Subacute thyroiditis (SAT) is a thyroid disease of viral or post-viral origin. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak.
To report the first case of SAT related to SARS-CoV-2 infection.
We describe the clinical, laboratory and imaging features of a 18 year old woman who came to our attention for fever, neck pain radiated to the jaw and palpitations occurring 15 days after a SARS-CoV-2 positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patients had completely recovered in few days.
At physical examination the patient presented with an increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams FT4 and FT3 were high, TSH undetectable and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging were both normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within two days and the remaining symptoms within one week. Thyroid function and inflammatory markers normalized in 40 days.
We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.