Covid-19 Tracheostomized patients in a terciary hospital: long-term voice, swallowing and airway outcomes

Authors

  • Mariana Oliveira Centro Hospitalar Lisboa Central, Portugal
  • Tiago Infante Velada Centro Hospitalar Lisboa Central, Portugal
  • Iulia Dorozhko Centro Hospitalar Lisboa Central, Portugal
  • Inês Alpoim Moreira Centro Hospitalar Lisboa Central, Portugal
  • Tiago Chantre Centro Hospitalar Lisboa Central, Portugal
  • Susana Correia Centro Hospitalar Lisboa Central, Portugal
  • Aníbal Eliseu Centro Hospitalar Lisboa Central, Portugal
  • Herédio Sousa Centro Hospitalar Lisboa Central, Portugal

DOI:

https://doi.org/10.34631/sporl.1030

Keywords:

COVID-19, Tracheostomy, Voice, Swallowing, Mechanical ventilation, Complications

Abstract

COVID-19 has led to an increase number of tracheotomized patients requiring prolonged mechanical ventilation, whose consequences on voice, swallowing and high airway are poorly known in these patients. The objective of this project was to study them. The 37 COVID-19 patients, hospitalized in an Intensive Care Unit, who had undergone tracheotomy and were subsequently decannulated, between March 2020 and November 2021, were considered. 14 of these patients were included and submitted to an interview, answering questionnaires. 8 of them underwent to endoscopic examination, too. The mean age was 49 years and the male:female ratio was 11:3. The mean time from intubation to tracheotomy was 24 days and 51 days to decannulation. 29% reported swallowing disorders, 14% voice disorders and 29% symptoms indicative of pharyngolaryngeal reflux. 62% of the endoscopies presented alterations. Preliminary results show a high incidence of laryngeal injury but long-term studies are needed, including in non-tracheotomized COVID-19 patients.

References

- Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX. et al Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032.

- Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648.

- Piazza C, Filauro M, Dikkers FG, Nouraei SAR, Sandu K, Sittel C. et al. Long‑term intubation and high rate of tracheostomy in COVID‑19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society. Eur Arch Otorhinolaryngol. 2021 Jan;278(1):1-7. doi: 10.1007/s00405-020-06112-6.

- Tay JK, Khoo ML, Loh WS. Surgical considerations for tracheostomy during the COVID-19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak. JAMA Otolaryngol Head Neck Surg. 2020 Jun 1;146(6):517-518. doi: 10.1001/jamaoto.2020.0764.

- Freeman BD, Morris PE. Tracheostomy practice in adults with acute respiratory failure. Crit Care Med. 2012 Oct;40(10):2890-6. doi: 10.1097/CCM.0b013e31825bc948.

- Siempos II, Ntaidou TK, Filippidis FT, Choi AMK. Efect of early versus late or no tracheostomy on mortality and pneumonia of critically ill patients receiving mechanical ventilation: a systematic review and meta-analysis. Lancet Respir Med. 2015 Feb;3(2):150-158. doi: 10.1016/S2213-2600(15)00007-7.

- Rouhani MJ, Clunie G, Thong G, Lovell L, Roe J, Ashcroft M. et al. A prospective study of voice, swallow, and airway outcomes following tracheostomy for COVID-19. Laryngoscope. 2021 Jun;131(6):E1918-E1925. doi: 10.1002/lary.29346.

- COVIDTrach collaborative. COVIDTrach; the outcomes of mechanically ventilated COVID-19 patients undergoing tracheostomy in the UK: Interim Report. Br J Surg. 2020 Nov;107(12):e583-e584. doi: 10.1002/bjs.12020.

- Piazza C, Filauro M, Dikkers FG, Nouraei SAR, Sandu K, Sittel C. et al. Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European laryngological society. Eur Arch Otorhinolaryngol. 2021 Jan;278(1):1-7. doi: 10.1007/s00405-020-06112-6.

