COVID-19-related voice disorders: a scoping review.

Abstract

Purpose: To map the available evidence on voice changes in non-intubated adults diagnosed with mild to moderate COVID-19.

Research strategies: Scoping review conducted according to PRISMA-ScR guidelines, including studies published between 2019 and 2025. Systematic searches were performed in the MEDLINE (PubMed), EMBASE, LILACS, Scopus, Web of Science, and Cochrane Library databases and in grey literature sources (Google Scholar, MedRxiv, and ProQuest). Controlled descriptors and free terms related to COVID-19 and voice disorders were combined using Boolean operators.

Selection criteria: The review included studies with adults (18-65 years) with a confirmed diagnosis of mild to moderate COVID-19 and excluded studies with individuals undergoing endotracheal intubation and with a previous history of voice disorders or respiratory comorbidities. The selection was performed by two independent reviewers.

Data analysis: The data were extracted and analyzed descriptively and quantitatively, considering study characteristics, vocal assessment methods, and main outcomes.

Results: Of the 35,497 records identified, 19 studies met the inclusion criteria. The most frequent voice disorders were dysphonia, hoarseness, reduction in maximum phonation time, and changes in acoustic measures such as jitter, shimmer, and harmonic-to-noise ratio. Associated symptoms included vocal fatigue, cough, dyspnea, and laryngeal discomfort, as well as a negative impact on voice-related quality of life.

Conclusion: Mild to moderate COVID-19 can lead to clinically relevant vocal impairments, reinforcing the need for speech-language-hearing follow-up and research to support vocal assessment and rehabilitation protocols in the post-infection period.