Persistent Shortness of Breath in Post-COVID-19 Patients: Inducible Laryngeal Obstruction Can Be a Cause

Tamer Abou-Elsaad; Maii Saad; Ahmed M Zayed; Mohamed Farahat; Tamer A Mesallam; Khalid H Malki

doi:10.1016/j.jvoice.2024.01.018

Persistent Shortness of Breath in Post-COVID-19 Patients: Inducible Laryngeal Obstruction Can Be a Cause

J Voice. 2024 Feb 22:S0892-1997(24)00017-1. doi: 10.1016/j.jvoice.2024.01.018. Online ahead of print.

Authors

Tamer Abou-Elsaad¹, Maii Saad¹, Ahmed M Zayed¹, Mohamed Farahat², Tamer A Mesallam², Khalid H Malki³

Affiliations

¹ Unit of Phoniatrics, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
² Research Chair of Voice, Swallowing, and Communication Disorders, Department of Otolaryngology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
³ Research Chair of Voice, Swallowing, and Communication Disorders, Department of Otolaryngology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: kalmalki@ksu.edu.sa.

PMID: 38395655
DOI: 10.1016/j.jvoice.2024.01.018

Abstract

Background: Inducible laryngeal obstruction (ILO) is the adduction of the true vocal folds during inspiration or, less frequently, expiration. Its etiology is unknown.

Purpose: This study aimed to identify ILO as a possible cause of shortness of breath (SOB) in post-COVID-19 patients.

Methods: A retrospective study was conducted on 59 post-COVID-19 adults complaining of SOB. We collected the cases' clinical and chest imaging data, including demographic data, pulmonary function test (PFT), CT chest, and laryngeal endoscopic examination. A visual score was used to assign the severity of the glottic obstruction. The grades of this score ranged from 0 (complete patency) to 3 (almost complete closure).

Results: ILO was detected in 8 out of 59 cases (13.5%). Two cases out of eight had glottic closure grade 1, while five cases had glottic closure grade 2, and one had glottic closure grade 3. There was a positive correlation between ILO grades (the severity of glottic closure) and PFT results (the degree of upper airway restriction). PFTs in ILO have a specific pattern. It was typical for the expiratory loop to be normal and the inspiratory loop to be flattened.

Conclusion: ILO is a possible cause of SOB in post-COVID-19 adult cases. It should be considered during evaluation and management.

Keywords: Induced laryngeal obstruction; Post COVID-19; Shortness of breath.