ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of thyroid nodules and cancer

Eur J Endocrinol. 2020 Jul;183(1):G41-G48. doi: 10.1530/EJE-20-0269.

Abstract

Most patients with thyroid nodules and thyroid cancer (TC) referred for diagnostic work-up and treatment are not considered at higher risk of infection from SARS-CoV-2 compared to the general population. On the other hand, healthcare resources should be spared to the maximum extent possible during a pandemic. Indeed, while thyroid nodules are very common, only a small percentage are cancerous and, in turn, most thyroid cancers are indolent in nature. Accordingly, diagnostic work-up of thyroid nodules, thyroid surgery for either benign or malignant thyroid nodules and radioiodine treatment for differentiated thyroid cancers may be safely postponed during SARS-CoV-2 pandemic. Appropriate patient counselling, however, is mandatory and red flags should be carefully identified prompting immediate evaluation and treatment as appropriate. For these selected cases diagnostic work-up (e.g. ultrasound, scintigraphy, fine-needle aspiration), surgery and radioiodine therapy may proceed despite the threat of SARS-CoV-2 infection and COVID-19, after an individual risk-benefit analysis.

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / virology
  • Disease Management
  • Endocrinology / methods
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / virology
  • Risk Assessment
  • SARS-CoV-2
  • Thyroid Neoplasms / complications
  • Thyroid Neoplasms / diagnosis
  • Thyroid Neoplasms / therapy
  • Thyroid Neoplasms / virology
  • Thyroid Nodule / complications
  • Thyroid Nodule / diagnosis*
  • Thyroid Nodule / therapy
  • Thyroid Nodule / virology