Thyroid Disease in the Time of COVID-19

Thyroid Diseases and COVID-19 FAQs

There is currently no evidence that those with thyroid diseases, even if poorly controlled, are more susceptible to contracting viral illnesses including infection with SARS-CoV-2 or that they are at risk of developing more severe COVID-19 disease. This would include patients with existing autoimmune thyroid diseases like Graves’ disease and Hashimoto’s thyroiditis.

Anti-thyroid drugs (ATDs) are not known to increase the risk of infection, and patients on ATDs are not considered to be at a higher risk of contracting COVID-19 or of developing more severe disease in the event of contracting the infection. It is therefore strongly recommended that patients with thyroid dysfunction continue taking their thyroid medication(s) to reach or maintain normal thyroid function status. 

Although there is no evidence of increased likelihood of getting COVID-19 infection in patients with thyroid disease, it is probable that patients with uncontrolled thyroid dysfunction, especially those with hyperthyroidism, may be at higher risk for complications (e.g. thyroid storm), just as they would from any other infection. Likewise, subsets of patients with Graves’ ophthalmopathy who are actively undergoing immunosuppressive therapy (e.g. steroids, mycophenolate, azathioprine, rituximab), are likely to be at increased risk of developing severe corona virus infection.

On the other hand, no particular concerns are evident for the management of patients with hypothyroidism during this pandemic.

Similar to the general measures given by the WHO to prevent transmission of COVID-19, to protect yourself and others from infection, everyone must practice the following:

  • frequent hand-washing or disinfection with alcohol-based hand sanitizer
  • avoid touching surfaces especially in public settings or healthcare facilities
  • respiratory hygiene such as covering the mouth when coughing
  • physical distancing of at least 1 meter or more according to the national recommendations
  • wearing of masks when with other people especially where distancing is not possible and indoors
  • regular environmental cleaning and disinfection
  • make sure there is good ventilation
  • limiting unnecessary travel and stay at home as much as possible
  • avoid social gatherings or inviting house guests

Clear policies, training, and education for staff in the work place to increase awareness of COVID-19 are essential. Anyone who is unwell or who develop symptoms should stay at home, self-isolate and contact a medical professional or the local COVID-19 information line for advice on testing and referral.

People with thyroid conditions, including autoimmune thyroid disease and thyroid cancer, should receive the COVID vaccine if they are medically stable. The vaccines in current use have been tested and some clinical trials have included patients with thyroid conditions among the thousands of subjects involved. Currently, there is no evidence that having thyroid disease makes you at higher risk for vaccine-related problems. Likewise, there is no preferred vaccine for people with thyroid diseases.

References:

  • American Thyroid Association. Novel Coronavirus and the Thyroid
  • World Health Organization. COVID-19 and Related health Topics
  • European Society of Endocrinology, Endocrinology in the Time of COVID. Jul 2020. Vol 183: issue 1