Post-COVID-19 paradoxical vocal fold movement disorder

Abstract

A 28-year-old female presented to the laryngology office with a 7-week history of sudden inspiratory noise and dyspnea. The patients suffered from COVID-19 at the end of March; the diagnosis being confirmed through nasopharyngeal swabs and RT-PCR. The COVID-19 related symptoms lasted 7 days and included loss of taste and smell senses, mild dysphonia, headache, and nasal obstruction. Patient did not have cough or fever. The overall clinical picture was mild to moderate and did not require hospitalization. At the exception of the loss of smell, the other symptoms completely resolved in one week. One week after the symptom resolution, she developed sudden inspiratory noise and dyspnea when speaking, both being persistent 7 weeks after the COVID-19 resolution. The disorder was present at rest, at both inspiration and expiration times and increased when patient was speaking for a long time. The patient did not report medical history and she did not practice sport. The general otolaryngological and neurological examinations were normal. Patient had no finding of laryngopharyngeal reflux and the reflux symptom score-12 was 4, making the

Vocal Signs and Symptoms Related to COVID-19 and Risk Factors for their Persistence

“…This study hypothesized that respiratory sequelae and vocal tract symptoms related to COVID-19 might be risk factors for the development of dysphonia. This study indicates that hoarseness was present in 48.89% of the cases during the disease, higher rates than those described in the literature regarding dysphonia, which is 27% 12 . In this study, 26.67% of patients presented with symptoms of hoarseness after the disease.…”

“…Dysphonic patients had a higher occurrence of cough, chest pain, sticky sputum, arthralgia, diarrhea, headache, fatigue, nausea, and vomiting. The severity of dyspnea, dysphagia, ear pain, facial pain, sore throat, and nasal obstruction was higher in the dysphonic group than in the non-dysphonic group 12 .…”

“…This is because the integrity of the respiratory system is fundamental for proper voice production with respect to providing the air pressure necessary for phonation 14 , 15 , 16 , 17 . Moreover, in the new scenario imposed by COVID-19, some laryngeal occurrences have been described, with scarcely known causes, as paradoxical movement of the vocal fold 12 .…”

De Novo Movement Disorders and COVID‐19: Exploring the Interface

“…The selection process carried out according to the Preferred Reporting for Systematic Review and Meta‐Analysis (PRISMA) consensus statement is shown in Figure 1. The published cases are summarized in Table 1 35–56 . Twenty‐two articles were finally selected for the qualitative synthesis.…”

Dysphonia in COVID-19 patients: Direct or indirect symptom?

“…They reported that dysphonia persisted at least 1-month post-hospitalization. The study of dysphonia in COVID-19 patients is important regarding the neurotropism of the virus and the expression of angiotensin converting enzyme 2 (ACE2) in vocal folds [2] , [3] . We congratulate authors for this research.…”