Laryngotracheal Complications after Intubation for COVID-19: A Multicenter Study

Area of Science:

• Otolaryngology
• Pulmonology
• Infectious Diseases

Background:

• COVID-19 frequently causes respiratory distress requiring prolonged mechanical ventilation.
• Endotracheal intubation (ETI) can lead to laryngotracheal complications affecting vital functions.
• Laryngeal sequelae post-ETI in COVID-19 patients require further investigation.

Purpose of the Study:

• To describe laryngeal injuries diagnosed after endotracheal intubation (ETI) in COVID-19 patients.
• To analyze the incidence and types of laryngeal complications in a multicenter study.
• To identify risk factors associated with post-ETI laryngeal injuries.

Main Methods:

• Prospective descriptive observational study (January 2021 - December 2021).
• Inclusion of COVID-19 patients with laryngeal complications from ETI across multiple Spanish hospitals.
• Analysis of epidemiological data, comorbidities, intubation/ventilation times, tracheostomy rates, and lesion types.

Main Results:

• 49 patients were included; 44.9% underwent tracheostomy, often delayed.
• Mean ETI duration was 17.63 days.
• Common symptoms included dysphonia (87.8%), dysphagia (42.9%), and dyspnea (34.7%).
• Altered laryngeal mobility (79.6%) was the most frequent injury.
• Stenosis correlated with late ETI and delayed tracheostomy.

Conclusions:

• Prolonged ETI in COVID-19 patients, potentially due to pronation protocols, is linked to increased laryngeal sequelae.
• Altered laryngeal mobility and stenosis are significant post-ETI complications.
• Findings underscore the impact of ETI duration on laryngeal health post-COVID-19.