Vocal Disorders in Patients with COVID 19 in Egypt

Abstract

COVID-19 is considered a respiratory disease which has many symptoms associated with the larynx and the lungs infections. COVID-19 has wide spectrum of clinical features starting from mild symptoms to severe illness. Otolaryngological symptoms as nasal obstruction, loss of smell, taste dysfunction, sore throat, sticky mucus, and dysphagia are common in COVID-19 patients. Other vocal symptoms as dysphonia and phonesthenia are common in COVID-19 patients. The aim of this study is to detect the occurrence of vocal symptoms in COVID-19 patients in Egypt and to investigate the videolaryngoscopic findings associated with these symptoms. A total number of 106 patients diagnosed with COVID-19 were randomly assessed for vocal symptoms. The following epidemiological and clinical data were collected: age, gender, smoking consumption, general symptoms, otolaryngological and vocal symptoms as dysphonia and phonesthenia. Auditory perceptual assessment of voice and videolaryngoscopic examination were done. The occurrence of dysphonia and phonesthenia were observed in COVID -19 patients. Of the 106 patients, 84 patients (79%) were dysphonic, 20 (18.8%) patients were phonesthenic. The correlation of the different otolaryngological symptoms with dysphonia and phonesthenia were reported. A significant correlation was found between dysphonic patients and rhinorrhea, taste dysfunction, sore throat, and cough. A significant correlation was found between phonesthenic patients and allergic rhinitis. Videolaryngoscopic findings were detected in COVID-19 patients. Vocal fold congestion was found in 42 patients (39.6%), benign vocal fold swellings was found in 18 patients (16.9%), ventricular hypertrophy was found in 6 patients (0.05%), unilateral vocal fold immobility was found in 14 patients (13.2%), and vocal fold congestion associated with ventricular fold hypertrophy was found in 20 patients (18.8%).There was significant correlation of dysphonia and phonesthenia with vocal fold congestion (P value:0.001, P value:0.039 respectively).There was a significant correlation between cough and vocal fold congestion (P value: 0.000). Benign vocal fold swellings were associated with 18 patients (16.9%), but it was not statistically significant (P value: 0.931). Dysphonia and phonesthenia were observed in patients with mild to moderate COVID-19.The vocal symptoms were associated with different laryngoscopic findings, in which, vocal fold congestion was the commonest.

A systematic review and meta-analysis of otorhinolaryngological manifestations of coronavirus disease 2019 in paediatric patients

“…The current report showed fewer than 10 per cent of the studies reporting on the presence or absence of these symptoms. [115][116][117][118][119] The current analysis showed asymptomatic infections in almost a fourth of affected children. Previous reviews reported the proportion of asymptomatic infections as 40-45 per cent, 120 while the pooled prevalence of asymptomatic cases was calculated to be 48 per cent by Syangtan et al using a random effect model.…”

“…The current report showed fewer than 10 per cent of the studies reporting on the presence or absence of these symptoms. 115–119…”

Postacute Laryngeal Injuries and Dysfunctions in COVID-19 Patients: A Scoping Review

“…The present study did not require institutional review board approbation. Eight papers met our inclusion criteria, accounting for 393 patients ( Figure 1 ) [ 8 , 9 , 10 , 11 , 12 , 17 , 18 , 19 ]. Five studies were uncontrolled prospective [ 8 , 10 , 12 , 17 , 19 ] and three publications were retrospective case-series [ 9 , 11 , 18 ].…”

Post-COVID-19 paradoxical vocal cord movement and dysfunctional dysphonia: A clinical case

“…Laryngeal complications of the post- COVID-19 syndrome, are common and have already been described in the literature: unilateral vocal cord paralysis (the most frequent especially after intubation), vocal cord congestion and ventricular hypertrophy , glottic stenosis, subglottic stenosis, subglottic granulation tissue, laryngopharyngeal reflux, muscle tension dysphonia were the most reported abnormalities [ 3 , 4 ]. The occurrence of paradoxical vocal fold movement disorder (PVFMD) after acute COVID-19 is rare, Leriche et al and Aviv et al have described PVFMD in non-hospitalized COVID-19 patients, highlighting it through direct visualization of the vocal cords (by videolaryngostroboscopy or flexible laryngoscopy).…”