A prospective study of voice, swallow, and airway outcomes following tracheostomy for COVID‐19
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Accepted version
Author(s)
Type
Journal Article
Abstract
Objective The COVID‐19 pandemic has led to unprecedented demands on healthcare with many requiring intubation. Tracheostomy insertion has often been delayed and the enduring effects of this on voice, swallow, and airway outcomes in COVID‐19 tracheostomy patients are unknown. The aim of this study was to prospectively assess these outcomes in this patient cohort following hospital discharge. Methods All COVID‐19 patients who had undergone tracheostomy insertion, and were subsequently decannulated, were identified at our institution and followed up 2 months post‐discharge. Patient‐reported (PROMS) and clinician‐reported outcome measures, endoscopic examination, and spirometry were used to assess voice, swallow, and airway outcomes. Results Forty‐one patients were included in the study with a mean age of 56 years and male:female ratio of 28:13. Average duration of endotracheal intubation was 24 days and 63.4% of tracheostomies were performed at day 21 to 35 of intubation. 53.7% had an abnormal GRBAS score and 30% reported abnormal swallow on EAT‐10 questionnaire. 81.1% had normal endoscopic examination of the larynx, however, positive endoscopic findings correlated with the patient self‐reported VHI‐10 (P = .036) and EAT‐10 scores (P = .027). 22.5% had spirometric evidence of fixed upper airway obstruction using the Expiratory‐Disproportion Index (EDI) and Spearman correlation analysis showed a positive trend between abnormal endoscopic findings and EDI scores over 50 (P < .0001). Conclusion The preliminary results of this study reveal a high incidence of laryngeal injury among patients who underwent intubation and tracheostomy insertion during the COVID‐19 pandemic. As these patients continue to be followed up, the evolution of these complications will be studied. Level of Evidence Level 3. Laryngoscope, 2020
Date Issued
2021-06-01
Online Publication Date
2021-12-20T00:01:23Z
Date Acceptance
2020-12-09
ISSN
0023-852X
Publisher
Wiley
Start Page
E1918
End Page
E1925
Journal / Book Title
The Laryngoscope
Volume
131
Issue
6
Copyright Statement
© 2020 Owner. This is the accepted version of the following article: Rouhani, M.J., Clunie, G., Thong, G., Lovell, L., Roe, J., Ashcroft, M., Holroyd, A., Sandhu, G. and Al Yaghchi, C. (2021), A Prospective Study of Voice, Swallow, and Airway Outcomes Following Tracheostomy for COVID‐19. The Laryngoscope. which has been published in final form at https://doi.org/10.1002/lary.29346
Identifier
https://onlinelibrary.wiley.com/doi/10.1002/lary.29346
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, Research & Experimental
Otorhinolaryngology
Research & Experimental Medicine
COVID‐
19
voice
dysphonia
dysphagia
swallow
airway stenosis
RELIABILITY
DYSPHAGIA
VALIDITY
STENOSIS
COVID-19
airway stenosis
dysphagia/swallow
voice/dysphonia
Otorhinolaryngology
1103 Clinical Sciences
Publication Status
Published
Article Number
lary.29346
Date Publish Online
2020-12-28