| Abstrakt: |
Subacute thyroiditis (SAT) is a relatively mild and self-limiting thyroid disease caused by a viral or postviral inflammatory process. Besides infection, severe acute respiratory syndrome coronavirus 2 vaccines may have a role in SAT pathogenesis; however, the exact mechanism remains unknown. A systematic review was conducted to look into the published cases of postvaccination SAT, evaluate their clinical characteristics, symptom resolution rate, and determine differences in clinicodemographic characteristics according to vaccine type. PubMed, WHO COVID-19, The Cochrane Library, Science Direct, Embase, and Scopus were searched until April 11, 2022. Original articles of any design reporting SAT due to COVID-19 vaccination were included. The quality assessment was performed using the Joanna Briggs Institute's Critical Appraisal Checklist for studies. Thirty-five articles including 86 cases were retrieved and included for analysis. Of the 86 patients, 68 (79.1%) were female. The median age of the patients at the time of SAT onset was 41 (interquartile range [IQR] 35-50) years, and they developed SAT after a median of 10 (IQR 5-15) days' postvaccination. The incidence of cases was more in Asian countries (60.4%), and most of these cases were receiving non-mRNA vaccines (P = 0.019). In most of the cases, T3 (73%), T4 (77%), and inflammatory markers (90%) were high, while thyroid stimulating hormone [TSH] (86%) was low. Median TSH, free T3, and free T4 were 0.018 (IQR 0.01-0.085) mIU/L, 3.87 (IQR 1.9-6.8) pg/mL, and 2.44 (IQR 1.58-3.5) ng/dL, respectively. C-reactive-protein 28.6 mg/L (IQR 6.3-79.5) and erythrocyte sedimentation rate 60 mm/h (IQR 41.5-76.5) were elevated. Of 70 cases receiving therapy, 71.4% were treated with nonsteroidal anti-inflammatory drugs, 44.3% with steroids, and 37.1% with beta-blockers. The overall symptom resolution rate was 77.0% (95% confidence interval [CI]: 66%-85%), and the female subjects were more likely to achieve resolution (odds ratio 4.98; 95% CI: 1.48-16.8; P = 0.010). Despite these trends, vaccination against COVID-19 is recommended since SAT is exceedingly uncommon and, because it is self-limiting, is often linked with favorable clinical evolution and long-term outcomes. [ABSTRACT FROM AUTHOR] |
