COVID-19オミクロン株による急性喉頭炎の2例

抄録

Ever since the onset of the COVID-19 pandemic in December 2019, several variants of the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) have arisen. Although the alpha, beta, and delta variants mainly caused lower respiratory syndromes, the omicron variant caused upper airway symptoms like fever, sore throat, and odynophagia. After the omicron variant began to spread, it was reported that diffuse necrotic erosive lesions in acute laryngitis could be an indicator of infection with this variant. We report two cases of acute laryngitis caused by COVID-19.

One patient was a 40-year-old woman who presented with odynophagia and difficulty in swallowing. Flexible fiberoptic laryngoscopy revealed erosions and necrotic lesions on the posterior surface of the epiglottis and bilateral arytenoids. The patient was diagnosed as having COVID-19 using an antigen test. She was hospitalized and given intravenous fluids and analgesics. On the third hospital day, she began to eat and was discharged from the hospital.

The other patient was an 80-year-old man who presented with fever, odynophagia, and difficulty in swallowing. Flexible fiberoptic laryngoscopy revealed diffuse erosions along with edematous necrotic lesions on the posterior surface of the epiglottis, subglottis, and bilateral arytenoids. Saliva retention was observed at the hypopharynx. After COVID-19 was diagnosed based on an antigen test, the patient was hospitalized and treated with remdesivir, dexamethasone, and intravenous fluids. He began to eat on the third day and was discharged from the hospital on the fifth day. We diagnosed both cases of laryngitis as being due to the omicron variant based on the laryngeal findings and the status of the epidemic at that time.

Laryngitis caused by the omicron variant should be suspected from the characteristic laryngoscopic findings. We should collect information about the current status of the epidemic to suppress the spread of damage caused by the pandemic.