COVID-19 Associations With Thyroid Disease in Active-Duty Service Members: A Retrospective Cohort Study, 2026, McLaughlin et al.

Chandelier

Senior Member (Voting Rights)
COVID-19 Associations With Thyroid Disease in Active-Duty Service Members: A Retrospective Cohort Study

McLaughlin, Nicolas; Berill, Zella; Susi, Apryl; Nylund, Cade M; Jensen, Kirk

Abstract​

Introduction
There are bidirectional associations between COVID-19 and thyroid disease; little is known about these risks among active-duty service members (ADSM).
This study seeks to understand the associations between COVID-19 and thyroid disease in this population and in non–active-duty adults within the military health system.

Methods
The researchers conducted a retrospective propensity score-matched cohort study using the Military Health System Database including individuals 18-64 years of age. International Classification of Diseases, 10th revision codes and laboratory results identified COVID-19 infections from July 2020 to June 2021.
Patients with COVID-19 were matched 1:2 to controls based on age, sex, beneficiary type, month, and a propensity score.
Thyroid disease was identified by ICD-10 codes and those with a thyroid diagnosis in the year prior were excluded.
Hazard ratios (HR) and Bonferroni-adjusted 95% confidence intervals (95BoCI) were calculated.

Results
There were 103,778 exposures and 207,556 controls among ADSM and 125,399 exposures and 250,798 controls among non-ADSM.
Among ADSM there was a significant association with having any thyroid disease diagnoses (HR = 1.48, 95%CI [1.15-1.89]).
However, no significant relationship was found between COVID-19 infection and hypothyroidism (HR = 1.11, 95BoCI [0.93-1.31]), Hashimoto’s thyroiditis (HR = 1.07, 95BoCI [0.77-1.48]), Grave’s disease (HR = 1.20, 95BoCI [0.85-1.70]), or other thyroiditis (HR = 1.11, 95BoCI [0.83-1.47]).
Non-ADSM adults from ages 18-64 showed significantly increased rates of hypothyroidism (HR = 1.11, 95BoCI [1.03-1.19]), Hashimoto’s thyroiditis (HR = 1.15, 95BoCI [1.01-1.31]), Grave’s disease (HR = 1.26, 95BoCI [1.09-1.46]), and other thyroiditis (HR = 1.31, 95BoCI [1.18-1.45]).

Conclusions
ADSMs with COVID-19 infection demonstrate an increased risk for combined thyroid disease, although non-ADSM adults had significantly increased rates of Grave’s disease, Hashimoto’s disease, hypothyroidism, and other thyroiditis.
These results highlight that even in young, healthy populations like the ADSMs, COVID-19 can lead to long-term thyroid dysfunction.

Web | DOI | PDF | Military Medicine | Open Access
 
One problem with such studies is that the testing might be simplistic. "Your TSH is slightly above average, therefore you have hypothyroidism, case closed, and here's your prescription for synthroid." As some of the threads about thyroid testing show, it's not quite that simple. In my case, I think it's possible that my ME alters my glial kynurenine processes, elevating picolinic acid, which elevates TRH, which elevates TSH. So my above average TSH is actually normal for a human with that sort of glial dysfunction, and not a thyroid gland problem.
 
I had "extremely elevated" antithyroid antibodies during sudden ME onset. They went down on their own after 9 months. I still have elevated antimicrosomal antibodies, but the virologist didn't make anything of it.
 
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