Persistent Subacute Thyroiditis Post SARS-CoV-2 Vaccine in a Male Patient with Positive Thyroid Autoantibodies

ABSTRACT

Subacute thyroiditis (SAT) has been recently associated with severe acute respiratory syndrome-coronavirus-2 infection or vaccines against it. We report a case of a 41-yearold male patient who developed persistent SAT after the coronavirus disease-2019 (COVID-19) vaccination. He presented with sore throat and neck pain after the first dose of the COVID-19 vaccine (CoronaVac®). There was no history of a recent viral infection. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated, thyroidstimulating hormone (TSH) and free thyroxine (fT4) were normal, COVID-19 polymerase chain reaction test was negative, and sonography showed thyroiditis in the right lobe. The symptoms resolved after treatment with methylprednisolone. However, 2 weeks after the second dose of the vaccine, the patient suffered from neck pain and hoarseness. TSH and fT4 were normal, but anti-thyroid peroxidase (anti- TPO), anti-thyroglobulin (anti-Tg), ESR, and CRP were elevated. Sonography revealed thyroiditis in the left lobe. The patient was treated with ibuprofen. On follow-up, hypothyroidism was diagnosed, and levothyroxine started. Hence, the clinicians should suspect the possibility of SAT in the vaccinated subjects.