jaw, fatigue, moderately enlarged tender thyroid gland, and neck adenopathies | Not available | ESR = 72 mm/h
CRP = 66 mg/l | Thyrotoxic
TgAb (−)
TPOAb (−) | Not available | Not available | [17] |
| Patient 24 | 37/male | 30 days after COVID-19 infection (a PCR test is not available) | Anterior neck pain with tenderness, fatigue, chills, palpitation, anorexia, and weight loss | (−) | ESR = 31 mm/h
CRP = 14 mg/l | Thyrotoxic
TPOAb (−)
TSI (−) | Diffusely heterogeneous echotexture | (1) Aspirin
(2) Propranolol
(3) 1.6 mcg/kg/day of oral levothyroxine 50 days after admission | [18] |
| Patient 25 | 34/male | 5 days | Anterior neck pain, tachycardia, diffuse asymmetric goiter with tenderness, and few bilateral palpable cervical lymph nodes | (+) | CRP = 122 mg/l | Thyrotoxic
TPOAb (−)
TRAb (−) | Enlarged thyroid gland with heterogeneous echotexture. Both lobes had hypoechoic areas with ill-defined margins corresponding to the hard regions palpable. Color flow Doppler showed reduced blood flow in both lobes. There were no definite nodules seen in the thyroid gland. A few cervical lymph nodes with normal morphology were seen. | (1) Prednisolone 20 mg/d (followed by taper)
(2) Atenolol 25 mg/d | [19] |
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