ABSTRACT
PURPOSE: The purpose of this study is to compare patient-reported voice handicap and auditory-perceptual measures of voice between healthy individuals and COVID-19 patients, as well as to investigate the effect of clinical factors on voice quality. METHODS: COVID-19 patients (n = 138) and 90 healthy controls were included in the study. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) was used to grade voice samples based on overall severity, roughness, breathiness, strain, pitch, and loudness. The Voice Handicap Index-10 was completed by all participants (VHI-10). Physical (pVHI), emotional (eVHI) and functional (fVHI) subscores were calculated. Clinical data were collected (disease stage, CT grade, neutrophil/lymphocyte ratio, CRP, and symptoms). RESULTS: A statistically significant difference between patient and control groups in VHI-10 and CAPE-V scores was detected (p < 0.001). Except eVHI, total score and all subscale scores were higher in patients with COVID-19 as the pVHI was the most affected (η2 = 0.324) subscale. All scores of CAPE-V were significantly worse in patients with COVID-19 as highest impact of COVID-19 was on breathiness (η2 = 0.518). Pre-existing pulmonary comorbidity, dyspnoea and N/L was significantly associated with the VHI-10 overall score (ßpc = 4.27, ßdyspnoea = 5.69 and ßnl = 0.25). The overall severity of CAPE-V was significantly dependent on dyspnoea and pulmonary comorbidity (ßdyspnoea = 11.25, ßpc = 10.12). VHI ≥4 and CAPE-V overall severity ≥11 were good indicators of COVID-19 related dysphonia. CONCLUSIONS: COVID-19 causes patient-reported voice handicap and deteriorates auditory-perceptual measures of voice. COVID-19 related voice impairment was mainly associated with the decreased respiratory capacity.
ABSTRACT
Voice abnormalities were reported in patients during the course of COVID-19 infection. This study aims to evaluate the effect of COVID 19 infection on the self-perception of voice handicap in positive COVID 19 patients in addition to investigating the factors that might correlate with voice handicap if present. Voice handicap index-10 was filled in by 200 patients that were confirmed to be COVID 19 positive based on the RT-qPCR and symptomatology of the disease. The result showed that about 65.5% had mild degree of COVID 19 and 27.5% had moderate degree. Dysphonia was reported by 19% of the patients when questioned about voice symptoms. Dysphonia was detected in 35% of them by auditory perceptual assessment. Symptoms of Dyspnea, dysphonia, headache were significantly correlated with total and subtotal scores of Voice handicap index. COVID 19 infection has a negative impact on some of the patients? self- perception of voice handicap on the functional, physical and emotional domains. Age and degree of COVID 19 severity were correlating with the patients? self -perception of voice handicap.
ABSTRACT
INTRODUCTION: COVID-19 has various long-lasting effects on different aspects of health and life. This study aimed to evaluate the general health and voice-related quality of life (QOL) and assess their correlation in patients with COVID-19 compared to healthy people. STUDY DESIGN: This was a cross-sectional study. METHODS: Sixty-eight subjects (with a mean age of 40.07 ± 5.62 years) participated in two groups including 34 recovered-COVID-19 patients and 34 healthy subjects. All participants completed the Persian version of Short Form 36 (SF-36) and Voice Handicap Index (VHI). The patients were assessed two months after recovery when they were discharged from the hospital. RESULTS: The results showed the COVID-19 patients got significantly lower scores in all subcategories and two main components of SF-36 compared to the healthy group (P < 0.005). Also, the patients held significantly higher results in VHI and its subscales (P < 0.005). A significant correlation was observed between the physical and mental component summary (PCS and MCS) of SF-36 with a total score of VHI in the COVID-19 patients. CONCLUSION: COVID-19 has negative consequences on various aspects of general health and voice-related QOL. Two months after recovery from COVID-19, the patients had the worst scores in all subscales of SF-36 and also, decreased physical, emotional, and functional voice-related QOL which reveals the persistent effect of COVID-19 even after recovery. The general health and voice-related QOL had a noticeable correlation in recovered COVID-19 patients that demonstrates the effect of voice quality in different aspects of life.
