Potential COVID-Induced Vocal Cord Paralysis in Adolescents

Written by Ellen Wan on January 11, 2024. Posted in Current News

While it’s known that the COVID-19 virus can damage the lungs, it can be equally harmful to many other organs.

The girl experienced symptoms of nasal congestion, fever, and fatigue two weeks before the onset of vocal cord paralysis. She then tested positive for COVID-19 using a home antigen test. Nine days later, she exhibited symptoms of acute shortness of breath that worsened during physical activity, prompting her admission to the emergency department at Massachusetts General Hospital.

The patient displayed intermittent noisy breathing, but blood oxygen saturation was normal. Furthermore, a series of tests, including those for COVID-19, all returned negative results. Notably, she has a history of asthma and anxiety. Suspecting an asthma attack, the doctor prescribed steroids and bronchodilators, but there was no improvement. The patient also underwent speech therapy, but it similarly yielded no results.

After admission, the patient continued to experience noisy breathing and developed difficulty swallowing, weakness on the left side, “pins and needles,” and unsteady gait. She underwent consultations with otolaryngology, psychiatry, neurology, speech pathology, and neurosurgery. A laryngeal scope examination revealed a severe bilateral reduction in her vocal cords’ range of motion. The weakness on her left side and the pins-and-needles feeling were determined to be likely functional, but the possibility of a COVID-19-related cause could not be ruled out.

Dr. Danielle Reny Larrow, the lead author of the case report and a resident at Massachusetts Eye and Ear, a teaching hospital of Harvard Medical School, stated in a press release that considering the prevalence of the COVID-19 virus in children, any child presenting with breathing, talking, or swallowing symptoms after recent COVID-19 infection should be evaluated for this potential new complication. She emphasized that such symptoms could easily be attributed to more common conditions like asthma.

The report described the mechanisms of neuropathy following viral infection, including direct viral infection causing acute inflammation of the nerves, viral fusion with DNA in the neural ganglia, where it remains dormant until reactivated by external factors, and immune-mediated response leading to antibody production. These antibodies then destroy the myelin sheath enveloping neurons, resulting in neuropathy. Post-viral vagal neuropathy commonly occurs following an acute upper respiratory tract infection, resulting in impairment of both sensory and motor functions of the vagus nerve.

Source: Epoch Times

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