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Post-intubation Laryngeal Disorders in COVID-19 Patients: A Prospective Study.
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  • Stéphane Hans,
  • Marta Circiu,
  • Lise Crevier-Buchman,
  • Djillali Annane,
  • Nicholas Heming,
  • Jerome Lechien
Stéphane Hans
Hopital Foch
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Marta Circiu
Hospital Foch
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Lise Crevier-Buchman
Hôpital Foch
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Djillali Annane
APHP
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Nicholas Heming
APHP
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Jerome Lechien
Universite de Mons

Corresponding Author:jerome.lechien@umons.ac.be

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Abstract

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 glottic stenosis.
15 Dec 2022Submitted to Clinical Otolaryngology
20 Dec 2022Submission Checks Completed
20 Dec 2022Assigned to Editor
24 Dec 20221st Revision Received
04 Jan 2023Submission Checks Completed
04 Jan 2023Assigned to Editor
11 Jan 2023Reviewer(s) Assigned
18 Jan 2023Review(s) Completed, Editorial Evaluation Pending
05 Mar 2023Editorial Decision: Revise Major
08 Mar 20232nd Revision Received
09 Mar 2023Submission Checks Completed
09 Mar 2023Assigned to Editor
27 Mar 2023Reviewer(s) Assigned
05 Apr 2023Review(s) Completed, Editorial Evaluation Pending
21 May 2023Editorial Decision: Accept