Thyroid UK Statement regarding Coronavirus (COVID-19)

Our thoughts are with you all in these difficult times.  We understand how worrying it is to not see your family and friends and not know how the coronavirus would affect you if you catch it.

Thyroid UK is thankful to all front-line workers who are looking after us in a variety of ways but especially the NHS and carers who are in the midst of this awful disease.

Thyroid UK has received enquiries about whether people with thyroid disease are at an increased risk of coronavirus (COVID-19).

We have checked with our medical advisers and have the following statement to make:

COVID-19 is a new virus that can affect your lungs and airways and cause various symptoms, the most common of which is a cough, a high temperature (fever) and difficulty in breathing.

In people with weakened immune systems, older people, and those with long-term conditions like asthma, diabetes, cancer, heart disease and chronic lung disease the symptoms can be much worse. However, these symptoms are similar to other viruses such as a cold and the flu so having these symptoms does not necessarily mean you have the illness.  You can only know that if you test for it and we know that is difficult to do at the moment.  There are plans now, though, to send out testing to random members of the public and more testing will be available in the future.

Doctors are not completely sure how the virus is spread but it is probably spread by droplets produced when an infected person coughs or sneezes and may be caught by touching a surface, object or the hand of an infected person. How long any respiratory virus survives will depend on a number of factors such as what surface the virus is on; whether it is exposed to sunlight; differences in temperature and humidity and exposure to cleaning products.

COVID-19 can be spread by close contact (within 2 metres or less).  It is not definite whether people with the virus who don’t have symptoms can infect someone else.

The incubation period is between 2 to 14 days so if a person remains well 14 days after contact with someone who has the coronavirus, they have not been infected.

 

Are patients with thyroid disease at more risk?

At the moment, there is no evidence that people with thyroid disease are at any more risk than people without thyroid disease.

Although there is no reason to believe that people with thyroid problems who are well balanced are at any more risk from COVID-19 than people who are healthy, it is possible that untreated hypothyroidism, undertreated hypothyroidism (because the medication is not being taken or not taken properly) or poorly controlled hyperthyroidism may be at higher risk of complications from the virus.

It will pay to be vigilant.  Wash your hands regularly and, as the Government has now advised, work at home if you can, don’t travel on public transport unless it is necessary and use face masks if it gives you more confidence.

Hashimoto’s disease and Grave’s disease are autoimmune disorders that directly affect the thyroid i.e. the antibodies affect how the thyroid works.  Thyroid disease autoimmunity does not mean that you have a depressed immune system.  It means that your immune system is attacking your thyroid.  These are two different things.

Thyroid medications do not weaken your immune system.  Only immunosuppressants do this and those that are on immunosuppressants need to be extra vigilant and be shielded.

Also, anyone on high doses of steroids, such as those with thyroid eye disease, may be compromised because steroids can suppress the immune system.  Again, be vigilant if you are on steroids.

If you have thyroid cancer, you should definitely take the Governments advice and be shielded although shielded people can now start to go outside.

The British Thyroid Association have published some excellent information which we recommend you read:

“The COVID-19 pandemic presents significant challenges to us all. The following statements regarding the management of thyroid disease have been formulated to provide clinical advice to medical colleagues during this time: 

We hope you find them useful.”

Thyroid UK also recommends that everyone follows NHS and government advice about reducing the risk of infection which you can find here:

We are not completely out of lockdown yet but it looks like it will be possible in the not too distant future, although we will all still need to be very careful and keep to social distancing and shielding if you are vulnerable.

 

Can COVID-19 cause thyroid disease?

There does seem to be a link between COVID-19 and thyroid disease.

There has been a paper published in The Journal of Clinical Endocrinology & Metabolism regarding the case of an 18-year-old woman who contracted COVID-19 and recovered but a few days later was diagnosed with subacute thyroiditis.  The author has alerted clinicians about this case – https://academic.oup.com/jcem/article/105/7/dgaa276/5838793

There has also been a possible case in Texas – https://www.nbcdfw.com/news/coronavirus/covid-patient-develops-new-symptoms-months-later-likely-tied-to-virus/2403180/

The latest study comes from Italy and is entitled, “Thyrotoxicosis in Patients with Covid-19: The Thyrcov Study.”

It looked at 297 consecutive patients in non-intensive care units who were not on treatment for hypothyroidism or hyperthyroidism.  Fifty-eight patients (20.2%) were found with thyrotoxicosis (overt in 31 cases), 15 (5.2%) with hypothyroidism (overt in only 2 cases) and 214 (74.6%) with normal thyroid function.

The researchers concluded, “This study provides a first evidence that COVID-19 may be associated with high risk of thyrotoxicosis in relationship with systemic immune activation induced by the SARS-CoV-2 infection.” – https://eje.bioscientifica.com/view/journals/eje/aop/eje-20-0335/eje-20-0335.xml

 

 

 

So it seems that once you have had COVID-19, you need to be aware that it may affect your thyroid.

Our advisers will be keeping us up to date periodically and we will be updating this statement when necessary.

Stay safe everyone!

Date updated: 10.8.20 (V1.7)