Thyroid and Covid 19

Are people with Thyroid disease more prone to Covid 19?

Although there is not yet enough information regarding the relationship between different thyroid conditions and susceptibility to COVID-19, there is currently no reason to believe that most people with thyroid disease are at increased risk to contract this novel coronavirus or to experience complications.

Nevertheless, if thyroid medications are not taken as prescribed, uncontrolled thyroid disease may increase a person’s risk for viral infection and complications.

Patients on Corticosteroids or immunosuppressive agents for thyroid eye disease are more susceptible and are at high risk of severe illness from Covid 19, and such patients need to take more precautions.

How does Covid 19 affect individuals with Hypothyroidism?

As such patients with hypothyroidism are not at increased risk of viral infections in general and there is no association between hypothyroidism and severity of viral infection. It is recommended that patients with hypothyroidism should continue taking their levothyroxine treatment as suggested.

What about in Pregnancy?

There is no evidence that suggests that pregnant women are at increased risk of COVID-19. Pregnancy alters the body’s immune system and response to viral infections in general, which can occasionally be related to more severe symptoms, and this will be the same for COVID-19. Pregnant patients with hypothyroidism should continue taking levothyroxine treatment.

What actions prevent the spread of Covid 19 and better protect individuals with thyroid disease?

Take medications exactly as prescribed and ensure appropriate supplies of medications in case of an emergency. If experiencing fever, cough, shortness of breath or other symptoms, call both the COVID-19 hotline and your physician.

Stay at home as much as possible and avoid close contact with other people. Cover your mouth and nose with a cloth face cover when around others. Wash your hands with soap and water regularly for at least 20 seconds, especially before eating or drinking, after using the restroom, and after blowing your nose, coughing or sneezing. Avoid touching your eyes, mouth or nose with unwashed hands. Clean and disinfect frequently touched surfaces daily.

Are people with autoimmune thyroid disease, such as Hashimoto’s thyroiditis or Graves’ disease, at more risk for acquiring COVID-19 or having a more serious COVID-19 infection?

There is no information on how it affects individuals with thyrotoxicosis. However, uncontrolled thyrotoxicosis may be at higher risk of complications (such as thyroid storm) from any infection. It is recommended that patients with thyrotoxicosis continue taking their thyroid medication to reduce this risk.

Antithyroid drugs (ATDs) are not known to increase the risk of infection, unless they result in neutropenia, which is rare. Patients on ATDs are not at higher risk of contracting COVID-19 or of developing more severe disease in the event of contracting the infection.

Although rare, anti-thyroid medications used to treat Graves’ disease may cause side effects that resemble symptoms of COVID-19, such as fever, sore throat and muscle pain, as a result of a decrease in white blood cell count. If you experience these symptoms, contact your healthcare provider immediately and mention that you take thyroid medications.

Patients on corticosteroids or immunosuppressive agents for thyroid eye disease are more susceptible and are at high risk of severe illness from COVID-19, and such patients need to take more precautions.

Any non-urgent surgeries or procedures for definitive treatment for thyrotoxicosis should be postponed.

Are people with Thyroid cancer at greater risk for COVID-19 infection?

The majority of individuals with thyroid cancer are likely not more susceptible to COVID-19. However, individuals with metastatic thyroid cancer (papillary or medullary) may be at increased risk of viral infection or complications if they have lung metastases or if they are undergoing certain types of cancer treatment.

Having a previous diagnosis of thyroid cancer and receiving thyroid hormone medication is not a known risk factor for getting COVID-19 or being more severely affected by it.

For the rare thyroid cancer patients who are receiving chemotherapy medications for your thyroid cancer treatment, you would be considered at higher risk for severe illness due to COVID-19.

All elective surgeries for thyroid cancer should be postponed. Patients on suppressive doses of levothyroxine should continue their current dose. Being on suppressive dose of levothyroxine does not increase the risk of COVID-19 infection.

Is it safe to delay a biopsy of my thyroid nodule?

Most thyroid nodules are benign (not cancerous), but some nodules of a certain size that also have suspicious features on ultrasound may be advised to undergo a biopsy. Even if the thyroid nodule is found to be cancerous, there is usually little risk in delaying surgery to have it removed. Thus, it would also be generally safe to delay biopsy of the nodule unless your clinician strongly advises that it be done urgently.