In Reference to Voice, Swallow and Airway Outcomes Following Tracheostomy for COVID‐19

Abstract

We read with huge interest the manuscript of Rouhani et al. entitled "A Prospective Study of Voice, Swallow, and Airway Outcomes following Tracheostomy for COVID-19". 1 The authors revealed the high incidence of laryngeal injury among patients who underwent intubation and tracheostomy insertion during the COVID-19 pandemic. It seems that this is a very interesting observation that can be an important argument in the discussion about the timing of tracheostomy in patients with COVID-19.Analyzing the literature from the beginning of 2020, we noticed that there is a trend to perform a later tracheotomy (after the 10th day of intubation). 2 Available evidence suggests that viral shedding is maximal in the first week of infection and the most of the article was devoted to safety methods during tracheotomy. 3,4 On the other hand, the results of the works from the second half of 2020 based on the expanded knowledge of SARS-CoV-2 and the results of several months of observation of patients after decannulation suggest an early tracheotomy (before the 10th day after intubation). 5 Kwak et al. to delay or avoid tracheostomy in COVID-19 patient categorically. 6 Reducing the duration of a tracheostomy is also important in preventing complications. Hernández Martínez et al. as a result of randomized controlled trial revealed that basing the decision to decannulate on suctioning frequency plus continuous high-flow oxygen therapy allow to reduce the time to decannulation. 7 The question of which type of tracheostomy (percutaneous or open tracheostomy) is safer for staff remains controversial. 5,8