Editorial: the thyroid and Covid-19, volume II

• Autor(a) principal: Jiménez, Javier
• Data de Publicação: 2023
• Outros Autores: Campinho, Marco António, Nogueira, Celia Regina, Sgarbi, Jose
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.1/20281
• topic: COVID - 19; Thyroid; Pandemic (COVID19); COVID 19 vaccines; Thyroid cancer

Coronaviruses are enveloped RNA viruses of wide distribution in humans associated with mild respiratory disease. By contrast, severe acute respiratory syndrome coronavirus (SARS-CoV) is one of those coronaviruses that can cause fatal illness. In late December 2019, an outburst of pneumonia of unknown cause in Wuhan, China, was identified as the early stage of the coronavirus disease (COVID-19) pandemic outbreak, and the SARS-CoV-2 was found responsible (1). Two main proteins expressed by SARS-CoV-2 are essential for the manifestations of COVID-19. The first is the transmembrane protease serine 2 (TMPRSS2), which acts on the transcription and replication of the virus. The second is the Spike protein found on the surface of viral particles, which binds to angiotensin-converting enzyme 2 (ACE2) in tissue cells and is a determinant for transmitting infection. Therefore, SARS-CoV-2 infection depends on two steps: ACE2 receptor recognition via Spike protein and cell membrane fusion via transmembrane protease (2). ACE2 is expressed in different tissues, and the thyroid is no exception (3). It has been shown that the thyroid gland has high expression levels of ACE2, which may explain the direct effects on the thyroid parenchyma, making it more susceptible to viral attack (3). SARS-CoV-2 infection can lead to thyroid diseases by severely destroying parafollicular and follicular epithelial cells, leading to follicle rupture. As a result, SARS-CoV-2 virus infections are associated with inflammatory thyroid diseases such as subacute thyroiditis, Graves’ disease, thyrotoxicosis, Hashimoto’s thyroiditis, and euthyroid patient syndrome (4). As regards thyroid cancer, the COVID-19 pandemic has also affected its traditional management, and the consequences of this strategic change are largely unknown. Furthermore, it is intriguing that if the virus attacks the thyroid gland, it can also modulate thyroid cancer behavior (5).