Epidemiological, clinical and laryngological outcomes and
treatments
The following epidemiological and clinical data were collected:
demographic information; age; gender; comorbidities; dates/features of
documented COVID-19 infection, hospital stay; intubation and
tracheostomy; general, voice, swallowing and airway complaints; medical
and surgical required treatment and follow-up. The decision of
percutaneous tracheostomy was made by intensive care physicians in case
of prolonged intubation (>14 days).
The laryngological examination was performed by a senior laryngologist
(SH, MC, LCB or JRL) with a videolaryngostroboscopy (XION GmbH, Berlin,
Germany). The conclusion of the videolaryngostroboscopy examination was
reviewed by a second senior laryngologist in a blind manner according to
the initial conclusion. The following laryngeal disorders were
considered in the diagnosis: laryngopharyngeal reflux (LPR), laryngeal
diffuse edema, posterior commissure hypertrophy, laryngeal necrosis,
granuloma, posterior glottic stenosis, subglottic stenosis, and
posterior glottic diastasis. The Bogdasarian-Olson classification for
stenosis of the posterior glottic membrane,8 and the
McCaffrey staging system9 for subglottic and tracheal
strictures were used to characterize laryngeal lesions. Patients with a
suspicion of LPR and lack of response to medical therapy combining diet,
proton pump inhibitors and alginates, benefited from a 24-hour
hypopharyngeal-esophageal multichannel intraluminal impedance-pH
monitoring (HEMII-pH). According to the laryngeal disorders, the
following medical treatments included antibiotics, corticosteroids,
proton pump inhibitors (PPIs) and alginate. Patients with no improvement
of lesion with medical treatment benefited from surgical treatments,
i.e. CO2 laser posterior transverse cordotomy, placement
of Montgomery-type laryngeal calibration tube, laser flange (scare), or
vocal fold fat injection.