Increased Risk of Thyroid Eye Disease Following Covid-19 Vaccination.
J Clin Endocrinol Metab
; 109(2): 516-526, 2024 Jan 18.
Article
em En
| MEDLINE
| ID: mdl-37622279
ABSTRACT
CONTEXT SARS-CoV-2 infection and Covid-19 vaccines have been associated with thyroid disorders. OBJECTIVE:
We analyzed the risk of thyroid eye disease (TED) following Covid-19 vaccination. This was a self-controlled case series study at a tertiary referral center for TED. A total of 98 consecutive patients with newly developed (n = 92) or reactivated (n = 6) TED occurring between January 1, 2021, and August 31, 2022, were included. TED was assessed in patients undergoing Covid-19 vaccination. Person-days were defined as exposed if TED occurred 1 to 28 days after vaccination, and unexposed if occurring outside this time window. Conditional Poisson regression models were fitted to calculate incidence rate ratio (IRR) and 95% CI of exposed vs unexposed. Sensitivity analyses were conducted considering different exposed periods, and effect modification by potential TED risk factors.RESULTS:
Covid-19 vaccines were administered in 81 people, 25 (31%) of whom developed TED in exposed and 56 (69%) in unexposed periods. The IRR for TED was 3.24 (95% CI 2.01-5.20) and 4.70 (95% CI 2.39-9.23) in patients below 50 years of age. Sex, smoking, and radioiodine treatment did not modify the association between TED and vaccination. TED risk was unrelated to the number of vaccine doses, and progressively decreased over time following vaccination (P trend = .03).CONCLUSION:
The risk of TED was significantly increased after Covid-19 vaccination, especially in people below 50 years of age. Possible mechanisms include spike protein interaction with the angiotensin-converting enzyme II receptor, cross-reactivity with thyroid self-proteins, and immune reactions induced by adjuvants. We suggest monitoring of individuals undergoing Covid-19 vaccination, especially if young and at risk for autoimmunity.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Oftalmopatia de Graves
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Vacinas contra COVID-19
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COVID-19
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article