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Case Reports
. 2021 Feb 1;60(3):473-477.
doi: 10.2169/internalmedicine.6105-20. Epub 2020 Dec 15.

Two Cases of Post-intubation Laryngotracheal Stenosis Occurring after Severe COVID-19

Maki Miwa  1 , Mikio Nakajima  1   2 , Richard H Kaszynski  1 , Syoichiro Hamada  1   2 , Tomotsugu Nakano  1 , Masamitsu Shirokawa  1 , Hideaki Goto  1 , Yoshihiro Yamaguchi  2
Affiliations
Case Reports

Two Cases of Post-intubation Laryngotracheal Stenosis Occurring after Severe COVID-19

Maki Miwa et al. Intern Med. .

Abstract

We experienced two cases of post-intubation laryngotracheal stenosis (PILS) occurring in patients after acute coronavirus disease (COVID)-19 in a relatively narrow time period. The patients required mechanical ventilation for 9 days in one and 28 days in the other. In both cases, the patients were discharged but later developed symptoms of cough and dyspnea, which were later diagnosed as PILS. Persistent cough and dyspnea are common symptoms in both PILS and the recovery phase of severe COVID-19. For this reason, PILS should be considered in the differential diagnosis post-COVID-19 patients. In addition, the prevalence of PILS may be greater than that of other critical diseases in severe COVID-19 patients.

Keywords: COVID-19; SARS-CoV-2; coronavirus disease 19; mechanical ventilation; post-intubation laryngotracheal stenosis; tracheal stenosis.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Case 1 chest X-ray (A) and CT (B) findings on admission. Bilateral patchy infiltrates were observed.
Figure 2.
Figure 2.
Case 1 CT findings of the larynx and trachea on readmission. Sagittal CT (A) showed laryngeal stenosis (arrow). Axial CT (B) revealed laryngeal stenosis (arrow) with granulation tissue at the larynx (arrowhead).
Figure 3.
Figure 3.
Case 1 flexible laryngoscopy findings on readmission. Laryngoscopy revealed swelling of the vestibular fold and stenosis of the larynx on the superior aspect of the glottis (arrow).
Figure 4.
Figure 4.
Case 2 chest CT findings on admission. Bilateral ground-glass opacities were observed in the lungs.
Figure 5.
Figure 5.
Case 2 CT findings on readmission. CT revealed tracheal stenosis (arrows). (A: sagittal, B: axial)
Figure 6.
Figure 6.
Case 2 flexible laryngoscopy findings on readmission. Retrograde perspective on tracheal stenosis observed from tracheal stoma (arrow).
See this image and copyright information in PMC

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