- Brodsky MB, Levy MJ, Jedlanek E, Pandian V, Blackford B, Price C. et al. Laryngeal injury and upper airway symptoms after oral endotracheal intubation with mechanical ventilation during critical care: a systematic review. Crit Care Med. 2018 Dec;46(12):2010-2017. doi: 10.1097/CCM.0000000000003368.

- Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and validation of the voice handicap Index-10. Laryngoscope. 2004 Sep;114(9):1549-56. doi: 10.1097/00005537-200409000-00009.

- Azevedo SR, Santos M, Sousa F, Freitas S, Coutinho MB, Sousa CAE. et al. Validation of the portuguese version of the voice handicap Index-10. J Voice. 2020 Nov 20;S0892-1997(20)30410-0. doi: 10.1016/j.jvoice.2020.10.019.

- Belafsky PC, Postma GN, Koufman JA. Validity and reliability of the reflux symptom index (RSI). J Voice. 2002 Jun;16(2):274-7. doi: 10.1016/s0892-1997(02)00097-8.

- Almeida AG, Saliture TB, da Silva AS, Eckley CA. Translation and cultural adaptation of the reflux finding score into brazilian portuguese. Braz J Otorhinolaryngol. Jan-Feb 2013;79(1):47-53. doi: 10.5935/1808-8694.20130009.

- Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J. et al. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008 Dec;117(12):919-24. doi: 10.1177/000348940811701210.

- Queirós A, Moreira S, Silva A, Costa R, Lains J. Contributo para a adaptação e validação da eat assessment tool (EAT-10) e da functional oral intake scale (FOIS). Revista da Sociedade Portuguesa de Medicina Física e de Reabilitação [Internet] 2013; 24(2):25-30. Available from: http://dx.doi.org/10.25759/spmfr.108.

- Crary MA, Mann GD, Groher ME. Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients. Arch Phys Med Rehabil. 2005 Aug;86(8):1516-20. doi: 10.1016/j.apmr.2004.11.049.

- Patterson JM, Hildreth A, McColl E, Carding PN, Hamilton D, Wilson JA. The clinical application of the 100 mL water swallow test in head and neck cancer. Oral Oncol. 2011 Mar;47(3):180-4. doi: 10.1016/j.oraloncology.2010.11.020

- Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA. 2020 Aug 11;324(6):603-605. doi: 10.1001/jama.2020.12603.

- Jiang G, Cai Y, Yi X, Li Y, Lin Y, Li Q. et al. The impact of laryngopharyngeal reflux disease on 95 hospitalized patients with COVID-19 in Wuhan, China: a retrospective study. Med Virol. 2020 Oct;92(10):2124-2129. doi: 10.1002/jmv.25998.

- Lorenz RR. Adult laryngotracheal stenosis: etiology and surgical management. Curr Opin Otolaryngol Head Neck Surg. 2003 Dec;11(6):467-72. doi: 10.1097/00020840-200312000-00011.

- Pedersen A, Wilson J, McColl E, Carding P, Patterson J. Swallowing outcome measures in head and neck cancer - how do they compare? Oral Oncol. 2016 Jan;52:104-8. doi: 10.1016/j.oraloncology.2015.10.015.

- Wu MC, Chang YC, Wang TG, Lin LC. Evaluating swallowing dysfunction using a 100-ml water swallowing test. Dysphagia. 2004 Winter;19(1):43-7. doi: 10.1007/s00455-003-0030-x.

Published

2022-12-18

How to Cite

Oliveira, M., Infante Velada, T., Dorozhko, I., Alpoim Moreira, I., Chantre, T., Correia, S., Eliseu, A., & Sousa, H. (2022). Covid-19 Tracheostomized patients in a terciary hospital: long-term voice, swallowing and airway outcomes. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 60(4), 307–311. https://doi.org/10.34631/sporl.1030

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Section

Original Article