Laryngeal neuropathy after SARS-CoV-2 infection: case series

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is the cause of the pandemic declared since March 2020. The neurotropic effect of the virus has been demonstrated in experimental studies and case reports; however, few case reports are presented regarding laryngeal neuropathy. Objective: Describe the frequency of laryngeal neuropathy, paralysis, or paresis of one or both vocal folds, in patients who have had SARS-CoV-2 infection treated in the Otorhinolaryngology-Laryngology Service in Hospital Militar Central. Methods: An observational, descriptive, case series study, was developed in patients with laryngeal neuropathy after SARS-CoV-2 infection who met the inclusion criteria and were managed by the Otorhinolaryngology-Laryngology Service since the start of the pandemic in March 2020. Data collection was carried out from the review of medical records of patients with impaired mobility of the vocal folds after infection. The clinical and endoscopic variables found in these patients are characterized and described. Results: 20 patients with findings of laryngeal neuropathy after SARS-CoV-2 infection were presented with an average age of 53.9 ± 17.7 years and 55% being male. The appearance of paralysis or paresis of the vocal folds occurred in 80% of the patients requiring orotracheal intubation during the infection, most of the involvement being by bilateral paralysis of the vocal folds followed by unilateral paralysis. Conclusions: SARS-CoV-2 infection generates a series of laryngeal affections, among which neuropathy stands out. Although the pathophysiological mechanisms are not fully explained, various reports in the literature describe the involvement of various cranial nerves and the neutropic role of the virus.