Consequences of Intubation in COVID-19 Patients: Are We Ready?

Ab s t r Ac t Aim and objective: We report a case of a 61-year-old man, still recovering from COVID-19, who developed acute respiratory distress syndrome (ARDS) requiring hospitalization and intubation in early March 2020. Consequently, he developed post-intubation bilateral massive vocal fold granulomas. To date, this is the first case report of laryngeal granulomas following intubation since the outbreak. Background: Clinical presentation of COVID-19 ranges from being asymptomatic to mild symptoms while a fraction of them develop ARDS. There is a need to highlight the probability of a rise in the number of patients with complaints of voice change and laryngeal lesions in the coming months. More specifically, post-intubation laryngeal granulomas. Case description: The patient timeline, blood exams, serological tests, radiological examination, voice evaluation, and videolaryngoscopy of a 61-year-old recovered COVID-19 patient with bilateral vocal fold granulomas have been described in detail that would assist in clinical decision-making. Conclusion: A significant number of patients underwent intubation at the beginning of the pandemic. These patients can be expected to be frequent visitors at the outpatient clinic and emergency rooms in the future with complaints of change in voice and laryngeal lesions. The question of whether we are ready for it needs to be assessed. Clinical significance: Patients who underwent long-term intubation following ARDS after contracting COVID-19 infection need to be further evaluated and kept on a regular follow-up. Conclusion: Information regarding intubation granuloma risk, breathing exercises, and speech therapy might be beneficial to such patients. We need to be well prepared to expect a surge in the number of cases reporting with voice disorders shortly.