Larynx Injuries After Orotracheal Intubation: What are Risk Factors Observed in Patients with Covid?

Objective: To evaluate the risk factors for the development of laryngotracheal injuries in patients with coronavirus disease 2019 (COVID-19) undergoing orotracheal intubation (OTI). Methods: A cohort study was performed with intubated patients diagnosed with COVID-19, hospitalized from March 1st to October 31st, 2020. They were called for outpatient follow-up after being discharged from the hospital. Results: There were 421 patients with COVID-19 (31%) who required OTI, of which the outcome was: hospital discharge for 172 (40.9%) and death for 249 (59.1%). Outpatient videoendoscopy was performed in 95 patients (55.2%). Conclusion: We observed a greater risk for the development of laryngotracheal injury in patients who presented an increase in leukocyte count at hospital admission with lymphopenia, hypoalbuminemia, increased arterial lactate, troponin, and total bilirubin, as well as endotracheal tube with larger caliber and pronation. Furthermore, patients who at the time of OTI showed greater inflammatory reactivity or developed coagulation disorders were also at greater risk.