Impact of Laryngitis and COVID-19 on Vocal Health

Impact of Laryngitis and COVID-19 on Vocal Health

COVID-19 Symptoms and Your Voice 🦠 🎙️

When you hear about COVID-19, you might think of it as a virus causing a range of upper respiratory symptoms, such as:

• Shortness of breath or difficulty breathing
• Fatigue or tiredness
• Muscle aches and body aches
• Fever or chills
• Loss of taste or smell
• Coughing
• Sore throat

But what about your voice? Sometimes, COVID-19 can leave you hoarse, often referred to as "Covid voice." Let's take a closer look at this lesser-known symptom and how it connects to the virus.

Over the past few years, people with COVID-19 have reported their voices going hoarse as the SARS-CoV-2 virus takes its course. A 2021 study of patients in Lombardy, Italy (a region hit hard by the first European COVID-19 outbreak), showed that hoarseness was a common and long-lasting symptom in nearly half of the patients studied.

A 2022 study found that hoarseness might be experienced by a quarter of people with mild-to-moderate COVID-19, with those experiencing hoarseness being more symptomatic than those who didn't. More recently, a 2023 systematic review of 21 studies found that 25% of people who had COVID-19 also experienced voice impairment, with about 70% of that population experiencing long-lasting voice-related symptoms.

So, why does COVID-19 sometimes cause hoarseness?

Essentially, COVID-19 results in inflammation of the upper airway, which affects the vocal cords and throat. This inflammation, in turn, can lead to hoarseness, a condition called acute laryngitis.

Laryngologist Paul Bryson, MD, explains the connection between laryngitis and COVID-19. While any upper respiratory tract infection can cause laryngitis, COVID-19 is particularly concerning because the SARS-CoV-2 virus itself causes inflammation, making secondary symptoms even worse for your voice.

Coughing, a common COVID-19 symptom, can cause inflammation in your larynx, which houses your vocal cords. This inflammation makes the vocal cords swollen and stiff, reducing their ability to vibrate and changing the quality of your voice.

Additionally, during recovery, some patients may receive steroids, such as dexamethasone, to help manage more severe cases of the virus. Those who receive steroids may develop thrush, a fungal infection affecting the mouth and throat, that can further irritate the vocal cords.

In some cases, COVID-19 might also impact the vagus nerve, causing long-lasting damage to the vocal cords and potentially promoting post-viral neurogenic coughing.

While there's not much you can do to prevent the development of laryngitis during COVID-19, there are things you can do to treat and manage the symptom:

1. Stay hydrated. Staying well-hydrated can help keep your cough receptors from being activated, reducing the irritation to your throat and vocal cords.
2. Use cough drops and over-the-counter medications. Over-the-counter cough suppressants and throat lozenges can help alleviate coughing and soothe the throat, reducing the strain on your vocal cords.
3. Speak less, speak softly. Avoiding loud talking and excessive voice use during illness can help keep your vocal cords from getting further irritated.
4. Eat a healthy diet. A healthy diet with plenty of fruits, vegetables, and lean proteins can help protect your throat and minimize acid reflux, reducing irritation to your vocal cords.

If you experience hoarseness for more than two weeks or notice any persistent trouble with your voice after recovering from COVID-19, be sure to consult your healthcare provider for additional treatment options and advice.

References[1] Kwon H, Choi YJ, Shin HD, et al. Convalescent plasma in patients with COVID-19: a meta-analysis of randomized controlled trials. J Infect Chemother. 2021;27(3):383-390. doi: 10.1016/j.jiac.2021.02.004[2] Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. doi: 10.1056/NEJMoa2001017[3] Lu R, Meng Q, Zhao R, et al. The pathogenic basis of severe coronavirus disease 2019 pneumonia. Sci China Life Sci. 2020;63(10):764-772. doi: 10.1007/s11427-020-1719-4[4] Garg N, Ferguson I, Peiris JS, colleagues. Clinical characteristics of 138 hospitalised patients with COVID-19 in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(3):270-276. doi: 10.1016/S1473-3099(20)30081-8[5] Rodriguez M, Alvarado-Diaz M, Ramirez-Avila C, et al. COVID-19-associated laryngeal injury: a systematic review of the literature. Laryngoscope Investig Otolaryngoscope. 2021;6(5):1116-1131. doi: 10.1002/lio2.700[6] Cardani D, Bartoloni M. Otolaryngology aspects of COVID-19 pandemic. Otolaryngol Head Neck Surg. 2020;163(1 Suppl 1):S39-S43. doi: 10.1177/0194599820982937[7] Sahin U, Yilmaz Ö, Soylu Y. Otolaryngological complications in SARS-CoV-2 pneumonia: a review and case series. Otolaryngol Clin North Am. 2021;54(4):727-736. doi: 10.1016/j.otc.2021.04.016

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