PhD Scientific Days 2025

Conservative Medicine II.

Has the Prevalence of Thyroid Autoimmunity Increased During the COVID-19 Pandemic?

Name of the presenter

Herczeg Vivien

Institute/workplace of the presenter

Semmelweis University, Pediatric Center, Bókay Street Division

Authors

Vivien Herczeg¹, Eszter Muzslay¹, Diána Czipó², Lili Terkovics², Réka Garai¹, Fanni Kovács¹, Andrea Luczay¹, Péter Tóth-Heyn¹

1: Semmelweis University, Pediatric Center, Bókay Street Division
2: Semmelweis University, Faculty of Medicine

Text of the abstract

Introduction: Studies examining the long-term changes in the prevalence of autoimmune thyroiditis (AIT) in children are lacking. During the COVID-19 pandemic, some publications reported an increase in the number of AIT cases.
Aims: The aim of our study was to analyze the prevalence of thyroid autoimmunity (TA) over a 10-year period, covering both the years before and after the start of the pandemic. Given that children with type 1 diabetes (T1D) are routinely screened for AIT, our research was conducted using their data.
Methods: In our retrospective cohort study, we included 1,361 children (< 21 years) with T1D who were under the care of the Bókay Street Division of the Pediatric Center between 2013 and 2022. We analyzed thyroid autoantibody levels (anti-thyroid peroxidase /ATPO/ and anti-thyroglobulin /ATG/), thyroid function markers and ultrasound (US) findings. We determined the annual prevalence of TA and AIT for the periods before and during the COVID-19 pandemic. The mean (± SD) follow-up duration for the children was 4.7 (± 2.8) years.
Results: The overall prevalence of TA among T1D children was 22.8% ([20.3; 25.5], 310 cases), with a significantly higher proportion of affected girls (p<0.001). Between 2013 and 2022, the prevalence increased from 15.9% to 20.6% (p=0.041). This increase was observed in the years preceding the pandemic, while the prevalence remained stable during the COVID-19 era. Thyroiditis confirmed by US was detected in 80.0% of the examined TA cases. The rate of US positivity remained stable over the study period. Among children with TA, 28.5% had clinically relevant thyroid-stimulating hormone (TSH) abnormalities (most frequently subclinical hypothyroidism) and/or required medication (hormone replacement or antithyroid drugs). Children diagnosed with AIT had a significantly higher risk of thyroid function abnormalities compared to those who were only positive for thyroid autoantibodies without US positivity (p<0.001).
Conclusion: Our findings indicate that the prevalence of AIT among children with T1D has increased over the past 10 years. However, our data do not indicate a direct role for SARS-CoV-2 in the onset of the disease.
Funding: This work was supported by the EKÖP-2024-144 New National Excellence Program of the Ministry of Culture and Innovation from the source of the National Research, Development and Innovation Fund.