COVID-19 survivorship: How otolaryngologist-head and neck surgeons can restore quality of life after critical illness

Vinciya Pandian; Martin B Brodsky; Emily P Brigham; Ann M Parker; Alexander T Hillel; Joshua M Levy; Christopher H Rassekh; Anil K Lalwani; Dale M Needham; Michael J Brenner

doi:10.1016/j.amjoto.2021.102917

COVID-19 survivorship: How otolaryngologist-head and neck surgeons can restore quality of life after critical illness

Am J Otolaryngol. 2021 May-Jun;42(3):102917. doi: 10.1016/j.amjoto.2021.102917. Epub 2021 Jan 9.

Authors

Affiliations

¹ Department of Nursing Faculty, Johns Hopkins University, Baltimore, MD, United States; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States. Electronic address: vpandia1@jhu.edu.
² Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States; Department of Physical and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States. Electronic address: mbbrodsky@jhmi.edu.
³ Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States. Electronic address: epfeil1@jhmi.edu.
⁴ Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States. Electronic address: aparke36@jhu.edu.
⁵ Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States. Electronic address: ahillel@jhmi.edu.
⁶ Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA, United States. Electronic address: joshua.levy2@emory.edu.
⁷ Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: Christopher.Rassekh@pennmedicine.upenn.edu.
⁸ Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University, NY, New York, United States. Electronic address: akl2144@cumc.columbia.edu.
⁹ Department of Nursing Faculty, Johns Hopkins University, Baltimore, MD, United States; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, MD, United States; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, United States; Department of Physical and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States. Electronic address: dale.needham@jhmi.edu.
¹⁰ Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical Center, Ann Arbor, MI, United States; Global Tracheostomy Collaborative, Raleigh, NC, United States. Electronic address: mbren@med.umich.edu.

Abstract

Mortality from COVID-19 has obscured a subtler crisis - the swelling ranks of COVID-19 survivors. After critical illness, patients often suffer post-intensive care syndrome (PICS), which encompasses physical, cognitive, and/or mental health impairments that are often long-lasting barriers to resuming a meaningful life. Some deficits after COVID-19 critical illness will require otolaryngologic expertise for years after hospital discharge. There are roles for all subspecialties in preventing, diagnosing, or treating sequelae of COVID-19. Otolaryngologist leadership in multidisciplinary efforts ensures coordinated care. Timely tracheostomy, when indicated, may shorten the course of intensive care unit stay and thereby potentially reduce the impairments associated with PICS. Otolaryngologists can provide expertise in olfactory disorders; thrombotic sequelae of hearing loss and vertigo; and laryngotracheal injuries that impair speech, voice, swallowing, communication, and breathing. In the aftermath of severe COVID-19, otolaryngologists are poised to lead efforts in early identification and intervention for impairments affecting patients' quality of life.

Keywords: COVID-19; Critical care; Dizziness; Gustatory; Head and neck cancer; Hearing loss; Iatrogenic injury; Intensive care unit; Laryngotracheal injury, Subglottic stenosis, Tracheal stenosis; Olfactory; Pandemic; Patient safety and quality improvement; Quality of life; SARS-CoV-2, coronavirus; Smell; Speech; Swallowing; Taste; Tracheocutaneous fistula; Tracheostomy; Tracheotomy; Ventilator.

Publication types

Review

MeSH terms

COVID-19 / complications*
Critical Care / methods
Critical Illness / therapy*
Humans
Intensive Care Units
Otolaryngologists*
Otorhinolaryngologic Diseases / etiology*
Otorhinolaryngologic Diseases / therapy*
Quality of Life*
SARS-CoV-2
Survivorship*

Supplementary concepts

postintensive care syndrome

Abstract

Publication types

MeSH terms

Supplementary concepts

Grants and funding