Graves’ disease (GD) is a systemic autoimmune disorder characterized by the infiltration of thyroid antigen-specific T-cells into thyroid-stimulating hormone receptor (TSH-R)-expressing tissues. Stimulatory autoantibodies (Ab) in GD activate the TSH-R leading to thyroid hyperplasia and unregulated thyroid hormone production and secretion. Diagnosis of GD is straightforward in a patient with biochemically confirmed thyrotoxicosis, positive TSH-R-Ab, a hypervascular and hypoechoic thyroid gland (ultrasound), and associated orbitopathy. In GD, measurement of TSH-R-Ab is recommended for an accurate diagnosis/differential diagnosis, prior to stopping antithyroid drug (ATD) treatment and during pregnancy. Graves’ hyperthyroidism is treated by decreasing thyroid hormone synthesis with the use of ATD, or by reducing the amount of thyroid tissue with radioactive iodine (RAI) treatment or total thyroidectomy. Patients with newly diagnosed Graves’ hyperthyroidism are usually medically treated for 12–18 months with methimazole (MMI) as the preferred drug. In children with GD, a 24- to 36-month course of MMI is recommended. Patients with persistently high TSH-R-Ab at 12–18 months can continue MMI treatment, repeating the TSH-R-Ab measurement after an additional 12 months, or opt for therapy with RAI or thyroidectomy. Women treated with MMI should be switched to propylthiouracil when planning pregnancy and during the first trimester of pregnancy. If a patient relapses after completing a course of ATD, definitive treatment is recommended; however, continued long-term low-dose MMI can be considered. Thyroidectomy should be performed by an experienced high-volume thyroid surgeon. RAI is contraindicated in Graves’ patients with active/severe orbitopathy, and steroid prophylaxis is warranted in Graves’ patients with mild/active orbitopathy receiving RAI.

The “new disease” COVID-19, which causes acute respiratory distress syndrome, by the time of writing this article had already affected 5 million 400 thousand people on Earth and claimed the lives of at least 400 thousand people in more than 200 countries. The disease can be either asymptomatic or occur with the development of severe viral pneumonia, complicated by acute respiratory syndrome and sepsis, myocarditis and renal failure. Although the likelihood of a more severe course is noted in individuals with diabetes, and these patients are mainly drawn to the attention of endocrinologists in the pandemic, the actual endocrine manifestations of COVID-19 are not yet considered in detail. There are few data on coronavirus damage to the pituitary, hypothalamus, thyroid gland and adrenal glands, their structural and functional disorders in case of COVID-19 infection, due to the lack of convincing results of preclinical and clinical studies.

The literature review presented in this article does not claim to be a full-fledged systematic review, not only for the reason that to date, only 51 works have been found at the time of writing in the databases for the keywords «thyroid and COVID-19» and «adrenal and COVID-19», after excluding duplicates, but also because these messages themselves contain little information and are mainly based on analogies with previously existing viral infections and their role in the development of hypothalamus-pituitary axis pathology-adrenal glands and hypothalamus-pituitary-thyroid.

Background: The Aral crisis consider as one of the largest ecological catastrophes on the planet. TheKazakhstan part of the Aral Sea regiondeclared an environmental disaster zone. The constantly changing unfavorable environmental situation contributed to higher number of thyroid pathology and initiates the study of this problem in women of reproductive age in the AralSea area.

Aims:To study thyroid function in women of reproductive age living in ecologically unfavorable territories of Kazakhstan part of the Aral Sea region.

Materials and methods: The survey was conducted within scientific and technical program: “Integrated approaches in managing the health status of the population of the Aral Sea region”  2014–2016 years, performed by Ministry of Health and Social Development of the Republic of Kazakhstan. The study was cross-sectional, observational, uncontrolled and multicenter.Study included the representative sample of 2205 women of reproductive age from 18 to 49 years old living in the Aral Sea region.The levels ofTSH,FT4and AntiTPOweredetermined by the laboratory of collective use of KSMU on the Evolis Robotized System using“Tiroid-ELISA-TTG,0.23-3.4µIU/ml”, “Thyroid–ELISAfreeT4,10-23.2pmol/l”,“Tiroid ELISA – atTPO,<30EDU/ml”testsystems.

Results:A huge number of women from environmental disadvantaged areas of the Kazakhstan part of the Aral Sea region have TSH values exceeding reference of 3.4 μI/ml.

The frequency of SH was 0.2%;0.9%,0.2% in the different study areas at TTG values≥10.0 μIU/ml and freeT4 from 10to23.2 pmol/l. The frequency of MH was 2.4%;2.7%,2.5% in the studied areas at TSH values ≥10.0μIU/ml and FreeT4<10.0 pmol/l, Thus, the data obtained on the prevalence of reduced thyroid function in women living in the studied areas of the Aral Sea ecological disaster can be considered as comparative. About3%of women of reproductive age neededon replacement therapy for hypothyroidism. Thelargest number of women with elevated AT-TPO identified in the zone of the ecological crisis. Almost same number of women with hypothyroidism was revealed among AT-TPO hosts in all studied zones.

Conclusions: Women of reproductive age living in ecologically unfavorable territories havea high, comparable frequency of manifest hypothyroidism in the three studied zones of the Kazakhstan part of the Aral Sea region of the Republic of Kazakhstan.

The editors of the journal created a new section - “Handling errors” - and commissioned me to analyze the text of the article “Thyroid function in women of childbearing age from the Kazakhstan part of the Aral Sea region”, published in the same issue. The need for such a rubric is dictated by the obvious fact that the editors constantly receive inadequate quality manuscripts from the authors. Some of them are so much deviating from journal’s standard that they quickly fly to the "basket". Others have serious flaws in the methodology, analysis or discussion of the results. But they can potentially be brought to an acceptable level, although, sometimes, the initial mistakes in the design of the study make this extremely difficult. The review discusses shortcomings of the work: the absence of a control group and the fact that the authors tried to study the effect on the thyroid gland of unidentified chemical agents in an unknown concentration. Due to the mistakes made during the planning process, the data obtained, no matter how reliable and unique they were, became impossible to interpret.