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

## TL;DR

This study identifies risk factors for larynx injuries in COVID-19 patients after intubation, including high white blood cell count and specific clinical conditions.

## Contribution

The study identifies specific risk factors for laryngotracheal injuries in COVID-19 patients undergoing orotracheal intubation.

## Key findings

- Higher leukocyte count and lymphopenia at admission increase injury risk.
- Larger endotracheal tube size and patient pronation are associated with injury.
- Inflammatory reactivity and coagulation disorders also raise injury risk.

## Abstract

To evaluate the risk factors for the development of laryngotracheal injuries in patients with coronavirus disease 2019 (COVID-19) undergoing orotracheal intubation (OTI).

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.

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%).

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.