2023-12-19 19:50:22
(EMBARGO TO 6.01 PM) – Vocal cords paralyzed by Covid. It happened in the USA to a 15-year-old girl who, due to this serious complication, failed speech therapy and spent 15 months with a hole in her throat: the only way she could breathe. More than a year to recover the lost functionality, in time to allow the young woman to graduate and attend the prom. “She said she would never go there with a tracheotomy in sight,” says Christopher Hartnick of the Mass Eye and Ear hospital in Boston, senior author of the study which in the journal ‘Pediatrics’ describes what doctors consider to be “the first pediatric case of paralysis of the vocal cords after Sars-CoV-2 virus infection. A unique case of its kind”.
The girl, without previous health problems, arrived at the emergency room of the Massachusetts General Hospital, Harvard Medical School, with symptoms of respiratory difficulty 9 days after being diagnosed positive for Covid-19. The endoscopic examination revealed bilateral paralysis of the vocal cords which, after an in-depth analysis, excluding other causes, the researchers traced back to Covid. “The paralysis of the vocal cords – they write – could be a complication of the virus related to the nervous system (neuropathic), which adds to the neurological complications already known in children and adults”. If “post-viral neuropathy is a known cause of vocal cord paralysis, and several cases of paralysis of one or both vocal cords have been reported in adults as a complication of Sars-CoV-2 infection, this is the first finding of the complication in an adolescent”. An important element, the authors underline, given that “there are over 15 million reported cases of Covid in pediatric age” and “similar complications are usually not expected in young, healthy patients”.
At the hospital, Mass General Brigham doctors subjected the 15-year-old to an extensive series of extensive diagnostic tests including blood tests, imaging, cerebrospinal fluid analysis and consultations with specialists in ear, nose and throat, neurology, psychiatry, speech disorders and neurosurgery . Nothing worked and so, to alleviate the respiratory problems, all that remained was the tracheotomy. The young woman has been dependent on the hole in her throat for more than 13 months, indicating that “this type of nerve complication may not be temporary.” It was possible to remove the tracheotomy just a year and 3 months after having it done, just in time for high school graduation and prom.
“Considering the spread of the Sars-CoV-2 virus in pediatric age, this possible complication should be taken into consideration in any child who presents respiratory, speech or swallowing disorders after a recent diagnosis of Covid-19”, is the invitation by Danielle Reny Larrow of Mass Eye and Ear, first author of the article. “This is particularly important,” she cautions, “because such disorders could easily be attributed to more common diagnoses such as asthma.”
“To see a young, healthy, vibrant high school student suddenly lose one of his key cranial nerves to the point where he can no longer breathe is very unusual and required some investigation,” Hartnick highlights. “The fact that children can suffer long-term neurotrophic effects due to Covid-19 is something that is important for the pediatric community to be aware of – he points out – in order to treat our patients well”.
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