Objectives: We examined prevalence, characteristics, and quality of life assessments of laryngeal dysfunction after recovery from COVID-19 infection.
Methods: 653 patients presenting to Yale’s COVID clinic from April 2020-August 2021 were identified retrospectively. Patients with confirmed COVID-19 >1 year before data extraction and evaluated by fellowship-trained laryngologists were included. Patient demographics, comorbidities, intubation/tracheostomy, strobolaryngoscopy, vocal and pulmonary metrics, and management were collected. Patient-reported outcomes were Dyspnea Index (DI), Cough Severity Index (CSI), Voice Handicap Index-10 (VHI-10), Eating Assessment Tool-10 (EAT-10), and Reflux Symptom Index (RSI).
Results: Of 653 patients, 63 (9.6%) presented to laryngology and 35/63 patients had a COVID-19 diagnosis >1 year ago. Median duration between COVID-19 diagnosis and presentation to laryngology was 214.0 days (IQR:135-366 days). Of 35 patients, 57.1% were hospitalized and 31% were intubated. Stroboscopy revealed laryngeal abnormalities in 76.9% patients, including all intubated patients. 77.1% of patients had dysphonia attributable to neurogenic, structural, muscle tension, or postintubation phonatory insufficiency. 20% presented with laryngeal hypersensitivity syndrome or globus unexplained by laryngopharyngeal reflux. Proportion of patients with abnormal dyspnea and dysphagia scores decreased between initial and follow-up visits: 64.3% vs. 44.4% reported abnormal DI, 74.1% vs. 37.5% abnormal CSI, and 53.6% vs. 22.2% abnormal EAT-10. Abnormal scores on VHI-10 (41.3%) and RSI (63.3%) remained stable.
Conclusions: This is the first known study to comprehensively describe laryngeal effects of COVID-19 beyond post-intubation airway stenosis. Even among non-intubated patients, laryngeal complaints commonly present and persistent for months after recovery