Wechsler Shmuel, Pitaro Jacob, Shlamkovich Nathan, Kalmovich Limor Muallem, Gavriel Haim
Department of Otolaryngology, Head and Neck Surgery, Shamir (Assaf Haroffeh) Medical Center, Tzriffin, Israel.
Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Eur Arch Otorhinolaryngol. 2025 May 17. doi: 10.1007/s00405-025-09458-x.
COVID-19 has been previously considered a lower respiratory tract disease. However, as the disease has evolved, studies have described its upper respiratory involvement. This study's objective was to present, for the first time, a series of patients with supraglottitis with unique characteristics of coronavirus disease.
This retrospective single-center case study included patients who were referred to the Emergency Department (ED) between June 1, 2022, and September 1, 2023, with clinical and endoscopic findings consisting of supraglottitis and positive PCR results for SARS-CoV-2.
Ten patients met the inclusion criteria. The mean age was 61. Six (60%) patients had comorbidities. Two (20%) patients were not vaccinated, whereas the others were vaccinated between one and five times. All patients presented with odynophagia, and most had fever and hoarseness. Laryngeal findings included epiglottic ulcers in the inner portion of the epiglottis in all patients, with varying degrees of severity. Presentation with a choking sensation, hoarseness, and elevated CRP and WBC levels may indicate a more severe disease course.
The latest COVID-19 variants can manifest with clinical and endoscopic findings of acute supraglottitis, with specific endoscopic characteristics of the larynx. Physicians should be aware of this clinical entity, refer suspected patients to the ED, and perform urgent laryngoscopy, while the otolaryngologist should be aware of the specific endoscopic presentation and manage the patient accordingly.
4: This study was approved by the institutional review board. Approval number- 0212-23ASF- 22/09/2023.
新冠病毒病（COVID-19）此前一直被认为是一种下呼吸道疾病。然而，随着病情的演变，有研究描述了其对上呼吸道的累及情况。本研究的目的是首次呈现一系列具有冠状病毒病独特特征的会厌炎患者。
这项回顾性单中心病例研究纳入了2022年6月1日至2023年9月1日期间被转诊至急诊科的患者，这些患者的临床和内镜检查结果包括会厌炎以及严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的聚合酶链反应（PCR）结果呈阳性。
10名患者符合纳入标准。平均年龄为61岁。6名（60%）患者有合并症。2名（20%）患者未接种疫苗，其余患者接种了1至5次疫苗。所有患者均有吞咽痛，大多数患者有发热和声音嘶哑。喉部检查结果包括所有患者会厌内部均有会厌溃疡，严重程度各不相同。出现哽咽感、声音嘶哑以及C反应蛋白（CRP）和白细胞（WBC）水平升高可能表明疾病进程更严重。
最新的COVID-19变体可表现为急性会厌炎的临床和内镜检查结果，并具有喉部特定的内镜特征。医生应了解这种临床实体，将疑似患者转诊至急诊科并进行紧急喉镜检查，而耳鼻喉科医生应了解特定的内镜表现并相应地对患者进行管理。
4级：本研究经机构审查委员会批准。批准号 - 0212 - 23ASF - 22/09/2023。
