Post-intubation Laryngeal Disorders in COVID-19 Patients: A Prospective
Objective: To investigate post-intubation laryngeal complications in
severe COVID-19 patients. Methods: From September 2020 to April 2021,
consecutive patients presenting with laryngological symptoms following
severe COVID-19 infection and related intubation were included.
Demographic, age, gender, comorbidities, symptoms, intubation duration,
tracheostomy features, and laryngeal findings were collected.
Videolaryngostroboscopy findings were analyzed by two senior
laryngologists in a blind manner. Results: Forty-three patients
completed the evaluations. The intubation duration was <14
days in 22 patients (group 1) and >14 days in 21 patients
(group 2). The following abnormalities were found on an average
post-intubation time of 51.6 days: posterior glottic stenosis (N=14),
posterior commissure hypertrophy (N=19) or laryngeal diffuse edema
(N=10), granuloma (N=8), laryngeal necrosis (N=2), vocal fold atrophy
(N=2), subglottic stenosis (N=1) and glottic flange (N=1). Sixteen
patients required surgical treatment (N=17 procedures). The number of
intubation days was significantly higher in patients with posterior
glottic stenosis (26.1 ± 9.4) compared with those presenting posterior
commissure hypertrophy (11.5 ± 2.9) or granuloma (15.1 ± 5.8;
p<0.001). Fourteen patients required surgical management.
Conclusion: Prolonged intubation used in severe COVID-19 patients is
associated with significant laryngeal disorders. Patients with a history
of >2-week intubation have a higher risk of posterior