Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jul:67:102468.
doi: 10.1016/j.amsu.2021.102468. Epub 2021 Jun 9.

Post-intubation tracheal stenosis after severe COVID-19 infection: A report of two cases

Ahmad Alturk  1 , Albaraa Bara  1 , Bassam Darwish  2
Affiliations
Case Reports

Post-intubation tracheal stenosis after severe COVID-19 infection: A report of two cases

Ahmad Alturk et al. Ann Med Surg (Lond). 2021 Jul.

Abstract

Introduction and importance: Coronavirus disease 2019 (COVID-19) is a pandemic disease that spread rapidly throughout the world and became a major public health concern. Approximately 5-12% of COVID-19 patients require admission to the intensive-care unit (ICU), where they often require oxygen therapy and prolonged intubation. Post-intubation laryngotracheal stenosis (PILS) is a complication that occurs in 10-22% of non-COVID-19 patients after prolonged intubation, while the rate of COVID-19 related PILS remains unknown. Additionally, there is still no consensus in the literature regarding the management modalities for PILS following COVID-19.

Case presentation: Here we report two cases of tracheal stenosis after prolonged intubation due to severe COVID-19 infection. The first patient was admitted to the ICU and intubated for 21 days; 3 months after discharge, he developed a 3 cm long tracheal stenosis that narrowed 70% of the lumen. The second patient was intubated for 2 months and, 4 months after discharge, developed a 2.5 cm long tracheal stenosis that narrowed 80% of the lumen.

Clinical discussion: In both cases, the diagnosis was confirmed by CT scan and Rigid bronchoscopy; then, they were managed successfully with tracheal resection and reconstruction by end-to-end anastomosis.

Conclusion: In conclusion, we would like to highlight the importance of suspecting PILS in recovered COVID-19 patients re-presenting with breathing difficulties following weaning from mechanical ventilation; therefore, careful follow-up in such patients is required. Moreover, we would like to point out that the management of tracheal stenosis after COVID-19 appears to be similar to that of tracheal stenosis in general.

Keywords: COVID-19; Case report; PILS; Resection; Stenosis.

PubMed Disclaimer

Conflict of interest statement

All of the authors declared that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
CT scan findings for Case 2. A significant tracheal stenosis after 2 months of intubation due to SARS-CoV-2 infection (A,B arrows).
See this image and copyright information in PMC

References

    1. Vestergaard L.S., Nielsen J., Richter L., Schmid D., Bustos N., Braeye T., Denissov G., Veideman T., Luomala O., Möttönen T., Fouillet A., Caserio-Schönemann C., An der Heiden M., Uphoff H., Lytras T., Gkolfinopoulou K., Paldy A., Domegan L., O'Donnell J., De' Donato F., Noccioli F., Hoffmann P., Velez T., England K., van Asten L., White R.A., Tønnessen R., da Silva S.P., Rodrigues A.P., Larrauri A., Delgado-Sanz C., Farah A., Galanis I., Junker C., Perisa D., Sinnathamby M., Andrews N., O'Doherty M., Marquess D.F., Kennedy S., Olsen S.J., Pebody R., Krause T.G., Mølbak K. Excess all-cause mortality during the COVID-19 pandemic in Europe - preliminary pooled estimates from the EuroMOMO network, March to April 2020. Euro Surveill. : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin. 2020;25(26) - PMC - PubMed
    1. Piazza C., Filauro M., Dikkers F.G., Nouraei S.A.R., Sandu K., Sittel C., Amin M.R., Campos G., Eckel H.E., Peretti G. Long-term intubation and high rate of tracheostomy in COVID-19 patients might determine an unprecedented increase of airway stenoses: a call to action from the European Laryngological Society. Eur. Arch. Oto-Rhino-Laryngol. 2021;278(1):1–7. - PMC - PubMed
    1. Miwa M., Nakajima M., Kaszynski R.H., Hamada S., Nakano T., Shirokawa M., Goto H., Yamaguchi Y. Two cases of post-intubation laryngotracheal stenosis occurring after severe COVID-19. Intern. Med. (Tokyo, Japan) 2021;60(3):473–477. - PMC - PubMed
    1. Farzanegan R., Feizabadi M., Ghorbani F., Movassaghi M., Vaziri E., Zangi M., Lajevardi S., Shadmehr M.B. An overview of tracheal stenosis research trends and hot topics. Arch. Iran. Med. 2017;20(9):598–607. - PubMed
    1. Agha R.A., Franchi T., Sohrabi C., Mathew G., Kerwan A. The SCARE 2020 guideline: updating consensus surgical CAse REport (SCARE) guidelines. Int. J. Surg. 2020;84:226–230. - PubMed

Publication types

LinkOut - more resources