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Batman A, Yazıcı D, Dikbaş O, Ağbaht K, Saygılı ES, Demirci İ, Bursa N, Ayas G, Anıl C, Cesur M, Korkmaz FN, Bahçecioglu AB, Çorapçıoğlu D, Erdoğan MF, Bostan H, Calapkulu M, Hepşen S, Uçan B, Çakal E, Güler BY, Haymana C, İpekçi SH, Aydın S, Sezer H, Özışık S, Deyneli O, Alagöl F, Tanakol R, Eroğlu M, Mutlu Ü, Hacışahinoğulları H, Üzüm AK, Demir C, Koç G, Fırat SN, Omma T, İnce N, Polat ŞB, Topaloğlu O, Aydın C, Çakır B, Bahadır ÇT, Güven M, Sözen M, Selek A, Cantürk Z, Çetinarslan B, Aydemir M, Taşkaldıran I, Bozkuş Y, İyidir ÖT, Haydardedeoğlu FE, Basmaz SE, Ünal MÇ, Demir T, Oğuz A, Çelik Ö, Yilmaz M, Cimsir A, Kayıhan S, Uc ZA, Tekin S, Topaloğlu Ö, Saydam BÖ, Ünsal YA, Özer Ö, Yorulmaz G, Uğur K, Çakır SD, Aşık M, Unubol M, Genc S, Andac B, Okur M, Dogan O, Karakiliç E, Kocabas GU, Kirac CO, Cansu GB, Uygur MM, Pekkolay Z, Öztürk S, Güngüneş A, Gürkan E, Keskin L, Çağlayan K, Günay YE, İmre E, Şener SY, Kalkan AT, Gök DE, Şahin M. Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study. J Clin Endocrinol Metab 2023; 108:e1013-e1026. [PMID: 37186260 DOI: 10.1210/clinem/dgad235] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
CONTEXT The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. METHODS This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19-related SAT (Cov-SAT), SARS-CoV-2 vaccine-related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. RESULTS Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. CONCLUSION Since there is no difference in terms of follow-up parameters and outcomes, COVID-19- and SARS-CoV-2 vaccine-related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.
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Affiliation(s)
- Adnan Batman
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Dilek Yazıcı
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Oğuz Dikbaş
- Department of Endocrinology and Metabolism, Giresun University School of Medicine, 28200 Giresun, Turkey
| | - Kemal Ağbaht
- Department of Endocrinology and Metabolism, Defne Hospital, 31030 Hatay, Turkey
| | - Emre Sedar Saygılı
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, 17020 Canakkale, Turkey
| | - İbrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Nurbanu Bursa
- Department of Statistics Beytepe, Hacettepe University, 06230 Ankara, Turkey
| | - Görkem Ayas
- School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - Cüneyd Anıl
- Department of Endocrinology and Metabolic Diseases, Güven Hospital, 06540 Ankara, Turkey
| | - Mustafa Cesur
- Department of Endocrinology and Metabolic Diseases, Güven Hospital, 06540 Ankara, Turkey
| | - Fatma Nur Korkmaz
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Adile Begüm Bahçecioglu
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Murat Faik Erdoğan
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Hayri Bostan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Murat Calapkulu
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Sema Hepşen
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Bekir Uçan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Erman Çakal
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Bağdagül Yüksel Güler
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Süleyman Hilmi İpekçi
- Department of Endocrinology, Hisar Intercontinental Hospital, 34768 Istanbul, Turkey
| | - Selami Aydın
- Department of Internal Medicine, Hisar Intercontinental Hospital, 34768 Istanbul, Turkey
| | - Havva Sezer
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Seçil Özışık
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Oğuzhan Deyneli
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Faruk Alagöl
- Department of Endocrinology and Metabolism, VKV Amerikan Hospital-Koç University School of Medicine, 34365 Istanbul, Turkey
| | - Refik Tanakol
- Department of Endocrinology and Metabolism, VKV Amerikan Hospital-Koç University School of Medicine, 34365 Istanbul, Turkey
| | - Mustafa Eroğlu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Balikesir University Faculty of Medicine, 10145 Balikesir, Turkey
| | - Ümmü Mutlu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Hülya Hacışahinoğulları
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Ayşe Kubat Üzüm
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Canan Demir
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Atilim University School of Medicine, 06830 Ankara, Turkey
| | - Gönül Koç
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Research Hospital, 06230 Ankara, Turkey
| | - Sevde Nur Fırat
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Research Hospital, 06230 Ankara, Turkey
| | - Tülay Omma
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Reasearch Hospital, 06230 Ankara, Turkey
| | - Nurcan İnce
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Şefika Burçak Polat
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Oya Topaloğlu
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Cevdet Aydın
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Bekir Çakır
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Çiğdem Tura Bahadır
- Department of Endocrinology and Metabolism, Amasya University, School of Medicine, 05100 Amasya, Turkey
| | - Mehmet Güven
- Department of Endocrinology and Metabolism, Sirnak State Hospital, 73000 Sirnak, Turkey
| | - Mehmet Sözen
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Alev Selek
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Zeynep Cantürk
