Endocrine Abstracts

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has led to unparalleled burden on national and global healthcare systems. Vaccines were viewed as way of combating Covid 19 pandemic. This led to development and implementation of vaccination programmes worldwide. Several vaccines have been approved for use in worldwide including Pfizer-BioNTech, Oxford-AstraZeneca vaccine and Moderna vaccine. Disturbingly, the speed at which these vaccines been approved suggest limited studies regarding their efficacy and possible side effects were carried out. Following their widespread use in general public, a problematic trend of post Covid-19 vaccine manifestations are become more apparent and are being reported with increasing frequency. One such manifestation of post Covid -19 vaccination is new onset of autoimmune diseases such as immune thrombotic thrombocytopenia, IgA nephropathy, rheumatoid arthritis and rarely thyroid dysfunction.

Case series: 1- A 49-year-old male presented with shortness of breath and palpitations 2 weeks after AstraZeneca vaccine. The patient also reported significant weight loss. On examination, the patient was tachycardic and palpable thyroid nodules. Blood test results can be seen in table 1. Ultrasounds scan of thyroid gland which demonstrated bilateral thyroid nodules with peripheral vasculature. The patient was subsequently diagnosed with Graves’ disease and started on treatment with iv hydrocortisone, propranolol, carbimazole. With endocrine team follow up scheduled. 2- A 53-year-old female referred by her GP with deranged thyroid function tests. Patient reported significant weight loss, lethargy, hair loss and ongoing spikes in temperature at night with associated night sweats. The patient indicated her symptoms started 2 weeks after administration of AstraZeneca vaccine. On examination she was found to be tachycardic and visible anterior neck swelling suggestive of goitre. Further to this she underwent Ultrasound scan of Thyroid gland which demonstrated atrophic thyroid gland with right thyroid nodule. The patient was treated with steroids, propranolol, carbimazole.

Discussion/Conclusion: Thyroid dysfunction after vaccination is a rare phenomenon. However, clinicians should be aware that thyroiditis might be an underreported adverse effect of COVID-19 vaccines. Further research is needed to investigate the prevalence and the mechanisms of thyroiditis after COVID-19 vaccination. Based on the finding of these cases we recommend performing Thyroid function test post Covid-19 vaccination to monitor for thyroid dysfunction.