Abstract
Although the most common neuro-otolaryngological findings associated with COVID-19 infection are chemosensory changes, it should be known that these patients may present with different clinical findings. We present a 57-year-old woman who developed progressive hoarseness while suffering from COVID-19 infection without a history of chronic disease or any other etiological cause. Laryngeal fiberscopy revealed left vocal cord fixed at the cadaveric position and there was a 5–6-mm intraglottic gap during phonation. No other etiological causes were found in the examinations performed with detailed ear-nose-throat examination, neurological evaluations, and imaging methods. Injection laryngoplasty was applied to the patient, and voice therapy was initiated, resulting in significant improvement in voice quality. The mechanism of the idiopathic vocal cord paralysis remains unclear; it is suspected to be related to COVID-19 neuropathy, because the patient had no pre-existing vascular risk factors or evidence of other neurologic diseases on neuroimaging. Laryngeal nerve palsies may represent part of the neurologic spectrum of COVID-19. When voice changes occur in patients during COVID 19 infection, the possibility of vocal cord paralysis due to peripheral nerve damage caused by the SARS-CoV-2 should be considered.
Highlights
The coronavirus disease 2019 (COVID-19), the causative agent of which is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared as a pandemic by the World Health Organization (WHO)
The most obvious theory of the neurological effects of the COVID-19 virus is the mechanism of angiotensin-converting enzyme 2 (ACE2), which is identified as a functional receptor of SARS-CoV-2
Studies have shown that the virus enters the central nervous system through the olfactory nerve, another pathway, and can spread from neuron to neuron via axonal transport [5]
Summary
The coronavirus disease 2019 (COVID-19), the causative agent of which is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared as a pandemic by the World Health Organization (WHO). The SARS-CoV-2 virus, the last identified member of the coronavirus family, is a single-stranded RNA virus that is transmitted via droplets [1] It leads to significant morbidity and its mortality rate is estimated to be around 3.4% [2]. The literature review has shown one case report presenting bilateral VCP associated with COVID-19 infection recently [7]. The patient was followed as an outpatient without the need for hospitalization She was admitted to our outpatient clinic since hoarseness continued despite the second COVID-19 test result became negative. Contrast-enhanced cranial MRI and thoracic CT scan were performed to exclude other etiologic causes. Significant improvement was observed in voice quality and acoustic parameters in the postoperative period
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