TUESDAY, November 3, 2020 (HealthDay News) – Nerve damage to the vocal cords could be the reason some people recovering from COVID-19 experience mysterious shortness of breath for months after shaking off the coronavirus, researchers say.

The vocal cords are designed to constrict the airways as you speak, vibrating in the passing air to create the sound of your voice.

When you are not speaking, the vocal cords retract to allow air to flow more freely through your lungs.

But, in some patients, COVID-19 appears to damage the nerve that regulates speech, preventing their vocal cords from breathing even when they’re not speaking, said Dr Jonathan Aviv, an ear, nose and nose specialist. gorge at Mount Sinai Hospital. At New York.

“Think about when you are chatting. Every time you finish a sentence, your vocal cords have to open so you can catch your breath,” Aviv said. “Imagine if they didn’t open. After your third or fourth sentence, you’ll feel short of breath. Your airways are closed.”

The good news is that this type of breathing problem can be easily treated with a common speech therapy technique, Aviv said.

In a recent article by International Journal of Pulmonary and Respiratory SciencesAviv and his colleagues said they have successfully treated 18 former COVID-19 patients with a combination of speech therapy and diet modification – avoiding foods that could exacerbate nerve irritation.

“All the patients resolve their shortness of breath. You can see it when they come back. Their vocal cords are now moving normally,” Aviv said.

The vagus nerve starts from the brain and controls voice, swallowing, breathing and coughing, Aviv said. Previous research has shown that damage to the vagus nerve can prevent the vocal cords from retracting, which impedes airflow.

“If the vagus nerve has been pulled out by a virus, it won’t function normally, and one manifestation is shortness of breath with or without a cough,” Aviv said.

Doctors have been baffled by occasional COVID-19 patients who continue to have shortness of breath even though the inflammation caused by the viral infection has subsided and imaging scans show no lasting lung damage, said the Dr Joseph Khabbaza, pulmonologist at the Cleveland Clinic. in Ohio.

“We are seeing a group of people who have normal breathing tests and do not respond to asthma inhalers,” Khabbaza said. “They have real symptoms but their tests are getting normal.”

To see if the vocal cords could be involved, Aviv and his colleagues ran a tiny camera smaller than a lace through the nose of 18 COVID-19 ‘long-haul’ people to get a closer view of their airways. .

Sure enough, the camera showed that people’s vocal cords were not pulling out properly.

“I show them the video, and they basically fall off the examination chair. They can’t believe what’s going on,” Aviv said.

This type of vocal cord dysfunction is treated with “respiratory rehabilitation,” a series of exercises designed to improve the function of the respiratory muscles, Aviv said.

Aviv also urged patients to avoid highly acidic foods that can irritate the vagus nerve, including flavored drinks in cans or bottles, citrus fruits, tomato sauce, vinegar and wine.

COVID-19 patients who continue to have persistent shortness of breath even after their other symptoms have gone away should discuss the possibility with their doctor, Aviv suggested.

After reading the Aviv article, Khabbaza said he has a few patients he plans to see for possible vocal cord issues.

“If you suffer from shortness of breath I think it sounds like something worth investigating because we know it responds very well to speech therapy,” Khabbaza said. “This vagal neuropathy is said to be one of those things that would cause shortness of breath but not respond to the most common treatments for shortness of breath after a COVID infection. “

More information

US Centers for Disease Control and Prevention has more on COVID-19[female[feminine.

SOURCES: Jonathan Aviv, MD, ear, nose and throat specialist, Mount Sinai Hospital, New York City; Joseph Khabbaza, MD, pulmonologist, Cleveland Clinic, Cleveland, Ohio; International Journal of Pulmonary and Respiratory Sciences, October 2020


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