Long-term Outcomes Following Prolonged Mechanical Ventilation for COVID-19

ABSTRACT

Introduction: The purpose of this study is to evaluate longterm laryngotracheal outcomes in patients who required 10 or more days of invasive mechanical ventilation (IMV) for COVID-19. Method(s) This is a prospective cohort study of patients previously hospitalized for active COVID-19 infection between January 2020 and March 2021 who required intubation for 10+ days. Subjects who met criteria were enrolled at an outpatient laryngology clinic, where they underwent a clinical evaluation with head and neck exam, nasolaryngoscopy, and patient-reported outcome measures (Voice Handicap Index, EAT-10). Medical history was collected through electronic medical record review. Result(s) In total, 166 patients met criteria based on chart review. Of these patients, 31 (18.6%) were deceased since discharge. Enrolled subjects included 16 patients, 2 women and 14 men, with mean (SD) age of 57.4 (14.12) years. The mean duration (SD) of IMV was 36.8 (21.8) days. Fourteen of 16 patients underwent tracheostomy for prolonged endotracheal intubation. The mean time (SD) from hospital admission to intubation was 2.7 (3.2) days, intubation to tracheostomy or extubation was 13.9 (5.3) days, and tracheostomy to decannulation was 38.1 (22.6) days. Conclusion(s) Patients who required prolonged mechanical ventilation to treat COVID acute respiratory distress syndrome demonstrated significant laryngeal or tracheal pathology during laryngoscopy at 1-year follow-up, though subjectively, their self-reported voice and swallowing deficits were mild.