Nodular goiter and anamnesis of COVID-19: clinical and pathogenetic relationships, sonographic and cytological features

There is literature data on the development of destructive thyroiditis in patients with COVID-19, which may increase the risk of thyroid pathology in the post-COVID period. Special attention is paid to autoimmune thyroid diseases, while the impact of COVID-19 on nodular goiter (NG) has been studied little. The aim of this study was to investigate the sonographic and cytological features of nodular goiter in patients with a recent history of COVID-19. Materials and Methods: A total of 132 patients who sequentially presented to a healthcare facility between October and May 2021-2022, where they were fi rst diagnosed with nodular goiter, were examined. Of these, 36 denied a history of COVID-19 (control group), while 96 had experienced it 2-9 months prior (main group). Results: According to sonographic data, there were more patients in the main group with microcalcifications (17 (17.8%) vs. 2 (5.6%), p = 0.047), cystic components of nodules (22 (22.9%) vs. 2 (5.6%), p = 0.015), and hypoechoic nodules (23 (23.9%) vs. 4 (11.1%), p = 0.078). In the main group, cytological signs of degenerative changes in thyrocytes combined with macrophage clusters were more frequently observed, which is a nonspecifi c but common manifestation of the consequences of destructive thyroiditis (16 (39.0%) vs. 2 (10.0%), p = 0.017). Conclusion: Nodular goiter identified in the post-COVID period is characterized by an increased prevalence of microcalcifi cations, a tendency towards reduced echogenicity of nodules, as well as cyst formation against a background of degenerative changes in thyroid tissue. The features of nodular goiter identified in the post-COVID period do not exclude a propensity for oncogenic disorders.