Subacute Thyroiditis Associated with COVID-19: A Case Report

Background: Subacute Thyroiditis is a self-limiting thyroidal illness caused by viral infection with clinical course divided into three phases: hyperthyroidism, hypothyroidism followed by euthyroidism. Several viral infections have been linked to be associated with subacute thyroiditis but often no etiology can be found. Objective: The aim of this study is to explore a possible link between subacute thyroiditis and Coronavirus disease (COVID-19) infection. Method: Here we describe a case of subacute thyroiditis which occurred during the recovery phase of initial flu like illness. The initial illness was mild and was treated symptomatically. Later, the patient presented with features of hyperthyroidism and neck pain during recovery of initial flu like illness. Result: Two weeks after the onset of initial illness, the patient presented with neck pain, palpitation, sweating, and weight loss along with mid-line tenderness in neck. Thyroid function test revealed suppressed TSH and elevated free T4 along with reduced uptake on radionuclide thyroid scan. He was treated with NSAIDs and B-blocker which resulted in dramatic improvement in neck pain. Conclusion: Since Subacute thyroiditis is a self limiting disorder, it is often under reported. But It is important to recognize the disorder as it can directly impact on the morbidity and mortality related to other associated primary disorder like respiratory illness. Clinician must be aware about the possibility of thyroiditis in patient developing fever and neck pain and look for it.