medigraphic.com
ISSN 2539-0859 (Electronic)
ISSN 0120-8411 (Print)
Asociación Colombiana de Otorrinolaringología y Cirugía de Cabeza y cuello, Maxilofacial y Estética Facial (ACORL)

2023, Number 2

Next >>

Acta de Otorrinolaringología CCC 2023; 51 (2)

Laryngeal manifestations of COVID-19

Sánchez-Burbano NA, Valderrama-Penagos JX, Serrano-García NJ, Morales-Rubio LJ, Hernández-Alarcón VJ, Bernal-Trujillo GL

Language: Spanish
References: 50
Page: 107-115
PDF size: 233.52 Kb.


ABSTRACT

Introduction: COVID 19 infection affects the upper aerodigestive tract through angiotensin-converting enzyme 2 (ACE2) and/or Transmembrane serine protease 2 (TMPRSS2). Its acute manifestations and sequelae have been very varied, and not all of them are related to orotracheal intubation. The objective is to describe the sociodemographic and clinical characteristics and the endoscopic findings of patients with laryngopharyngeal symptoms after SARS-CoV-2 infection evaluated at the Hospital Militar Central and Hospital Universitario Clínica San Rafael between March 2020 and March 2022. Methods: Cross-sectional observational study, obtaining sociodemographic data, comorbidities, need for orotracheal intubation, variety of symptoms and their endoscopic findings. Results: 118 patients were collected; the mean age was 51 years ± 14.4. The most frequent symptom was dysphonia (69.5%), followed by dyspnea (39.8%). 58.9% required orotracheal intubation and of these the most frequent manifestation was muscular tension dysphonia (MTD) and subglottictracheal stenosis. In the remaining 41.1%, the most frequent finding was irritative laryngitis. Conclusions: COVID-19 has multiple laryngopharyngeal manifestations in relation to its mechanism of infection and invasion in the tissues of this area, as an inflammatory and structural type, and not all of them are related to intubation.


REFERENCES

  1. World Healh Organization (WHO). WHO Coronavirus(COVID-19) Dashboard [Internet]. 2022[citado en mayo de 2022]. Disponible en: https://covid19.who.int/

  2. El-Anwar MW, Elzayat S, Fouad YA. ENT manifestation inCOVID-19 patients. Auris Nasus Larynx. 2020;47(4):559-64.doi: 10.1016/j.anl.2020.06.003

  3. Wu J, Weng W. COVID-19 virus released from larynx mightcause a higher exposure dose in indoor environment. EnvironRes. 2021;199:111361. doi: 10.1016/j.envres.2021.111361

  4. Descamps G, Verset L, Trelcat A, Hopkins C, Lechien JR,Journe F, et al. ACE2 Protein Landscape in the Head and NeckRegion: The Conundrum of SARS-CoV-2 Infection. Biology(Basel). 2020;9(8):235. doi: 10.3390/biology9080235

  5. Sato T, Ueha R, Goto T, Yamauchi A, Kondo K, Yamasoba T.Expression of ACE2 and TMPRSS2 Proteins in the Upper andLower Aerodigestive Tracts of Rats: Implications on COVID19 Infections. Laryngoscope. 2021;131(3):E932-E939. doi:10.1002/lary.29132

  6. Das A, Roy S, Swarnakar S, Chatterjee N. Understandingthe immunological aspects of SARS-CoV-2 causingCOVID-19 pandemic: A therapeutic approach. Clin Immunol.2021;231:108804. doi: 10.1016/j.clim.2021.108804

  7. Naunheim MR, Zhou AS, Puka E, Franco RA Jr, CarrollTL, Teng SE, et al. Laryngeal complications of COVID-19.Laryngoscope Investig Otolaryngol. 2020;5(6):1117-124. doi:10.1002/lio2.484

  8. Neevel AJ, Smith JD, Morrison RJ, Hogikyan ND, KupferRA, Stein AP. Postacute COVID-19 Laryngeal Injury andDysfunction. OTO Open. 2021;5(3):2473974X211041040. doi:10.1177/2473974X211041040

  9. Mattioli F, Marchioni A, Andreani A, Cappiello G, Fermi M,Presutti L. Post-intubation tracheal stenosis in COVID-19patients. Eur Arch Otorhinolaryngol. 2021;278(3):847-48. doi:

  10. 10.1007/s00405-020-06394-w10. Schweiger C, Manica D. Acute laryngeal lesions followingendotracheal intubation: Risk factors, classification andtreatment. Semin Pediatr Surg. 2021;30(3):151052. doi:10.1016/j.sempedsurg.2021.151052

  11. Brodsky MB, Levy MJ, Jedlanek E, Pandian V, Blackford B,Price C, et al. Laryngeal Injury and Upper Airway SymptomsAfter Oral Endotracheal Intubation With MechanicalVentilation During Critical Care: A Systematic Review.Crit Care Med. 2018;46(12):2010-2017. doi: 10.1097/CCM.0000000000003368

  12. Ramos PH, Lagos AE, Napolitano CA, Badía PI. PostintubationPhonatory Insufficiency: A Challenging Diagnosis. J Voice.2022;36(4):554-58. doi: 10.1016/j.jvoice.2020.07.011

