• Andra - Maria Olteanu “Constantin Ion Parhon” National Institute of Endocrinology, Bucharest, Romania
  • Adina Ghemigian “Constantin Ion Parhon” National Institute of Endocrinology, Bucharest, Romania & “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • Ana Valea “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania & Clinical County Hospital, Cluj-Napoca, Romania
  • Daniel Diaconu “Constantin Ion Parhon” National Institute of Endocrinology, Bucharest, Romania
  • Eugenia Petrova “Constantin Ion Parhon” National Institute of Endocrinology, Bucharest, Romania & “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • Mara Carsote “Constantin Ion Parhon” National Institute of Endocrinology, Bucharest, Romania & “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • Florica Șandru Elias Clinical Emergency Hospital, Bucharest, Romania & “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Keywords: subacute thyroiditis, thyroid, inflammation, ultrasound, pandemic, TSH, thyroid antibodies


Otorhinolaryngology specialists are sometimes required to provide an evaluation for compressive neck signs and symptoms potentially associated with inflammatory sign which actually are related to a thyroid condition, most probably not a cancer, but an atypical form of subacute thyroiditis.  Thyroid conditions like cancers, compressive goitre or inflammatory diseases may associate compressive local symptoms including difficulties of breathing, eating, troubles of voices and local pain. Atypical thyroid subacute disease may cause a first presentation to otorhinolaryngology. We present a series of 3 cases. The importance of differential diagnostic is essential in order to provide adequate therapy and to avoid unnecessary thyroid biopsy/fine needle aspiration investigations in cases without typically inflammatory panel.


[1]AB Bahçecioğlu, ZC Karahan, BI Aydoğan, IA Kalkan, A Azap, MF Erdoğan Subacute thyroiditis during the COVID-19 pandemic: a prospective study. .J Endocrinol Invest. 2022 Apr;45(4):865-874.
[2]J Zhang, G Ding, J Li, X Li, L Ding, X Li, S Yang, F Tang. Risk Factors for Subacute Thyroiditis Recurrence: A Systematic Review and Meta-Analysis of Cohort Studies. Front Endocrinol (Lausanne). 2021 Dec 23;12:783439. doi: 10.3389/fendo.2021.783439.
[3]L Das, SK Bhadada, A Sood. Post-COVID-vaccine autoimmune/inflammatory syndrome in response to adjuvants (ASIA syndrome) manifesting as subacute thyroiditis. J Endocrinol Invest. 2022 Feb;45(2):465-467. doi: 10.1007/s40618-021-01681-7.
[4]I Pirola, E Gandossi, M Rotondi, F Marini, A Cristiano, L Chiovato, M Castellano, A Ferlin, C Cappelli. Incidence of De Quervain's thyroiditis during the COVID-19 pandemic in an area heavily affected by Sars-CoV-2 infection. Endocrine. 2021 Nov;74(2):215-218.
[5]TH Brix, L Hegedüs. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and thyroid disease. An update. Curr Opin Endocrinol Diabetes Obes. 2021 Oct 1;28(5):525-532.
[6]J Christensen, K O'Callaghan, H Sinclair, K Hawke, A Love, K Hajkowicz, AG Stewart. Risk factors, treatment and outcomes of subacute thyroiditis secondary to COVID-19: a systematic review. Intern Med J. 2022 Apr;52(4):522-529.
[7]N Dumitru, A Ghemigian, M Carsote, SE Albu, D Terzea, A Valea. Thyroid nodules after initial evaluation by primary health care practitioners: an ultrasound pictorial essay. Arch Balk Med Union. 2016;51(3):434-438.
[8]R Abreu, R Miguel, M Saieg. Subacute (De Quervain) thyroiditis during the COVID-19 pandemic. Cancer Cytopathol. 2021 Nov;129(11):844-846.
[9]M Stasiak, A Lewiński. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021 Dec;22(4):1027-1039.
[10]P Trimboli, C Camponovo, L Scappaticcio, G Bellastella, A Piccardo, M Rotondi. Thyroid sequelae of COVID-19: a systematic review of reviews. Rev Endocr Metab Disord. 2021 Jun;22(2):485-491.