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Berrin Çetinarslan
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Mustafa Aydemir
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Akdeniz University, School of Medicine, 07050 Antalya, Turkey
| | - Işılay Taşkaldıran
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Yusuf Bozkuş
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Özlem Turhan İyidir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Filiz Ekşi Haydardedeoğlu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 79097 Adana, Turkey
| | - Seda Erem Basmaz
- Department of Endocrinology and Metabolism, Kocaeli Derince Training and Research Hospital, 41900 Kocaeli, Turkey
| | - Mehmet Çağrı Ünal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylul University, 35330 Izmir, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylul University, 35330 Izmir, Turkey
| | - Ayten Oğuz
- Department of Endocrinology and Metabolism, Faculty of Medicine, Biruni University, 34295 Istanbul, Turkey
| | - Özlem Çelik
- Department of Endocrinology and Metabolism, Faculty of Medicine, Acıbadem University, 34752 Istanbul, Turkey
| | - Merve Yilmaz
- Department of Endocrinology and Metabolism, Samsun State Hospital, 55060 Samsun, Turkey
| | - Aykut Cimsir
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Serdar Kayıhan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Ziynet Alphan Uc
- Department of Endocrinology and Metabolism, Usak University, Usak Training and Research Hospital, 64300 Usak, Turkey
| | - Sakin Tekin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Zonguldak Bulent Ecevit University, 67100 Zonguldak, Turkey
| | - Ömercan Topaloğlu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Zonguldak Bulent Ecevit University Obesity and Diabetes Practice and Research Center, 67100 Zonguldak, Turkey
| | - Başak Özgen Saydam
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Yenimahalle Training and Research Hospital, 06370 Ankara, Turkey
| | - Yasemin Aydoğan Ünsal
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Yenimahalle Training and Research Hospital, 06370 Ankara, Turkey
| | - Özge Özer
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, 26040 Eskisehir, Turkey
| | - Göknur Yorulmaz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, 26040 Eskisehir, Turkey
| | - Kader Uğur
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Fırat University, 23119 Elazıg, Turkey
| | - Sezin Doğan Çakır
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Istanbul Taksim Training and Research Hospital, 34433 Istanbul, Turkey
| | - Mehmet Aşık
- Endocrinologist, Private Office, Bodrum, 48400 Mugla, Turkey
| | - Mustafa Unubol
- Department of Endocrinology and Metabolism, School of Medicine, Adnan Menderes University, 09100 Aydin, Turkey
| | - Selin Genc
- Department of Endocrinology and Metabolism, School of Medicine, Inonu University, 44280 Malatya, Turkey
| | - Burak Andac
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, 22130 Edirne, Turkey
| | - Mine Okur
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, 22130 Edirne, Turkey
| | - Ozlem Dogan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Haseki Training and Research Hospital, 34096 Istanbul, Turkey
| | - Ersen Karakiliç
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, 17020 Canakkale, Turkey
| | - Gokcen Unal Kocabas
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ege University, 35100 Izmir, Turkey
| | - Cem Onur Kirac
- Department of Endocrinology and Metabolism, Kahramanmaras Necip Fazil City Hospital, 46050 Kahramanmaras, Turkey
| | - Güven Barış Cansu
- Department of Endocrinology and Metabolism, School of Medicine, Kutahya University of Health Sciences, 43100 Kutahya, Turkey
| | - Meliha Melin Uygur
- Department of Endocrinology and Metabolism, School of Medicine, Marmara University, Pendik Training and Research Hospital, 34899 Istanbul, Turkey
| | - Zafer Pekkolay
- Department of Endocrinology and Metabolism, School of Medicine, Dicle University, 21100 Diyarbakir, Turkey
| | - Sadettin Öztürk
- Department of Endocrinology and Metabolism, School of Medicine, Gaziantep University, 27850 Gaziantep, Turkey
| | - Aşkın Güngüneş
- Department of Endocrinology and Metabolism, School of Medicine, Kırıkkale University, 71300 Kırıkkale, Turkey
| | - Eren Gürkan
- Department of Endocrinology and Metabolism, School of Medicine, Hatay Mustafa Kemal University, 31001 Hatay, Turkey
| | - Lezzan Keskin
- Department of Endocrinology and Metabolism, School of Medicine, Malatya Turgut Ozal University, Malatya Training and Research Hospital, 44000 Malatya, Turkey
| | - Kenan Çağlayan
- Department of Endocrinology and Metabolism, School of Medicine, Baskent University Istanbul Hospital, 34662 Istanbul, Turkey
| | - Yasemin Emur Günay
- Department of Endocrinology and Metabolism, School of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey
| | - Eren İmre
- Department of Endocrinology and Metabolism, Dr Ersin Arslan Education and Research Hospital, 27010 Gaziantep, Turkey
| | - Selcuk Yusuf Şener
- Department of Endocrinology and Metabolism, Pendik Medikalpark Hospital, 34899 Istanbul, Turkey
| | - Ahmet Toygar Kalkan
- Department of Endocrinology and Metabolism, Kastamonu Research and Training Hospital, 37150 Kastamonu, Turkey
| | - Deniz Engin Gök
- Department of Endocrinology and Metabolism, Lokman Hekim Hospital, 06700 Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
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