A rare case of COVID-19 infection with laryngeal involvement
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A 44-year-old man with obesity, but no other comorbidities, presented with a 3-day onsets of fever and headache. On examination, he was not in respiratory distress, his body temperature was 38.0°C, body mass index was 35.8 kg/m2 and oxyhaemoglobin saturation was 98% on room air. Novel COVID-19 was confirmed on nasopharyngeal swab PCR testing, and he was admitted to our hospital.

On day 5 of admission (8 days after symptom onset), he experienced rapidly progressing acute hypoxemic respiratory failure and was treated with dexamethasone (6.6 mg intravenously) and remdesivir (200 mg loading dose intravenously on day 1, followed by 100 mg/day for 4 days). On day 7 of admission, he reported of new-onset hoarseness and difficulty breathing at rest. CT revealed bilateral peripheral/basal-predominant ground-glass opacities with linear opacities and laryngeal oedema.

His symptoms were considered to be due to laryngeal oedema rather than pneumonia, and he was treated with a hydrocortisone drip (100 mg). On the next day, his symptoms became less severe, and dexamethasone (6.6 mg intravenously) administration was continued for 10 days. On day 14 of admission, all his symptoms were completely improved, and follow-up CT revealed an improvement of both lung involvement and laryngeal oedema. On day 19 of admission, the patient was discharged.

laryngeal oedema may be a critical complication of COVID-19 infection, and CT can be an alternative to laryngeal fiberscopy for the detection of laryngeal oedema. Systemic steroids may be effective against not only COVID-19 pneumonia but also the associated laryngeal oedema.

Source: https://casereports.bmj.com/content/14/6/e242426?rss=1
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