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Editorial Volume 9 Issue 3
Severe and non-severe Covid-19 patients with postintubation tracheal stenosis
Attapon Cheepsattayakorn,1,2 
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Ruangrong Cheepsattayakorn,3 Porntep Siriwanarangsun1
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1Faculty of Medicine, Western University, Thailand
210th Zonal Tuberculosis and Chest Disease Center, Thailand
3Department of Pathology, Faculty of Medicine, Chiang Mai University, Thailand
Correspondence: Attapon Cheepsattayakorn, 10th Zonal Tuberculosis and Chest Disease Center, 143 Sridornchai Road Changklan Muang Chiang Mai 50100 Thailand, Tel 6653140767, 6653276364, Fax 6653140773, 6653273590
Received: December 23, 2022 | Published: December 23, 2022
Citation: Cheepsattayakorn A, Cheepsattayakorn R, Siriwanarangsun P. Severe and non-severe Covid-19 patients with post-intubation tracheal stenosis. J Hum Virol Retrovirol. 2022;9(3):75-76. DOI: 10.15406/jhvrv.2022.09.00252
Editorial
Acute respiratory distress syndrome (ARDS), the most common and severe complication in COVID-19 patients requires ventilation and oxygen therapies.1 A previous study from China indicated that invasive mechanical ventilation (IMV) was required between 9.8 and 15.2 % of the patients.2 Median duration of mechanical ventilation of 17 days and high frequent re-intubation were found in COVID-19 patients.3,4 Several previous studies lastly revealed the association between obesity (a proven risk factor for benign subglottic/tracheal stenosis (SG/TS) and required-IMV-COVID-19 patients.5 Approximately, 10-22 % of non-COVID-19 patients were reported of SG/TS.6 Currently, experiences in SG/TS in COVID-19 scenario are still not demonstrated.1 Hypothetically, after extubation, a SG/T cicatricial concentric stenosis (Figure 1)1 in a number of these patients, including long-COVID-19 will be developed and differential diagnosis of SG/TS with other pulmonary or tracheobronchial diseases could be significantly played by high-resolution-computed tomography (HRCT) (Figure 2).6,7 Consensus about the best therapy strategy for SG/TS is still not developed.1
Figure 1
A- Tracheoscopy. Circumferential cicatricial tracheal stenosis. Cotton-Meier grade 3;
B- Bronchoscopy. Anatomic result immediately after endoscopic balloon dilation. The airway patency is restored.
C- Endoscopic assessment 2 months after surgery.1
.
Figure 2 CT scan findings for Case 2. A significant tracheal stenosis after 2 months of intubation due to SARS-CoV-2 infection (A, B arrows).7
Conclusion
In conclusion, in recovered COVID-19 patients with breathing difficulties after mechanical ventilation weaning should be highlighted suspecting tracheal stenosis (SG/TS), whereas the management is similar to general tracheal stenosis.
Acknowledgments
None.
Funding
None.
Conflicts of interest
Author declares that there is no conflict of interest.
References
- Mattioli F, Marchioni A, Andreani A, et al. Post-intubation tracheal stenosis in COVID-19 patients. European Archieves of Oto-Rhino-Laryngology. 2021;278:847–848.
- Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
- Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–481.
- Bellani G, Laffey JG, Pham T, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016;315(8):788–800.
- Simonnet A, Chetboun M, Poissy J, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity. 2020;28(7):1195–1199.
- Miwa M, Nakajima M, Kaszynski RH, et al. Two cases of post-intubation laryngotracheal stenosis occurring after severe COVID-19. Intern Med. 2021;60(3):473–477.
- Alturk A, Bara A, Darwish B. Post-intubation tracheal stenosis after severe COVID-19 infection: a report of two cases. Annals of Medicine and Surgery. 2021;67:102468..
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