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Subacute Thyroiditis in the SARS-CoV-2 Era

Completed
Conditions
Subacute Thyroiditis
SARS CoV 2 Infection
Thyrotoxicosis
Registration Number
NCT06391515
Lead Sponsor
University of Modena and Reggio Emilia
Brief Summary

Many cases of subacute thyroiditis (SAT) have been described related to SARS-CoV-2 infection, but no prospective data about follow-up is known. This prospective, longitudinal, 3-year, multicentre study is aimed at exploring clinical peculiarities and outcome of SAT in relation to SARS-CoV-2 infection, ascertained with antibody dosage.

All patients receiving SAT diagnosis from November 2020 to May 2022 were enrolled. Multicentre study. Data about anamnesis, physical examination, blood tests (TSH, freeT4, freeT3, thyroglobulin, anti-thyroid antibodies, C-reactive protein, erythrocyte sedimentation rate, complete blood count), and thyroid ultrasound were collected. At baseline, the presence of IgG against the SARS-CoV-2 spike protein or nucleocapside was investigated. Patients were evaluated after 1, 3, 6, 12 months.

Detailed Description

A multicentre, longitudinal, prospective study was conducted, enrolling all patients diagnosed with SAT at the participating centres between November 2020 and May 2022. The following Italian centres participated: Endocrinology Unit of Azienda Ospedaliero-Universitaria of Modena (Coordinating center); Endocrinology Unit of IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milano; Endocrinology and Diabetes Prevention and Care Unit of the IRCCS Azienda Ospedaliero-Universitaria Policlinico of Bologna. These Units were involved through a call launched by the coordinating center to the young Italian members of the Club EnGioI (Endocrinologia Giovane in Italia) of the Italian Society of Endocrinology (SIE).

Five visits were planned: at diagnosis (V0) and after 1, 3, 6 and 12 months (V1, V2, V3 and V4, respectively). At each visit, subjects were evaluated with anamnesis, physical examination, thyroid ultrasound and blood tests. Patients were treated according to the clinical presentation and to the current guidelines. Nonsteroidal anti-inflammatory drugs (NSAIDs) were preferred in patients with mild symptoms and mild laboratory findings; steroid therapy was preferred in those with severe symptoms and/or those who did not respond to NSAIDs within 1 to 2 weeks. Beta-blockers were prescribed as symptomatic treatment in case of tachycardia. During the follow-up phase, the therapeutic approach and any change of it were recorded.

Finally, the treatment responsiveness and outcomes of transient hypothyroidism, permanent hypothyroidism, or recurrence during the follow-up period were all documented.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
66
Inclusion Criteria
  • clinical diagnosis of subacute thyroiditis
  • age ≥ 18 years
  • willingness to sign an informed consent
Exclusion Criteria
  • ongoing pregnancy
  • alcohol abuse.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
quantification of neck pain at diagnosisat diagnosis

evaluation in a scale from 0 to 10 (10 means maximum pain)

description of neck pain at diagnosisat diagnosis

localization at right or left side, migrating, radiating to the ears

duration of neck pain at diagnosisat diagnosis

duration in days

Secondary Outcome Measures
NameTimeMethod
thyroid function at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), thyroglobulin (Tg), thyroglobulin antibodies (TgAb), anti-thyroid peroxidase antibodies (TPOAb), thyrotropin receptor antibodies (TRAb)

quantification of neck pain at follow-up1, 3, 6 and 12 months after diagnosis

evaluation in a scale from 0 to 10 (10 means maximum pain)

description of neck pain at follow-up1, 3, 6 and 12 months after diagnosis

localization at right or left side, migrating, radiating to the earsmaximum pain)

free thyroxine (fT4) at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

free thyroxine (fT4) serum levels

free triiodothyronine (fT3) at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

free triiodothyronine (fT3) serum levels

anti-thyroid peroxidase antibodies (TPOAb) at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

anti-thyroid peroxidase antibodies (TPOAb) serum levels

thyroglobulin (Tg) at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

thyroglobulin (Tg) serum levels

duration of neck pain at follow-up1, 3, 6 and 12 months after diagnosis

duration in days

thyroid inhomogeneity at ultrasoundat diagnosis and after1, 3, 6 and 12 months

US examination performed by endocrinologists with at least 5 years of experience in US neck examination with a linear probe. SAT-related findings such as inhomogeneity will be evaluated (present or absent)

thyroid stimulating hormone (TSH) serum levels at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

thyroid stimulating hormone (TSH) serum levels

thyroglobulin antibodies (TgAb) at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

thyroglobulin antibodies (TgAb) serum levels

thyrotropin receptor antibodies (TRAb) at diagnosis and follow-upat diagnosis and after1, 3, 6 and 12 months

thyrotropin receptor antibodies (TRAb) serum levels

Trial Locations

Locations (1)

University of Modena and Reggio Emilia

🇮🇹

Modena, Italy

University of Modena and Reggio Emilia
🇮🇹Modena, Italy

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