Fatal Case of Possible Thyroid Crisis Induced by SARS-CoV-2 Infection

A Case Report


  • Febriyani Hamzah Hasanuddin University, Makassar, Indonesia https://orcid.org/0000-0002-5135-7830
  • Andi Makbul Aman Hasanuddin University – Wahidin Sudirohusodo Hospital, Makassar, Indonesia
  • Harun Iskandar Hasanuddin University, Makassar, Indonesia




COVID-19, SARS-CoV-2, thyrotoxic crisis, thryoid storm, thyrotoxicosis


Thyroid crisis is an emergency due to impaired thyroid function caused by various conditions, particularly infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that result in the dysfunction of various vital organs. We report a case of  a 31-year-old Indonesian female with a 2-year history of hyperthyroidism with elevated thyroid-stimulating hormone (TSH) receptor antibodies. (TRAb) who developed thyroid crisis possibly in association with SARS-CoV-2 pneumonia, sepsis, and disseminated intravascular coagulation (DIC). Prior to admission, she was treated for her hyperthyroidism with propylthiouracil and had been in stable remission for a year. She was admitted to the Emergency Room with complaints of watery stools, icteric sclerae, jaundice, coughing, and shortness of breath. The physical examination showed a World Health Organization (WHO) performance score of 4, delirium, blood pressure within normal limits, tachycardia, tachypnea, axillary temperature of 36.7°C, icteric sclerae, jaundice, and exophthalmos. There was a 3 cm palpable nodule on the right side of the neck. Auscultation  of the lungs revealed bilateral pulmonary rales. Abdominal examination noted a palpable liver and enlarged spleen.  Laboratory tests showed thrombocytopenia, electrolyte imbalance, hypoalbuminemia and elevated transaminases. The thyroid function tests showed a suppressed TSH level with an elevated free thyroxine (FT4) level. The SARS-CoV-2 polymerase chain reaction (PCR) swab test was positive. Initial patient management was with supportive therapy that included favipiravir and anti-hyperthyroidism medication; however, despite these interventions, her condition continued to deteriorate and she died after a few hours. This case demonstrates no difference in therapy between patients with thyroid crises and COVID-19 or other infections. Proper and timely treatment is important for reducing mortality rates.


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Author Biographies

Febriyani Hamzah, Hasanuddin University, Makassar, Indonesia

Department of Internal Medicine, Faculty of Medicine

Andi Makbul Aman, Hasanuddin University – Wahidin Sudirohusodo Hospital, Makassar, Indonesia

Lecturer, Division of Metabolic Endocrine, Department of Internal Medicine, Faculty of Medicine

Harun Iskandar, Hasanuddin University, Makassar, Indonesia

Division of Pulmonology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine


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How to Cite

Hamzah, F., Aman, A. M. ., & Iskandar, H. . (2022). Fatal Case of Possible Thyroid Crisis Induced by SARS-CoV-2 Infection: A Case Report. Journal of the ASEAN Federation of Endocrine Societies, 37(2), 101–105. https://doi.org/10.15605/jafes.037.02.19



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