•  
  •  
 

Turkish Journal of Medical Sciences

Abstract

Background/aim: To describe Graves’ Disease (GD) associated with COVID-19 infection (COVID) or its vaccines (VAC) and to compare the clinical presentations, laboratory parameters, and short-term clinical course of the disease among different etiology groups (COVID, VAC, and GD control).

Materials and methods: Included in this multicenter matched case–control, retrospective cohort study were 239 patients with newly diagnosed (n = 196) or recurrent GD (n = 43) associated with COVID (n = 79) or VAC (n = 160). Each case was matched (1:1) with a control who had been diagnosed with GD prior to COVID.

Results: The median age of the entire group was 42 years (female:male = 137:102). Both the COVID (4.6-fold) and VAC (4.1-fold) groups demonstrated higher TSH receptor antibody (TRAb) titers (p < 0.001) compared with the control group (3.5-fold), as well as a higher proportion of recurrent cases. At baseline, the COVID group had higher free triiodothyronine (fT3) levels than the other groups. Graves orbitopathy (GO) was observed in 60 patients (12.6%), with a higher frequency in classical GD (18.4%). At baseline, the variables associated with thyrotoxicosis severity (defined as fT3 levels) were younger age, higher thyroid gland volume (TGV), and etiology, with the COVID and, to a lesser extent, VAC groups presenting with higher fT3 levels. The variables associated with GO were higher TGV, TRAb titers, and smoking, while no association with etiology was identified.

Conclusion: The clinical course was similar in all groups other than in some laboratory findings. Although the frequency of GO associated with COVID and VAC was lower, the proportion of cases with a Clinical Activity Score of ≥3 was higher compared to GD. This pattern suggests a potentially stronger immunologic trigger in these cases.

Author ORCID Identifier

ASENA GÖKÇAY CANPOLATCANPOLAT: 0000-0003-1186-2960

KEMAL AĞBAHT: 0000-0003-3122-5491

ATİLLA ELHAN: 0000-0003-3324-248X

MUSTAFA CESUR: 0000-0003-1302-475X

ZİYNET UÇÜÇ: 0000-0002-0008-2742

SEÇKİN AKÇAY: 0000-0002-7964-7557

HÜLYA ILIKSU GÖZÜGÖZÜ: 0000-0001-7724-8168

MEHMET AŞIK: 0000-0002-6972-6382

HAYRİ BOSTAN: 0000-0002-4957-9856

BEKİR UÇANUCAN: 0000-0002-0810-5224

TUGÇETUĞÇE ÜNALŞAH ÜNAL: 0000-0002-0277-737X

MERVE YILMAZ: 0000-0002-3421-8548

AYŞE KUBAT ÜZÜMÜZÜM: 0000-0003-0478-1193

MEHMET ÜNAL: 0000-0001-8000-5220

CUNEYDCÜNEYD ANIL: 0000-0003-3802-9733

ÜMMÜ MUTLU: 0000-0002-5259-7326

NURCAN İNCE: 0000-0002-2582-1812

SEVGÜL FAKI: 0000-0003-1856-1263

GÜVEN CANSU: 0000-0003-2606-1103

MEHMET ERTURKERTÜRK: 0000-0002-0411-553X

AYTEN OGUZOĞUZ: 0000-0002-9518-8610

MUSTAFA AYDEMİR: 0000-0002-5145-0920

ŞEFİKA POLAT: 0000-0002-7729-5586

OYA TOPALOĞLU: 0000-0003-2501-935X

REYHAN ERSOY: 0000-0002-7437-1176

BEKİR ÇAKIR: 0000-0001-7526-8827

AYŞE OK: 0000-0002-1074-1801

ERSEN KARAKILIÇ: 0000-0003-3590-2656

MUHİTTİN YALÇIN: 0000-0002-1041-6881

YUSUF KAYHAN: 0000-0003-3200-8560

KADER UGURUĞUR: 0000-0003-4028-2041

DİLEK YAZICI: 0000-0001-5603-0004

ALPER GÜRLEK: 0000-0003-3697-271X

TÜLAY OMMA: 0000-0002-2557-9499

EMRE SAYGILI: 0000-0001-8226-1316

ADNAN BATMAN: 0000-0002-0933-6198

BANU KARA: 0000-0003-4278-6593

GÖKNUR YORULMAZ: 0000-0001-8596-9344

BAHRİ EVREN: 0000-0001-7490-2937

FÜSUN BALOŞ TÖRÜNERTÖRÜNER: 0000-0002-6168-937X

BÜLENT YILDIZ: 0000-0002-5368-2805

MURAT ERDOGANERDOĞAN: 0000-0002-0867-6393

FARUK ALAGOLALAGÖL: 0000-0002-6141-9038

ERMAN ÇAKAL: 0000-0002-9046-7258

MUSTAFA ŞAHİN: 0000-0002-4718-0083

ADNAN BATMAN: 0000-0002-0933-6198

BANU KARA: 0000-0003-4278-6593

GÖKNUR YORULMAZ: 0000-0001-8596-9344

FÜSUN BALOŞ TöRÜNER: 0000-0002-6168-937X

BÜLENT OKAN YILDIZ: 0000-0002-5368-2805

MURAT FAİK ERDOGAN: 0000-0002-0867-6393

FARUK ALAGOL: 0000-0002-6141-9038

ERMAN ÇAKAL: 0000-0002-9046-7258

DOI

10.55730/1300-0144.6096

Keywords

COVID-19 Infection, Graves' disease, Graves' orbitopathy, inactivated virus COVID-19 vaccination, mRNA COVID-19 vaccination

First Page

1381

Last Page

1393

Publisher

The Scientific and Technological Research Council of Türkiye (TÜBİTAK)

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Download

Share

COinS