Although there is not yet enough information regarding the relationship between thyroid conditions and susceptibility to COVID-19, there is currently no reason to believe that most people with thyroid disease are at increased risk to contract this novel coronavirus or to experience complications.

Nevertheless, if thyroid medications are not taken as prescribed, uncontrolled thyroid disease may increase a person’s risk for viral infection and complications. Additionally, immunosuppressive drugs, high-dose steroids and certain other treatments can increase a person’s risk for infections and complications. People receiving these types of treatments should speak to their healthcare provider to ask about their specific risk.

As COVID-19 continues to spread across the United States, it is crucial to adhere to the advice from experts and the Centers for Disease Control and Prevention (CDC) to reduce risk of infection. The following actions will help prevent the spread of COVID-19 and better protect individuals, including those with thyroid disease:

• Take medications exactly as prescribed, and ensure appropriate supplies of medications in case of an emergency.
• If experiencing fever, cough, shortness of breath or other symptoms, call both the COVID-19 hotline (check your state government website for contact information) and your primary care physician.
• If you experience any changes in your thyroid symptoms, contact your endocrinologist or primary care physician.
• Stay at home as much as possible and avoid close contact with other people.
• Cover your mouth and nose with a cloth face cover when around others.
• Wash your hands with soap and water regularly for at least 20 seconds, especially before eating or drinking, after using the restroom, and after blowing your nose, coughing or sneezing.
• If soap and water are not readily available, use an alcohol-based sanitizer with at least 60% alcohol.
• Cover your nose and mouth when coughing or sneezing with a tissue or a flexed elbow, then throw the tissue in the trash.
• Avoid touching your eyes, mouth or nose with unwashed hands.
• Clean and disinfect frequently touched surfaces daily.

In addition to following the general advice outlined above, individuals should observe specific guidance outlined below according to their thyroid condition.

Graves’ Disease or Hyperthyroidism

• There is currently no evidence that individuals with autoimmune thyroid disease have an increased risk of COVID-19 infection.
• It is crucial to continue taking your medications as prescribed. If your condition is not being treated appropriately, you may be at increased risk of viral infection or complications.
• Although rare, anti-thyroid medications used to treat Graves’ disease may cause side effects that resemble symptoms of COVID-19, such as fever, sore throat and muscle pain, as a result of a decrease in white blood cell count. If you experience these symptoms, contact your healthcare provider immediately and mention that you take thyroid medications.

Hashimoto’s Thyroiditis

• There is currently no evidence that individuals with autoimmune thyroid disease have an increased risk of COVID-19 infection.

Hypothyroidism

• It is crucial to continue taking your medications as prescribed. If your condition is not being treated appropriately, you may be at increased risk of viral infection or complications.

Thyroid Cancer

• The majority of individuals with thyroid cancer are likely not more susceptible to COVID-19. However, individuals with metastatic thyroid cancer (papillary or medullary) may be at increased risk of viral infection or complications if they have lung metastases or if they are undergoing certain types of cancer treatment. Following the CDC guidelines will help to prevent infection, but you should contact your healthcare provider immediately if symptoms occur.

Thyroid Eye Disease

• Thyroid eye disease (TED) may be treated with high-dose steroids, which cause individuals to be immunosuppressed and to be at increased risk of viral infection and complications. If you have been on steroid treatment, take your medication as prescribed and contact your endocrinologist or primary care physician to discuss your dosage during the COVID-19 pandemic.
• Some individuals receive infusions as treatment for TED. Although rare, side effects from the infusion can resemble symptoms of COVID-19, including feeling hot, tachycardia, dyspnea and muscle pain. If you experience these symptoms, contact your healthcare provider immediately and inform them of your treatment.
• Individuals that receive steroids or infusions for TED may also experience hyperglycemia and should follow COVID-19 precautions outlined for people with diabetes.