ArticleBMC infectious diseases2026
The role of COVID-19 infection and vaccination in the induction of anti-TPO antibodies and the potential impact on developing thyroid disease.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCOVID-19 infection and/or vaccination has been repeatedly reported to be the cause of initiating thyroid disease. Limited studies explored the impact of COVID-19 infection and/or vaccination on patients with thyroiditis history.
objectivesThis study aimed to relate COVID-19 infection and vaccination to the development of anti-Thyroid Peroxidase (TPO) auto-antibodies in groups of participants naturally infected with and/or vaccinated for COVID-19, with or without prior history of thyroid disease.
methodsParticipants were grouped into infected only (n = 75), vaccinated only (n = 122), infected and vaccinated (n = 97), infected/vaccinated with prior thyroid disease (n = 35), children (n = 69) and pre-COVID controls (n = 146). Participants were screened for anti-Spike and anti-Nucleocapsid, and anti- TPO antibodies. Anti-TPO positive participants were tested for thyroid function by measuring TSH, free T3 and free T4.
resultsSignificantly highest anti-TPO titers (mean = 91.45 IU/mL) and seropositivity rates (42.49%) were found in participants with pre-established thyroid disease. Combined infected and vaccinated participants with no history of thyroid disease also showed significantly higher anti-TPO titers (mean = 74.22 IU/mL, 17.5%) compared to vaccinated only (mean = 48.04 IU/mL, 15.6%), infected only (mean = 31.54 IU/mL, 12%), and control pediatric (mean = 4.8 IU/mL, 1.4%) and pre-COVID (mean = 20.16 IU/mL, 11%) groups. Among anti-TPO positive participants, TSH levels positively correlated with anti-TPO titers. Anti-TPO titers were significantly affected by number of vaccine doses but not with anti-Spike titers, anti-Nucleocapsid titers, number of COVID-19 infections or vaccine types. Age formed a significant factor correlating positively with mean anti-TPO titers. Elevated anti-TPO titers appeared more frequently months after infection and/or vaccination.
conclusionsWith accumulation of COVID-19 related immune events, patients with pre-established thyroid disease showed higher anti-TPO titers compared to those with no history of thyroid disease. This indicates that such immune events might boost the activation of pre-existing TPO specific T and B cells. Clinical follow up of thyroiditis patients during and months after COVID-19 infection/vaccination is essential.
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