  13. Decavel P, Nahmias O, Petit C, Tatu L. Lower Cranial NervePalsies in the COVID-19 Pandemic: A 10-Case Series ofIntensive Care Unit Patients. Eur Neurol. 2022;85(2):136-39.doi: 10.1159/000519226

  14. Ftiha F, Shalom M, Jradeh H. Neurological symptoms due toCoronavirus disease 2019. Neurol Int. 2020;12(1):8639. doi:10.4081/ni.2020.8639

  15. Li YC, Bai WZ, Hashikawa T. The neuroinvasive potentialof SARS-CoV2 may play a role in the respiratory failure ofCOVID-19 patients. J Med Virol. 2020;92(6):552-55. doi:10.1002/jmv.25728

  16. Cavalagli A, Peiti G, Conti C, Penati R, Vavassori F, TaveggiaG. Cranial nerves impairment in post-acute oropharyngealdysphagia after COVID-19. Eur J Phys Rehabil Med.2020;56(6):853-57. doi: 10.23736/S1973-9087.20.06452-7

  17. Rees CJ, Henderson AH, Belafsky PC. Postviral vagalneuropathy. Ann Otol Rhinol Laryngol. 2009;118(4):247-52.doi: 10.1177/000348940911800402

  18. Osbeck Sandblom H, Dotevall H, Svennerholm K, Tuomi L,Finizia C. Characterization of dysphagia and laryngeal findingsin COVID-19 patients treated in the ICU-An observationalclinical study. PLoS One. 2021;16(6):e0252347. doi: 10.1371/journal.pone.0252347

  19. Azzam AAA, Samy A, Sefein I, ElRouby I. Vocal Disorders inPatients with COVID 19 in Egypt. Indian J Otolaryngol HeadNeck Surg. 2022;74(Suppl 2):3420-426. doi: 10.1007/s12070-021-02663-0

  20. Rameau A, Young VN, Amin MR, Sulica L. FlexibleLaryngoscopy and COVID-19. Otolaryngol Head Neck Surg.2020;162(6):813-15. doi: 10.1177/0194599820921395

  21. Marchioni D, Bisi N, Molteni G, Rubini A. Covid-19 andENT practice: Our experience: ENT outpatient department,ward and operating room management during the SARSCoV-2 pandemic. Am J Otolaryngol. 2020;41(6):102676. doi:10.1016/j.amjoto.2020.102676

  22. Guven BB, Erturk T, Ersoy A. A serious complication afterlong-term covid-19 ards treatment: tracheal stenosis. (a casereport). Acta Medica Mediterranea. 2021;37(6):2953-6. doi:10.19193/0393-6384_2021_6_462

  23. Varga Z, Flammer AJ, Steiger P, Haberecker M, AndermattR, Zinkernagel AS, et al. Endothelial cell infection andendotheliitis in COVID-19. Lancet. 2020;395(10234):1417-418. doi: 10.1016/S0140-6736(20)30937-5

  24. Raucci F, Mansour AA, Casillo GM, Saviano A, Caso F, ScarpaR, et al. Interleukin-17A (IL-17A), a key molecule of innate andadaptive immunity, and its potential involvement in COVID-19-related thrombotic and vascular mechanisms. AutoimmunRev. 2020;19(7):102572. doi: 10.1016/j.autrev.2020.102572

  25. Rosen C, Simpson C. Operative techniques in laryngology.Alemania: Springer; 2008.

  26. Ferlito A. Diseases of the larynx. 3ª edición. San Diego: PluralPublishing; 2009.

  27. Piazza C, Filauro M, Dikkers FG, Nouraei SAR, Sandu K, SittelC, et al. Long-term intubation and high rate of tracheostomyin COVID-19 patients might determine an unprecedentedincrease of airway stenoses: a call to action from theEuropean Laryngological Society. Eur Arch Otorhinolaryngol.2021;278(1):1-7. doi: 10.1007/s00405-020-06112-6

  28. Scholfield DW, Warner E, Ahmed J, Ghufoor K. Subglotticand tracheal stenosis associated with coronavirus disease2019. J Laryngol Otol. 2021;135(7):656-58. doi: 10.1017/S0022215121001134

  29. Al Omari A, Al-Qarqaz W, Khresat M, Sataloff RT.Tracheobronchopathia osteochondroplastica in the setting ofCOVID-19. Ear Nose Throat J. 2022:1455613221083822. doi:10.1177/01455613221083822

  30. Ershadi R, Rafieian S, Sarbazzadeh J, Vahedi M. Trachealstenosis following mild-to-moderate COVID-19 infectionwithout history of tracheal intubation: a case report. GenThorac Cardiovasc Surg. 2022;70(3):303-07. doi: 10.1007/s11748-021-01747-6

  31. Shih M, Devore D, Hollas SE, Ongkasuwan J. Post-intubationGlottic Insufficiency. En: Multidisciplinary Management ofPediatric Voice and Swallowing Disorders. Cham: SpringerInternational Publishing; 2020. p. 423-30.

