Graves’ Disease before and after the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic: Experience of a Clinical Center

Introduction: New cases of Graves’ disease (GD) have been reported in association with SARS-CoV-2 infection and vaccination. We aimed to determine if there was an increase in the new cases of GD after the SARS-CoV-2 pandemic, to compare the characteristics of GD patients before and after the pandemic, and to compare GD patients’ characteristics in relation to the presence of SARS-CoV-2 infection and/or vaccination. Methods: Retrospective and observational study evaluating sociodemographic, analytical, and treatment-related characteristics of newly diagnosed GD patients, who had their first consultation at the Endocrinology Department of Hospital de Braga between 2018 and 2022 (GDbP: pre-pandemic symptoms; GDaP: post-pandemic symptoms). GDaP was subdivided into four subgroups (GDnIV, GDwI, GDwV, and GDwIV) based on SARS-CoV-2 infection (I) and/or vaccination (V). Results: We included 250 patients: 108 (43.2%) in the GDbP group and 142 (56.8%) in the GDaP group. There was a significant increase in the first endocrinology appointments due to GD after the pandemic (2.85% vs 5.11%, p < 0.001). When compared to GDbP, GDaP took less time to start (p < 0.05), reduce dosage (p < 0.05), and discontinue medical treatment (p < 0.05). Compared to the GDbP group, the GDwI subgroup showed higher anti-Tg levels (p < 0.05); the GDnIV, GDwV, and GDwIV subgroups took less time to initiate and discontinue medical treatment (p < 0.05). GDwI and GDwV patients had higher free thyroxine (FT4) levels than the GDnIV group (p < 0.05). GDwV patients took less time to reduce medical treatment dose compared to GDnIV (p < 0.05). Conclusions: There was an increase in the number of new GD cases with the SARS-CoV-2 pandemic. These patients took less time to initiate, reduce, and discontinue medical treatment. Some subgroups with GD related to I and V showed higher FT4 and anti-Tg titers when compared to pre-pandemic GD patients or GD with no relation to SARS-CoV-2 infection or vaccination.