Vocal Signs and Symptoms Related to COVID-19 and Risk Factors for their Persistence

Abstract

Objective: To compare the occurrence of vocal signs and symptoms before, during, and after coronavirus disease (COVID-19) and analyze possible risk factors for the persistence of these signs and symptoms after disease resolution. Method: This was an observational, analytical, and cross-sectional study. The participants were 45 individuals of both sexes, with a mean age of 44 years, who were previously affected by COVID-19. All participants answered a questionnaire about sociodemographic data, smoking history, disease course, vocal complaints, and the vocal signs and symptoms list (SSL), referring to three timepoints (before, during, and after COVID-19). Results: The most commonly reported vocal signs and symptoms before COVID-19 were phlegm (26.67%; n=12) and dry throat (24.44%; n=11). During COVID-19, the most frequent vocal signs and symptoms were tired voice after short-term use (73.33%; n=33) and dry throat (71.11%; n=32). After the disease, the most reported vocal signs and symptoms were dry throat (57.78%; n=26) and phlegm (53.33; n=24). The self-perception of vocal signs and symptoms before COVID-19 was lower than that during and after COVID-19 (p<0.001). Vocal complaints after COVID-19 and oxygen therapy were predictors of self-perception of vocal signs and symptoms after COVID-19. Conclusion: Individuals affected by COVID-19 had a higher frequency of vocal signs and symptoms during the disease. However, after remission, the frequency of vocal signs and symptoms was higher than that at baseline. The need for oxygen therapy may indicate a risk for a higher occurrence of vocal signs and symptoms after COVID-19.

Cancer survivors present physical and psychological sequelae after COVID-19 hospitalization: a prospective and longitudinal cross-sectional study assessing post-acute sequelae of SARS-CoV-2 infection (PASC) in cancer patients

“…Voice, speech or swallowing impairments were present in about 20% of our sample at the time of discharge, in line with previous studies [12,15,16,22,39]. Those symptoms became more prevalent in the following 12 months, in icting at least 30% of our sample.…”

Dysphonia Severity Index and Consensus Auditory-Perceptual Evaluation of Voice Outcomes, and Their Relation in Hospitalized Patients with COVID-19

“…The impact of COVID-19 on the respiratory system can include lung infection, pneumonia, and reduced respiratory volume, as well as acute respiratory distress syndrome 19 , 20 . Changes in lung function secondary to respiratory tract infections commonly seen in patients with COVID-19 can lead to reduced respiratory support for voice and speech; This impact on voice production is recognized in mild-to-severe cases of COVID-19 and is evidenced by the voice assessment outcomes performed in this and similar studies 21 , 22 , 23 . For instance, inadequate airflow increased aperiodicity, and signal perturbation are examples of these affected aspects 24 .…”

Vocal biomarker predicts fatigue in people with COVID-19: results from the prospective Predi-COVID cohort study

“… 41 Furthermore, in case of increased fatigue, the voice production process may be additionally disturbed due to reduced laryngeal muscle tension, resulting in dysphonia that appears in up to 49% of COVID-19 patients. 41 …”

“…The process is controlled by the laryngeal muscle activation40 but involves the entire respiratory system to provide the air pressure necessary for phonation. Decreased pulmonary function in COVID-19 patients can cause reduced glottal airflow that is essential for normal voice production 41. Furthermore, in case of increased fatigue, the voice production process may be additionally disturbed due to reduced laryngeal muscle tension, resulting in dysphonia that appears in up to 49% of COVID-19 patients 41…”