Laryngeal Complications After Mechanical Ventilation Management with COVID-19

Abstract

During the COVID-19 pandemic, the number of patients requiring ventilatory management increased owing to severe pneumonia, and the number of cases of laryngotracheal stenosis increased accordingly. We herein report three cases of laryngotracheal stenosis after percutaneous tracheostomy, cricoid cartilage necrosis and subglottic granuloma, and posterior vocal fold adhesion and cricoarytenoid joint fixation. The affinity of SARS-CoV-2 for the upper respiratory tract and the anatomy of cricoid cartilage were thought to contribute to the development of these complications. We discuss the mechanism by which the combined effects of long-term intubation, tracheostomy management, direct effects of the virus, and inflammatory response cause laryngotracheal stenosis. The importance of early detection and appropriate therapeutic intervention are emphasized, while the establishment of future countermeasures are also discussed.