SARS-CoV-2 plays a pivotal role in inducing hyperthyroidism of Graves' disease

Endocrine. 2021 Aug;73(2):243-254. doi: 10.1007/s12020-021-02770-6. Epub 2021 Jun 9.

Abstract

Coronavirus disease 2019 (COVID-19) advances to affect every part of the globe and remains a challenge to the human race. Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) was shown to affect many organs and organ systems including the thyroid gland as these parts highly express angiotensin-converting enzyme 2 (ACE2) protein, which functions as a receptor for initially entering the virus into the cells. Furthermore, some categories of the population including older people and persons with comorbidities are prone to be more vulnerable to COVID-19 and its complications. Recent reports showed that SARS-CoV-2 infection could cause Graves' disease (autoimmune hyperthyroidism) in post-COVID-19 patients. Factors that may boost the mortality risk of COVID-19 patients are not completely known yet and a clear perception of the group of vulnerable people is also essential. This review briefly summarizes the features of Graves' disease such as symptoms, risk factors, including environmental, genetic, immunological, and other factors, associated disorders, and therapeutic options. It comprehensively describes the recent advances in SARS-CoV-2-induced Graves' disease and the pivotal role of autoimmune factors in inducing the disease. The review also discusses the possible risks of SARS-CoV-2 infection and associated COVID-19 in people with hyperthyroidism. Furthermore, it explains thyroid disease and its association with the severity of COVID-19.

Keywords: ACE2; Autoimmune; COVID-19; Graves’ disease; Hyperthyroidism; RAAS; SARS-CoV-2; Thyroid.

Publication types

  • Review

MeSH terms

  • Aged
  • COVID-19*
  • Comorbidity
  • Graves Disease* / epidemiology
  • Humans
  • Peptidyl-Dipeptidase A
  • Risk Factors
  • SARS-CoV-2

Substances

  • Peptidyl-Dipeptidase A