Clinical, biochemical and imaging findings of patients at the time of presentation with post-COVID-19 subacute thyroiditis
Age and gender | Time since COVID-19 | Presenting symptoms | Laboratory investigations | Imaging | |
26/F | 6 | Palpitation, tremor | Total T4: 16.15 Free T4: 1.59 Total T3: 155.2 Free T3: 4.5 TSH: <0.001 TPO antibody: positive (67.8) | ESR: 67 CRP: 99.9 IL-6: 68.1 NLR: 3.03 ALC: 1267 | USG thyroid: diffusely enlarged thyroid gland, reduced vascularity, patchy hypoechoic areas 99mTc scan of thyroid: overall uptake 2.3%, patchy uptake |
54/M | 7 | Fever | Total T4: 24.78 Free T4: 3.61 Total T3: 200.9 Free T3: 8.6 TSH: 0.003 TPO antibody: negative | ESR: 36 CRP: 347.22 IL-6: 187.9 NLR: 2.5 ALC: 1780 | USG thyroid: normal-sized thyroid gland, reduced vascularity, patchy hypoechoic areas 99mTc scan of thyroid: overall uptake <2%, patchy uptake |
28/F | 12 | Palpitation, tremor | Total T4: 32.35 Free T4: 2.99 Total T3: 207.5 Free T3: 0.73 TSH: <0.001 TPO antibody: negative | ESR: 85 CRP: 219.58 IL-6: 138 NLR: 3.08 ALC: 1450 | USG thyroid: normal-sized thyroid gland, patchy hypoechoic areas 99mTc scan of thyroid: overall uptake <3% |
49/F | 21 | Palpitation, tremor | Total T4: 24.91 Free T4: 2.33 Total T3: 199.5 Free T3: 6.2 TSH: 0.005 TPO antibody: negative | ESR: 94 CRP: 109.93 IL-6: 98 NLR: 2.1 ALC: 2200 | USG thyroid: diffusely enlarged thyroid gland, patchy hypoechoic areas 99mTc scan of thyroid: overall uptake of thyroid 3.5%, patchy areas of uptake seen |
25/M | 7 | Palpitation, tremor, diarrhoea | Total T4: 17.09 Free T4: 2.2 Total T3: 168.55 Free T3: 6.5 TSH: <0.001 TPO antibody: negative | ESR: 51 CRP: 284.95 IL-6: 58 NLR: 3.3 ALC: 1254 | USG thyroid: normal-sized thyroid gland, patchy hypoechoic areas 99mTc scan of thyroid: diminished uptake in thyroid bed (<2%) |
26/F | 48 | Pain and tenderness over neck, fever | Total T4: 20.5 Free T4: 2.2 Total T3: 170.1 Free T3: 5.9 TSH: 0.003 TPO antibody: positive (59.9) | ESR: 82 CRP: 69.24 IL-6: 61.74 NLR: 1.81 ALC: 2689 | USG thyroid: diffusely enlarged thyroid gland, reduced vascularity, patchy hypoechoic areas 99mTc scan of thyroid: NA |
69/M | 28 | Pain and tenderness over neck, palpitation, congestive cardiac failure | Total T4: 21.81 Free T4: 2.45 Total T3: 128.4 Free T3: 5.1 TSH: 0.001 TPO antibody: negative | ESR: 80 CRP: 74.5 IL-6: 42.72 NLR: 1.56 ALC: 2156 | USG thyroid: diffusely enlarged thyroid gland, patchy hypoechoic areas 99mTc scan of thyroid: poor, patchy uptake in thyroid gland (2.2%) |
48/F | 35 | Pain and tenderness over neck, palpitation, fever | Total T4: 15.7 Free T4: 1.81 Total T3 : 148.2 Free T3 : 4.1 TSH : 0.02 TPO antibody: positive (75.6) | ESR: 76 CRP: 6.1 IL-6: 53 NLR: 2.13 ALC: 2320 | USG thyroid: diffusely enlarged thyroid gland, patchy hypoechoic areas 99mTc scan of thyroid: NA |
59/F | 28 | Pain and tenderness over neck, tremor, fever | Total T4: 19.6 Free T4: 2.1 Total T3: 185.6 Free T3: 4.8 TSH: <0.001 TPO antibody: negative | ESR: 73 CRP: 154.49 IL-6: 45 NLR: 1.78 ALC: 3100 | USG thyroid: diffusely enlarged thyroid gland, patchy hypoechoic areas 99mTc scan of thyroid: NA |
36/M | 26 | Pain and tenderness over neck, fever | Total T4: 18.29 Free T4: 1.72 Total T3: 162.5 Free T3: 4.9 TSH:<0.001 TPO antibody: negative | ESR: 40 CRP: 10.51 IL-6: 32 NLR : 2.2 ALC : 2800 | USG thyroid: diffusely enlarged thyroid gland, reduced vascularity, patchy hypoechoic areas 99mTc scan of thyroid: NA |
65/F | 44 | Pain and tenderness over neck, tremor | Total T4: 14.5 Free T4: 1.87 Total T3: 182 Free T3: 5.5 TSH: 0.03 TPO antibody: negative | ESR: 85 CRP: 99.9 IL-6: 68 NLR: 1.5 ALC: 3015 | USG thyroid: normal-sized thyroid gland, patchy hypoechoic areas 99mTc scan of thyroid: NA |
Total T4 measured in µg/dL (normal: 5.44–11.73), free T4 is measured in ng/dL (normal: 0.61–1.72), total T3 is measured in ng/dL (normal: 78–136), free T3 measured in pg/mL (normal: 2.2–4.2), TSH in µIU/mL (normal: 0.34–4.25) (TPO (thyroid peroxidase/microsomal) Ab measured in IU/mL (normal: 0–35). ESR reported as millimetres in first hour, CRP as mg/L (normal: <5), IL-6 levels in pg/mL (normal: <7).NA = Data not available
Ab, antibody; ALC, absolute lymphocyte count; CRP, C reactive protein; ESR, erythrocyte sedimentation rate; F, female; IL-6, interleukin 6; M, male; NLR, neutrophil-lymphocyte ratio ; TSH, thyroid-stimulating hormone; USG, ultrasonography.