Larynx Injuries After Orotracheal Intubation: What are Risk Factors Observed in Patients with Covid?

IF 1.1 Q3 OTORHINOLARYNGOLOGY

International Archives of Otorhinolaryngology Pub Date : 2026-03-03 eCollection Date: 2026-01-01 DOI:10.1055/s-0045-1812320

Leticia Felix, Gabriel de Souza Mares, Lara Freire Bezerril Soares, Romualdo Suzano Louzeiro Tiago, Sergio Roberto Nacif

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Abstract

Objective: To evaluate the risk factors for the development of laryngotracheal injuries in patients with coronavirus disease 2019 (COVID-19) undergoing orotracheal intubation (OTI).

Methods: A cohort study was performed with intubated patients diagnosed with COVID-19, hospitalized from March 1st to October 31st, 2020. They were called for outpatient follow-up after being discharged from the hospital.

Results: There were 421 patients with COVID-19 (31%) who required OTI, of which the outcome was: hospital discharge for 172 (40.9%) and death for 249 (59.1%). Outpatient videoendoscopy was performed in 95 patients (55.2%).

Conclusion: We observed a greater risk for the development of laryngotracheal injury in patients who presented an increase in leukocyte count at hospital admission with lymphopenia, hypoalbuminemia, increased arterial lactate, troponin, and total bilirubin, as well as endotracheal tube with larger caliber and pronation. Furthermore, patients who at the time of OTI showed greater inflammatory reactivity or developed coagulation disorders were also at greater risk.

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经气管插管后喉损伤：新冠肺炎患者观察到哪些危险因素？

目的：探讨冠状病毒病2019 （COVID-19）患者经口气管插管（OTI）后发生喉气管损伤的危险因素。方法：对2020年3月1日至10月31日住院的新型冠状病毒肺炎插管患者进行队列研究。他们出院后被要求进行门诊随访。结果：421例COVID-19患者（31%）接受了OTI治疗，其中172例（40.9%）出院，249例（59.1%）死亡。门诊内镜检查95例（55.2%）。结论：我们观察到，在住院时出现白细胞计数增加并伴有淋巴细胞减少、低白蛋白血症、动脉乳酸、肌钙蛋白和总胆红素升高以及气管内管口径和旋前变大的患者发生喉气管损伤的风险更大。此外，在OTI时表现出更大的炎症反应性或发生凝血功能障碍的患者也有更大的风险。

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