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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(04): s00451810026
DOI: 10.1055/s-0045-1810026
Original Research

Post-COVID-19 Dysphonia: Risk, Voice Handicap, and Laryngological Findings in COVID-19 Critical Illness Survivors

Authors

  • Juliana Alves Souza 

    1   Department of Speech Therapy and Human Communication Disorders, Federal University of Santa Maria, Santa Maria, RS, Brazil

  • Carla Aparecida Cielo

    1   Department of Speech Therapy and Human Communication Disorders, Federal University of Santa Maria, Santa Maria, RS, Brazil

  • Bruna Franciele da Trindade Gonçalves

    2   Multiprofessional Residency Program, Health Sciences Center, Federal University of Santa Maria, Santa Maria, RS, Brazil

  • Élisson Krug Oliveira

    3   Medical Residency Program in Otorhinolaryngology, Health Sciences Center, Federal University of Santa Maria, Santa Maria, RS, Brazil

  • Aloma Jacobi Dalla Lana

    3   Medical Residency Program in Otorhinolaryngology, Health Sciences Center, Federal University of Santa Maria, Santa Maria, RS, Brazil

  • Adriane Shmidt Pasqualoto

    4   Department of Physiotherapy and Human Communication Disorders, Federal University of Santa Maria, Santa Maria, RS, Brazil

Funding Partial financial support Brazilian National Council for Scientific and Technological Development CNPq. C.A.C. has received research support (Grant 305151/2022-3).
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Abstract

Objective

To investigate and relate the risk of dysphonia, voice handicap, and laryngological findings in COVID-19 critical illness survivors, stratified by sex and the need for orotracheal intubation (OTI) during hospitalization in the intensive care unit. Additionally, identify predictors of voice symptoms after COVID-19 critical illness.

Methods

A cross-sectional study included 50 patients (mean age 51.70 ± 11.90 years; 26 women and 24 men) from a post-COVID-19 Rehabilitation Outpatient Clinic. Evaluations for voice symptoms and dysphonia risk were conducted using the Screening Index for Voice Disorder, vocal handicap using the Voice Handicap Index, and laryngeal health via laryngoscopic examination.

Results

Dysphonia risk and voice handicap were significantly more frequent in women. There was no significant association between voice self-assessment instruments and OTI. However, voice symptoms were significantly higher in intubated women. Commonly reported voice symptoms included dry throat, throat clearing, hoarseness, and vocal fatigue. Intubation was associated with laryngeal disorders, particularly in women, with the hypopharyngeal and supraglottic regions more affected by erythema and edema. Female gender, dyspnea, and cough accounted for 51% of the variance in voice symptoms.

Conclusions

COVID-19 critical illness survivors reported dry throat, throat clearing, hoarseness, and vocal fatigue even four months post-discharge. Women were at greater risk of dysphonia and voice handicaps. More than a quarter of patients presented laryngeal disorders related to OTI. Female gender and persistent symptoms of cough and dyspnea were predictors of voice symptoms. These findings enhance understanding of COVID-19's impact on the voice, highlighting the need for multidisciplinary approaches.

Keywords

COVID-19 - dysphonia - intensive care units - larynx - voice - voice disorders

Authors' Contributions

JAS, CAC, ASP: conceptualization, methodology; JAS, BFTG, EKO, AJDL: data collection; JAS, CAC: formal analysis; JAS: writing – original draft; CAC, ASP: supervision. All authors contributed with data interpretation, writing – review & editing, approval of the final version, and accountability for all aspects of the work;.


Data Availability Statement

All data analyzed and presented in this study are included within the article, in accordance with the principles of scientific rigor and transparency. Additional variables collected are part of databases associated with ongoing research projects that address specific objectives distinct from those of the present study. To preserve the methodological integrity of these projects and to comply with confidentiality and scientific integrity standards, these data cannot be made publicly available at this time. Readers are not authorized to use the data supporting the results of this study for their own work. However, the authors are available to address any questions or provide further clarification upon reasonable request.




Publication History

Received: 25 August 2024

Accepted: 24 May 2025

Article published online:
16 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Juliana Alves Souza, Carla Aparecida Cielo, Bruna Franciele da Trindade Gonçalves, Élisson Krug Oliveira, Aloma Jacobi Dalla Lana, Adriane Shmidt Pasqualoto. Post-COVID-19 Dysphonia: Risk, Voice Handicap, and Laryngological Findings in COVID-19 Critical Illness Survivors. Int Arch Otorhinolaryngol 2025; 29: s00451810026.
DOI: 10.1055/s-0045-1810026