[11]G Lisco, A De Tullio, E Jirillo, VA Giagulli, G De Pergola, E Guastamacchia, V Triggiani. Thyroid and COVID-19: a review on pathophysiological, clinical and organizational aspects. J Endocrinol Invest. 2021 Sep;44(9):1801-1814.
[12]N Lafontaine, D Learoyd, S Farrel, R Wong. Suppurative thyroiditis: Systematic review and clinical guidance. Clin Endocrinol (Oxf). 2021 Aug;95(2):253-264.
[13]W Chen, Y Tian, Z Li, J Zhu, T Wei, J Lei. Potential Interaction Between SARS-CoV-2 and Thyroid: A Review. Endocrinology. 2021 Mar 1;162(3):bqab004.
[14]M Calapkulu, ME Sencar, D Sakiz, IO Unsal, M Ozbek, E Cakal. The Importance of Vitamin D Level in Subacute Thyroiditis Disease and the Effect of Vitamin D on Disease Prognosis. Endocr Pract. 2020 Oct;26(10):1062-1069.
[15]LH Singh, AK Chandra, SD Yumnam, D Sarkar, RK Manglem, T Dhabali, S Mookerjee, I Ray. Thiocyanate in excess develops goiter followed by auto immune thyroid diseases even after effective salt iodization in a rural community of north east India. Ecotoxicol Environ Saf. 2021 Jan 15;208:111711.
[16]F Gorini, F Bianchi, G Iervasi. COVID-19 and Thyroid: Progress and Prospects. Int J Environ Res Public Health. 2020 Sep 11;17(18):6630.
[17]F Sandru, M Carsote, RC Petca, Gheorghisan-Galateanu AA, Petca A, Valea A, Dumitrascu MC. COVID-19 – related thyroid conditions (Review). Exp Ther Med. 2021;22(756):1-5.
[18]Y Hu, D Zhou, J Chen, P Shan. Eosinophil/Monocyte Ratio Combined With Serum Thyroid Hormone for Distinguishing Graves' Disease and Subacute Thyroiditis. Front Endocrinol (Lausanne). 2020 May 8;11:264.
[19]N Zhao, S Wang, XJ Cui, MS Huang, SW Wang, YG Li, L Zhao, WN Wan, YS Li, ZY Shan, WP Teng. Two-Years Prospective Follow-Up Study of Subacute Thyroiditis. Front Endocrinol (Lausanne). 2020 Feb 28;11:47. doi: 10.3389/fendo.2020.00047.
[20]D Ricci, A Brancatella, M Marinò, M Rotondi, L Chiovato, P Vitti, F Latrofa. The Detection of Serum IgMs to Thyroglobulin in Subacute Thyroiditis Suggests a Protective Role of IgMs in Thyroid Autoimmunity. .J Clin Endocrinol Metab. 2020 Jun 1;105(6):dgaa038. doi: 10.1210/clinem/dgaa038.
[21]ME Sencar, M Calapkulu, D Sakiz, S Hepsen, A Kus, P Akhanli, IO Unsal, M Kizilgul, B Ucan, M Ozbek, E Cakal. An Evaluation of the Results of the Steroid and Non-steroidal Anti-inflammatory Drug Treatments in Subacute Thyroiditis in relation to Persistent Hypothyroidism and Recurrence. Sci Rep. 2019 Nov 15;9(1):16899.
[22]J Görges, J Ulrich, C Keck, D Müller-Wieland, S Diederich, OE Janssen.
Long-term Outcome of Subacute Thyroiditis. Exp Clin Endocrinol Diabetes. 2020 Nov;128(11):703-708.
How to Cite
Olteanu, A.- M., Ghemigian, A., Valea, A., Diaconu, D., Petrova, E., Carsote, M., & Șandru, F. (2023). SUBACUTE THRYODITIS AMID COVID-19 PANDEMIC: ATYPICAL ASPECTS. Romanian Journal of Clinical Research, 6(1). Retrieved from