Endoscopic Management of Benign Airway Stenosis in Coronavirus Disease 2019 Patients

Alfonso Fiorelli; Alfonso Pecoraro; Giuseppe Failla; Francesco De Blasio; Erino Angelo Rendina; Federico Venuta; Claudio Andreetti

doi:10.1055/a-2075-8109

Endoscopic Management of Benign Airway Stenosis in Coronavirus Disease 2019 Patients

Thorac Cardiovasc Surg. 2023 Jul 15. doi: 10.1055/a-2075-8109. Online ahead of print.

Authors

Alfonso Fiorelli¹, Alfonso Pecoraro², Giuseppe Failla², Francesco De Blasio³, Erino Angelo Rendina⁴, Federico Venuta⁴, Claudio Andreetti⁴

Affiliations

¹ Thoracic Surgery Unit, Università della Campania "Luigi Vanvitelli", Naples, Italy.
² Bronchoscopy Unit, Ospedale Cardarelli, Napoli, Campania, Italy.
³ Respiratory Medicine and Pulmonary Rehabilitation Unit, Clinic Center, Naples, Italy.
⁴ Thoracic Surgery Unit, Università degli Studi di Roma La Sapienza, Rome, Lazio, Italy.

PMID: 37072114
DOI: 10.1055/a-2075-8109

Abstract

Background: The aims of this study were to evaluate the results of endoscopic dilation for simple benign airway stenosis in coronavirus disease 2019 (COVID-19) patients and whether COVID-19 infection was associated with higher rate of recurrence compared with a control group.

Methods: It was an observational multicenter study including consecutive patients with simple benign airway stenosis undergoing endoscopic dilatation with at least 6 months of follow-up. The outcome of patients with COVID-19 infection was compared with that of a control group in relation to patient and stenosis characteristics, and procedure type. Then, univariable and multivariable analyses identified the risk factors for recurrence.

Results: Seventy-nine patients were included in the study; 56 (71%) of these developed airway stenosis after COVID-19 infection. COVID-19 patients presented a higher rate of stenosis due to prolonged intubation (82 vs. 43%; p = 0.0014); no other differences were found regarding demographic data, characteristics of stenosis, and procedure type. Twenty-four (30%) patients had recurrence after first dilatation (32% for No-COVID-19 vs. 26% for COVID-19 group; p = 0.70), and in 11 (35%) of these, the stenosis recurred after repeated endoscopic treatment (65% for No-COVID-19 vs. 45% for COVID-19 group; p = 0.40). Subglottic stenosis (p = 0.013) and the use of laser (p = 0.016) were significant predictive factors for stenosis recurrence.

Conclusion: COVID-19 infection did not affect the outcome of endoscopic treatment of simple airway stenosis, and the treatment of these subsets of patients should not differ from that of general population.