Incidence and types of laryngotracheal sequelae of prolonged invasive ventilation in COVID-19 patients

Eur Arch Otorhinolaryngol. 2022 Dec;279(12):5755-5760. doi: 10.1007/s00405-022-07467-8. Epub 2022 Jun 4.

Abstract

Purpose: The COVID-19 outbreak has led to an increasing number of acute laryngotracheal complications in patients subjected to prolonged mechanical ventilation, but their incidence in the short and mid-term after ICU discharge is still unknown. The main objective of this study is to evaluate the incidence of these complications in a COVID-19 group of patients and to compare these aspects with non-COVID-19 matched controls.

Methods: In this cohort study, we retrospectively selected patients from November 1 to December 31, 2020, according to specific inclusion and exclusion criteria. The follow-up visits were planned after 6 months from discharge. All patients were subjected to an endoscopic evaluation and completed two questionnaires (VHI-10 score and MDADI score).

Results: Thirteen men and three women were enrolled in the COVID-19 group while nine men and seven women were included in the control group. The median age was 60 [56-66] years in the COVID-19 group and 64 [58-69] years in the control group. All the patients of the control group showed no laryngotracheal lesions, while five COVID-19 patients had different types of lesions, two located in the vocal folds and three in the trachea. No difference was identified between the two groups regarding the VHI-10 score, while the control group showed a significantly worse MDADI score.

Conclusions: COVID-19 patients subjected to prolonged invasive ventilation are more likely to develop a laryngotracheal complication in the short and medium term. A rigorous clinical follow-up to allow early identification and management of these complications should be set up after discharge.

Keywords: COVID-19; Intensive care unit; Laryngotracheal lesions; SARS-CoV-2; Tracheal stenosis.

MeSH terms

  • COVID-19* / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Noninvasive Ventilation*
  • Respiration, Artificial / adverse effects
  • Retrospective Studies
  • SARS-CoV-2