Tracheal complications of mechanical ventilation for COVID-19: a plot twist for survivors

Abstract

Severe COVID19 patients require mechanical ventilation (MV) in up to 15.2% of cases [1]. Postintubation (PITS), post-tracheostomy (PTTS) tracheal stenosis and tracheoesophageal (TE) fistulas are tracheal complications of MV. The incidence of tracheal complications of MV was 1 in 200 000 patients annually before the COVID19 pandemic [2]. The most important risk factors for these complications include prolonged MV, reintubation and excessive tracheal tube cuff pressure (>30 cm H2O), all of which were common in mechanically ventilated COVID19 patients [3, 4]. We experienced a significant increase in referrals to our interventional pulmonology (IP) unit at a tertiary teaching hospital for PITS and PTTS treatment after the most severe COVID19 surges and thus conducted this retrospective study with prospective follow up aiming to describe this unique cohort of patients.