Virtual Conference

Marlen A. Álvarez-Castillo

Hospital General de México, Mexico

Title: Recommendations for the management of patients with thyroid disease facing COVID-19


Introduction: The effects and presence of other coronaviruses in the hypothalamic-pituitary-thyroid system have been demonstrated in previous epidemics, it’s possible that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may also affect them. Changes in thyroid hormone levels may also be related to the presence of sick euthyroid syndrome or thyroid dysfunction in the seriously ill patient, which is why the correct interpretation of these alterations is important when performing a thyroid profile. Although the currently known repercussions of SARS-CoV-2 on the thyroid system are limited, there are several situations in the management of thyroid disease that require observations or recommendations during the health emergency.
Objective: To provide guidance on thyroid disease management and special considerations during the coronavirus disease 2019 (COVID-19) pandemic. Discussion: Routine screening with a thyroid profile is not recommended in patients with acute disease, except in cases where there is a strong suspicion of thyroid alteration. In case of use of thionamides for hyperthyroidism and manifestations of COVID-19, a differential diagnosis with agranulocytosis and neutropenia must be made. Patients with thyroid ophthalmopathy being treated with glucocorticoids or other immunosuppressive drugs should exercise extreme hygiene measures. Hypothyroid patients should continue the same treatment with established form and dosage. Fine needle aspiration biopsies for thyroid nodular disease should be deferred. Elective thyroid surgical procedures should be avoided as should the administration of radioactive iodine. Most of the consultations related to thyroid dysfunction can be modified electronically, following the regulations established in this regard. Conclusion: Studies are required to evaluate the direct effects of SARS-CoV-2 on thyroid tissue and the thyroid function axis, as well as the clinical impact that this may represent. We issue these recommendations regarding some situations that may arise in the care of patients with thyroid disease, which may require modification if new information appears


Dr. Alvarez is Honduran, a specialist in internal medicine graduated from the Universidad Nacional autónomos{oma National Autonomous University of HOnduras, in addition to being a subspecialist in endocrinology and a high specialty in thyroid diseases both from the National Autonomous University of Mexico. Co-author of several publications and has participated in conferences with free papers and clinical cases. He currently works as a doctor at the Santa Maria Medical Center, Choluteca, Honduras.