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More Evidence Linking COVID-19 and Thyroid Disease

A new 4.5-year observational study published in The Journal of Clinical Endocrinology & Metabolism found that SARS-CoV-2 infection is associated with a significantly increased risk of developing new-onset thyroid disease, even in people who were not hospitalized.

Researchers from Montefiore Health System analyzed electronic health records from patients without prior thyroid disease. The study included 15,372 individuals hospitalized with COVID-19, 41,757 nonhospitalized patients with confirmed COVID-19, and large control groups without documented infection.

Compared with COVID-negative controls, patients hospitalized for COVID-19 had more than double the risk of developing thyroid disease. They also had an increased risk of hypothyroidism and hyperthyroidism. Nonhospitalized patients showed a more modest but still statistically significant increase in thyroid disease risk.

Overall, 2.99% of hospitalized patients developed thyroid disease, compared with 1.39% of nonhospitalized patients and 1.03% of controls.

While the absolute differences may appear small, researchers note that even modest increases could translate into a substantial healthcare burden given the large number of people infected worldwide.

One possible explanation is immune dysregulation. Severe COVID-19 can trigger elevated inflammatory signaling, including cytokines such as interleukin-6 and tumor necrosis factor-alpha. This inflammatory environment may contribute to thyroid tissue damage or the development of thyroid autoantibodies.

The authors suggest clinicians consider monitoring thyroid function in individuals recovering from COVID-19, particularly those with additional risk factors such as autoimmune disease.

Citation

Mehrotra-Varma, S., Hadidchi, R., Henry, S., Quangnguyen, H., Mehrotra-Varma, J., Coard, M. C., Changela, S., Collins, J., & Duong, T. Q. (2025). Elevated risk of new-onset thyroid disease associated with SARS-CoV-2 infection: a 4.5-year observational study. The Journal of clinical endocrinology and metabolism, dgaf688. Advance online publication. https://doi.org/10.1210/clinem/dgaf688