  32. Piersiala K, Kakabas L, Bruckova A, Starkhammar M, CardellLO. Acute odynophagia: A new symptom of COVID-19 duringthe SARS-CoV-2 Omicron variant wave in Sweden. J InternMed. 2022;292(1):154-61. doi: 10.1111/joim.13470

  33. Sahril S, Narayanan MS, Mohamad I. Managing supraglottitisin the COVID-19 era. Vis J Emerg Med. 2021;24:101092. doi:10.1016/j.visj.2021.101092

  34. Iwamoto S, Sato MP, Hoshi Y, Otsuki N, Doi K. COVID-19presenting as acute epiglottitis: A case report and literaturereview. Auris Nasus Larynx. 2023;50(1):165-68. doi: 10.1016/j.anl.2021.12.007

  35. Olivares MM, Zwiener RD, Panqueva LML, ContrerasVerduzco FA, Mansour E, Rodriguez JA, et al. COVID-19triggers attacks in HAE patients without worsening diseaseoutcome. J Allergy Clin Immunol Pract. 2022;10(3):855-58.doi: 10.1016/j.jaip.2021.12.008

  36. McGrath BA, Wallace S, Goswamy J. Laryngeal oedemaassociated with COVID-19 complicating airway management.Anaesthesia. 2020;75(7):972. doi: 10.1111/anae.15092

  37. Asaoka M, Chubachi S, Yamada Y, Fukunaga K. A rare caseof COVID-19 infection with laryngeal involvement. BMJ CaseRep. 2021;14(6):e242426. doi: 10.1136/bcr-2021-242426

  38. Nishiyama Y, Wasano K. Endoscopic findings of laryngitiscaused by SARS-CoV-2/Omicron variant infection. Infection.2023;51(1):283-84. doi: 10.1007/s15010-022-01808-9

  39. Oliver CM, Campbell M, Dulan O, Hamilton N, Birchall M.Appearance and management of COVID-19 laryngo-tracheitis:two case reports. F1000Res. 2020;9:310. doi: 10.12688/f1000research.23204.2

  40. Dominguez LM, Simpson CB. Viral laryngitis: a mimic anda monster - range, presentation, management. Curr OpinOtolaryngol Head Neck Surg. 2015;23(6):454-8. doi: 10.1097/MOO.0000000000000203

  41. Morrison M, Rammage L, Emami AJ. The irritable larynxsyndrome. J Voice. 1999;13(3):447-55. doi: 10.1016/s0892-1997(99)80049-6

  42. Morrison M, Rammage L. The Irritable Larynx Syndrome as aCentral Sensitivity Syndrome. Revue canadienne d’orthophonieet d’audiologie. 2010;34(4):282-8.

  43. Andrianopoulos MV, Gallivan GJ, Gallivan KH. PVCM,PVCD, EPL, and irritable larynx syndrome: what are we talkingabout and how do we treat it? J Voice. 2000;14(4):607-18. doi:10.1016/s0892-1997(00)80016-8

  44. Lechien JR, Circiu MP, Crevier-Buchman L, Hans S. Post-COVID-19 paradoxical vocal fold movement disorder. EurArch Otorhinolaryngol. 2021;278(3):845-46. doi: 10.1007/s00405-020-06391-z

  45. Curros Mata N, Alvarado de la Torre S, Carballo Fernández J,Martínez Morán A, Álvarez Refojo F, Rama-Maceiras P. Latebilateral vocal cord palsy following endotracheal intubation dueto COVID-19 pneumonia. Rev Esp Anestesiol Reanim (EnglEd). 202026;69(2):105–8. English, Spanish. doi: 10.1016/j.redar.2020.11.010

  46. Remacle M, Sulica L, Blitzer A. Vocal fold paralysis. Eur ArchOtorhinolaryngol. 2006;263(10):968-9. doi: 10.1007/s00405-006-0081-3

  47. Leis-Cofiño C, Arriero-Sánchez P, González-Herranz R, Arenas-Brítez Ó, Hernández-García E, Plaza G. Persistent Dysphoniain Hospitalized COVID-19 Patients. J Voice. 2021:S0892-1997(21)00234-4. doi: 10.1016/j.jvoice.2021.07.001

  48. Al-Ani RM, Rashid RA. Prevalence of dysphonia due toCOVID-19 at Salahaddin General Hospital, Tikrit City,Iraq. Am J Otolaryngol. 2021;42(5):103157. doi: 10.1016/j.amjoto.2021.103157

  49. Regan J, Walshe M, Lavan S, Horan E, Gillivan MurphyP, Healy A, et al. Post-extubation dysphagia and dysphoniaamongst adults with COVID-19 in the Republic of Ireland:A prospective multi-site observational cohort study. ClinOtolaryngol. 2021;46(6):1290-299. doi: 10.1111/coa.13832

  50. Brodsky MB, Gilbert RJ. The Long-Term Effects ofCOVID-19 on Dysphagia Evaluation and Treatment. ArchPhys Med Rehabil. 2020;101(9):1662-664. doi: 10.1016/j.apmr.2020.05.006




2020     |     www.medigraphic.com