Be Aware: Thyroid Symptoms Could Mimic Serious Pathologies in Patients Who’ve Had COVID-19

A patient presents to your urgent care center with palpitations and neck pain radiating to her jaw. She also has a painful, enlarged thyroid on palpation. Concerns for heart attack and malignancy were ultimately ruled out upon further evaluation in this real-world case published in The Journal of Clinical Endocrinology & Metabolism. The patient, who it was later learned had recently recovered from COVID-19, was found to have subacute thyroiditis (SAT), presumed to have stemmed from that infection. SAT is characterized by neck pain, general symptoms, and thyroid dysfunction is self-limited but can mimic more serious etiologies like acute coronary syndrome or cancer. Of particular note in the COVID-19 pandemic era, however, is that it usually follows an upper respiratory infection. If a patient presents with neck pain and systemic symptoms such as fever, fatigue, myalgia, and anorexia, probe for history of COVID-19 (or, absent that diagnosis or associated complaints, possible exposure to others who could have been infected). The patient in the published case report was treated with prednisone, 25 mg/day; her symptoms began subsiding within 2 days of treatment initiation.