ABSTRACT
Objectives: The aim of this study was to explore the prevalence and risk factors in public kindergarten and elementary school teachers in the Jimei district in Xiamen. We took particular interest in the relationship between work-related factors and voice disorders. Study Design: A cross-sectional investigation; a General Investigation. Methods: This study was conducted from September 14 to 18, 2020 at public kindergarten and elementary schools in Xiamen, China. A total of 3140 teachers were separated into a perceived voice disorder group (PVD) and no perceived voice disorder group (NPVD) according to the Voice Handicap Index. The chi-square test was applied to explore the differences between the PVD and NPVD groups. The univariate logistic regression models were used to identify the risk factors in terms of unadjusted odds ratio and 95% confidence interval. Stepwise logistic regression was then used to ascertain independent determinants. Results: We found that the prevalence of PVD was 47.52%. The results showed that risk factors of PVD included being female (OR = 1.574), middle-rank technical title and higher (OR = 2.199), continuous lecturing for more than 3 classes (OR = 3.034), lectured more than 10 classes a week (OR = 1.436) and taught art or physical education (OR = 1.742). Conclusions: Teachers' work-related characteristics were associated with PVD. This proves that a preventive voice care program for teachers, administered by the school or education bureau, is urgent. This could include components such as the reasonable arrangement of timetables and recruitment of a sufficient number of kindergarten and elementary school teachers.Level of evidence: Case-series.
ABSTRACT
OBJECTIVE: To evaluate the impact of face masks on voice in a sub-population of healthcare workers, namely residents, medical students, and nurses, during the COVID-19 era. MATERIALS AND METHODS: A cross-sectional study was conducted in a large tertiary care center where a 23-items web-based questionnaire was conveyed to sub-population of healthcare professionals, namely residents, medical students, and nurses. The questionnaire included demographic data, type, and duration of mask use. Voice outcome measures included the Voice Handicap Index (VHI)-10 questionnaire and the visual analogue scale for vocal effort and vocal fatigue. RESULTS: A total of 178 participants answered the survey. One third had an abnormal score on the VHI-10 questionnaire, one third reported moderate to severe vocal fatigue, and 45% of the participants had moderate to severe vocal effort based on a visual analogue scale score. There was a significant association between the type of mask used and vocal fatigue (P = 0.044). No significant association was seen between the duration of mask used and the different voice outcome measures. CONCLUSION: Masking habits during the COVID-19 pandemic were associated with a high prevalence of vocal fatigue, effort and abnormal VHI-10 score among residents, medical students, and nurses.
ABSTRACT
This study investigates self-perceptions of voice-related handicap as a function of facemask use in the general working population during the COVID19 outbreak, using the Voice Handicap Index (VHI). Each VHI item was answered twice in a row; the first answer referred to the condition of not wearing a facemask (henceforth, the Without condition) and the second to the condition of using a facemask (henceforth, the With condition). VHI scores were collected via Google Forms (Google, Mountain View, California), targeting 2 groups of speakers of different nationalities, Portuguese (n = 261) and Spanish (n = 297). A Wilcoxon test was carried out to compare VHI scores between With and Without conditions for each group of speakers; a Mann-Whitney U test was used to compare groups within each condition. Results suggested that VHI overall scores and scores for all dimensions were higher for the With condition, for both Portuguese and Spanish speakers. When comparing groups of speakers, Spanish speakers presented higher scores for functional and emotional dimensions, for both With and Without conditions. In addition, the overall score for the Without condition was higher for Spanish speakers. No differences between groups were found for the total VHI score for the With condition. When comparing overall VHIdiff between speakers, that is, the difference in the VHI total score between With and Without conditions, no significant differences could be found. Thus, a multiple regression analysis was carried out between the VHIdiff and the independent variables of interest: age, sex, smoking habits, professional occupation, nationality, facemask type and its hours of use. The resulting model providing the highest association suggested that 2.5% of the variation in overall VHIdiff total score could be associated with sex, smoking habits, and professional level. Female smokers who use their voices during prolonged hours at work (e.g., teachers, lawyers, sales people) presented a higher VHI total score when wearing a mask. Future voice-related health interventions should address preventive strategies towards speaking behaviors leading to vocal fatigue and vocal effort as a consequence of compulsory facemask use, especially with respect to female professional voice users who smoke.