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Endoscopic Management of Benign Airway Stenosis in Coronavirus Disease 2019 Patients

Alfonso Fiorelli1, Alfonso Pecoraro2, Giuseppe Failla2

  • 1Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy.

The Thoracic and Cardiovascular Surgeon
|April 18, 2023
PubMed

Insights

Endoscopic dilation is effective for benign airway stenosis following coronavirus disease 2019 (COVID-19). COVID-19 infection did not increase stenosis recurrence rates, indicating similar treatment outcomes compared to the general population.

Area of Science:

  • Pulmonology
  • Gastroenterology
  • Critical Care Medicine

Background:

  • Benign airway stenosis can occur after coronavirus disease 2019 (COVID-19) infection, often due to prolonged intubation.
  • Evaluating endoscopic dilation outcomes in these patients is crucial for understanding treatment efficacy.
  • Comparing recurrence rates in COVID-19 patients versus a control group helps determine infection-related risk.

Purpose of the Study:

  • To assess the effectiveness of endoscopic dilation for simple benign airway stenosis in COVID-19 patients.
  • To determine if COVID-19 infection is associated with a higher rate of stenosis recurrence.
  • To identify risk factors for airway stenosis recurrence after endoscopic treatment.

Main Methods:

  • An observational, multicenter study included patients with simple benign airway stenosis undergoing endoscopic dilation.
  • Follow-up was at least 6 months, comparing outcomes between COVID-19 positive and control groups.
  • Univariable and multivariable analyses identified risk factors for recurrence.

Main Results:

  • Airway stenosis developed in 71% of patients after COVID-19, frequently linked to prolonged intubation (82%).
  • Recurrence rates after the first dilation were similar between COVID-19 (26%) and non-COVID-19 (32%) groups (p=0.70).
  • Subglottic stenosis and laser use were significant predictors of recurrence (p<0.05).

Conclusions:

  • COVID-19 infection does not negatively impact the outcomes of endoscopic treatment for simple airway stenosis.
  • Treatment strategies for airway stenosis in COVID-19 patients should align with those for the general population.
  • Endoscopic dilation remains a viable treatment option for benign airway stenosis, irrespective of prior COVID-19 status.
Abstract

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