A recent report published in the January 2024 issue of Pediatrics highlighted a case of a 15-year-old girl who developed paralysis of her vocal cords as a result of a Covid-19 infection. The infection led to inflammation of the nerves that control the movement of the vocal cords, causing severe breathing difficulties for the patient. She ultimately required the placement of a tracheotomy tube to help her breathe. The patient was treated at Mass Eye and Ear in Boston, with Dr. Christopher Hartnick as the lead surgeon.
The patient initially experienced a mild Covid-19 infection, but several days later developed difficulty breathing and noisy high-pitched sounds when inhaling, known as inspiratory stridor. Upon examination, it was discovered that both of her vocal cords had weakened mobility and would close shut when she tried to breathe in. This condition, called bilateral vocal cord paralysis, was believed to be a result of post-viral inflammation of the nerves.
Various medications and treatments were attempted, but the patient continued to experience breathing issues. Eventually, the surgical team decided to place a tracheotomy tube in her windpipe to bypass the vocal cords and allow her to breathe comfortably. After multiple surgical interventions, including airway reconstructive surgery, the patient was able to have the tracheotomy tube removed and is now breathing well.
It is worth noting that Covid-19 infections have been known to affect other nerves in the body, leading to various symptoms such as facial weakness and loss of smell or taste. In some cases, these symptoms improve with time, medication, or surgery, while in others they may persist.
While this particular case of vocal cord paralysis is rare, it is important to recognize that nearly one in four children in the U.S. has had a Covid-19 infection since the start of the pandemic. As such, it is likely that we may encounter other rare conditions related to Covid-19 in pediatric patients.
It is important to continue monitoring and studying the long-term effects of Covid-19 infections, especially in children, to better understand and address any potential complications that may arise.