Laryngotracheal Stenoses Post-Acute Respiratory Distress Syndrome due to COVID-19: Clinical Presentation, Histopathological Findings and Management. A Series of 12 Cases

Luis Fernando Tintinago; William Victoria; Juliana Escobar Stein; Luis Fernando Gonzales; Maria Isabel Fernandez; Estephania Candelo

doi:10.1007/s12070-022-03076-3

Laryngotracheal Stenoses Post-Acute Respiratory Distress Syndrome due to COVID-19: Clinical Presentation, Histopathological Findings and Management. A Series of 12 Cases

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):3262-3267. doi: 10.1007/s12070-022-03076-3. Epub 2022 Apr 6.

Authors

Luis Fernando Tintinago¹, William Victoria¹, Juliana Escobar Stein², Luis Fernando Gonzales³, Maria Isabel Fernandez¹, Estephania Candelo^{1

4}

Affiliations

¹ Head and Neck and Airway Surgery Department, Fundacion Valle del Lili, Cali, Colombia.
² Pathology Department, Fundacion Valle del Lili, Cali, Colombia.
³ Anesthesiology Department, Fundacion Valle del Lili, Cali, Colombia.
⁴ Clinical Research Center, Fundacion Valle del Lili, Cali, Colombia.

Abstract

Coronavirus disease 2019 (COVID-19) has increased the risk of developing severe acute respiratory distress syndrome and subsequent moderate to severe laryngotracheal stenoses (LSTs) with an early presentation that occurs between two and three months after SARS-CoV-2 infection. We present a series of 12 cases of LST following SARS-CoV-2 infection. Dense lymphocyte infiltration with multinuclear giant cell granulomas was found on biopsy with intranuclear inclusions, suggestive of viral cytopathic effects in one case and intravascular fibrin thrombi with perivascular mononuclear infiltrate of CD3 + T lymphocytes. We present the largest and only series that describes clinical and histopathological characteristics of LTS and the management and outcomes after early laryngotracheal reconstruction in the context of the SARS-CoV-2 outbreak.

Keywords: COVID-19; Histopathology; Laryngotracheal stenosis; SARS-CoV-2; Subglottic tracheal stenosis.