Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19
Abstract Objectives Respiratory, voice, and swallowing difficulties after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may result secondary to upper airway disease from prolonged intubation or mechanisms related to the virus itself. We examined a cohort who presented with new larynge...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-04-01
|
| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.763 |
| _version_ | 1828784665760104448 |
|---|---|
| author | Annie E. Allisan‐Arrighi Sarah K. Rapoport Benjamin M. Laitman Rohini Bahethi Matthew Mori Peak Woo Eric Genden Mark Courey Diana N. Kirke |
| author_facet | Annie E. Allisan‐Arrighi Sarah K. Rapoport Benjamin M. Laitman Rohini Bahethi Matthew Mori Peak Woo Eric Genden Mark Courey Diana N. Kirke |
| author_sort | Annie E. Allisan‐Arrighi |
| collection | DOAJ |
| description | Abstract Objectives Respiratory, voice, and swallowing difficulties after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may result secondary to upper airway disease from prolonged intubation or mechanisms related to the virus itself. We examined a cohort who presented with new laryngeal complaints following documented SARS‐CoV‐2 infection. We characterized their voice, airway, and/or swallowing symptoms and reviewed the clinical course of their complaints to understand how the natural history of these symptoms relates to COVID‐19 infections. Methods Retrospective review of patients who presented to our department with upper aerodigestive complaints as sequelae of prior infection with, and management of, SARS‐CoV‐2. Results Eighty‐one patients met the inclusion criteria. Median age was 54.23 years (±17.36). Most common presenting symptoms were dysphonia (n = 58, 71.6%), dysphagia/odynophagia (n = 16, 19.75%), and sore throat (n = 9, 11.11%). Thirty‐one patients (38.27%) presented after intubation. Mean length of intubation was 16.85 days (range 1–35). Eighteen patients underwent tracheostomy and were decannulated after an average of 70.69 days (range 23–160). Patients with history of intubation were significantly more likely than nonintubated patients to be diagnosed with a granuloma (8 vs. 0, respectively, p < .01). Fifty patients (61.73%) were treated for SARS‐CoV‐2 without requiring intubation and were significantly more likely to be diagnosed with muscle tension dysphonia (19 vs. 1, p < .01) and laryngopharyngeal reflux (18 vs. 1, p < .01). Conclusion In patients with persistent dyspnea, dysphonia, or dysphagia after recovering from SARS‐CoV‐2, early otolaryngology consultation should be considered. Accurate diagnosis and prompt management of these common underlying etiologies may improve long‐term patient outcomes. Level of evidence 4 |
| first_indexed | 2024-12-11T23:35:44Z |
| format | Article |
| id | doaj.art-3a524fcb3ae54d3fa787ebc548acfd11 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-11T23:35:44Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-3a524fcb3ae54d3fa787ebc548acfd112022-12-22T00:45:52ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-04-017247648510.1002/lio2.763Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19Annie E. Allisan‐Arrighi0Sarah K. Rapoport1Benjamin M. Laitman2Rohini Bahethi3Matthew Mori4Peak Woo5Eric Genden6Mark Courey7Diana N. Kirke8Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USADepartment of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USAAbstract Objectives Respiratory, voice, and swallowing difficulties after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) may result secondary to upper airway disease from prolonged intubation or mechanisms related to the virus itself. We examined a cohort who presented with new laryngeal complaints following documented SARS‐CoV‐2 infection. We characterized their voice, airway, and/or swallowing symptoms and reviewed the clinical course of their complaints to understand how the natural history of these symptoms relates to COVID‐19 infections. Methods Retrospective review of patients who presented to our department with upper aerodigestive complaints as sequelae of prior infection with, and management of, SARS‐CoV‐2. Results Eighty‐one patients met the inclusion criteria. Median age was 54.23 years (±17.36). Most common presenting symptoms were dysphonia (n = 58, 71.6%), dysphagia/odynophagia (n = 16, 19.75%), and sore throat (n = 9, 11.11%). Thirty‐one patients (38.27%) presented after intubation. Mean length of intubation was 16.85 days (range 1–35). Eighteen patients underwent tracheostomy and were decannulated after an average of 70.69 days (range 23–160). Patients with history of intubation were significantly more likely than nonintubated patients to be diagnosed with a granuloma (8 vs. 0, respectively, p < .01). Fifty patients (61.73%) were treated for SARS‐CoV‐2 without requiring intubation and were significantly more likely to be diagnosed with muscle tension dysphonia (19 vs. 1, p < .01) and laryngopharyngeal reflux (18 vs. 1, p < .01). Conclusion In patients with persistent dyspnea, dysphonia, or dysphagia after recovering from SARS‐CoV‐2, early otolaryngology consultation should be considered. Accurate diagnosis and prompt management of these common underlying etiologies may improve long‐term patient outcomes. Level of evidence 4https://doi.org/10.1002/lio2.763airwayCOVID‐19long haullong termSARS‐CoV‐2swallow |
| spellingShingle | Annie E. Allisan‐Arrighi Sarah K. Rapoport Benjamin M. Laitman Rohini Bahethi Matthew Mori Peak Woo Eric Genden Mark Courey Diana N. Kirke Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19 Laryngoscope Investigative Otolaryngology airway COVID‐19 long haul long term SARS‐CoV‐2 swallow |
| title | Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19 |
| title_full | Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19 |
| title_fullStr | Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19 |
| title_full_unstemmed | Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19 |
| title_short | Long‐term upper aerodigestive sequelae as a result of infection with COVID‐19 |
| title_sort | long term upper aerodigestive sequelae as a result of infection with covid 19 |
| topic | airway COVID‐19 long haul long term SARS‐CoV‐2 swallow |
| url | https://doi.org/10.1002/lio2.763 |
| work_keys_str_mv | AT annieeallisanarrighi longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT sarahkrapoport longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT benjaminmlaitman longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT rohinibahethi longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT matthewmori longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT peakwoo longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT ericgenden longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT markcourey longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 AT dianankirke longtermupperaerodigestivesequelaeasaresultofinfectionwithcovid19 |