Wally Edge, MD
Prof., Peds/Inte
Albany Medical College
Woodstock
Disclosure information not submitted.
Robert Kaslovsky, MD
Attending Physician
Albany Medical Center, United States
Disclosure information not submitted.
Mary Teresa Evans, NP
Nurse practitioner
Albany Medical Center, United States
Disclosure information not submitted.
Shashikanth Reddy Ambati, MD
Assistant Professor
Albany Medical Center
Albany, NY
Disclosure information not submitted.
Title: I Can’t Breathe; Increased Incidence of Vocal Cord Dysfunction During the COVID-19 Pandemic
Introduction: Dyspnea is a complex sensation that occurs in many pathophysiologic disorders, both functional and cardiopulmonary. Vocal cord dysfunction (VCD) is an upper airway disorder characterized by exaggerated and transient glottic constriction causing respiratory and laryngeal symptoms. Common presentation is with stridor, often in the context of emotional stress and anxiety. Other symptoms include wheezing, frequent cough, choking sensation or throat and chest tightness. This is seen commonly in teenagers, particularly in adolescent females. The COVID-19 pandemic has been a trigger for anxiety and stress with an increase in psychosomatic illness. We hypothesize that COVID-19 pandemic elicited an uptick in the incidence of VCD in 2020.
Methods: In our tertiary outpatient pediatric pulmonary practice, we have observed an increase in the patients with symptoms of stridor or dyspnea during the pandemic in 2020 and were subsequently diagnosed with VCD by spirometry or laryngoscopy. We have looked at the diagnosis of VCD among the patients who were seen at our pulmonary practice in 2019 and compared to 2020.
Results: In our practice, we had a total of 55 new patients with symptoms or signs consistent with diagnosis of VCD among 786 new patients seen in 2019 with an incidence of 7%. This number increased to 14% with a total of 64 new patients with VCD diagnosis among 457 new patients seen in 2020. We report a one hundred percent increase in the incidence of VCD in our pediatric patients.
Conclusion: It is important to recognize that this entity has increased during the COVID-19 pandemic. In particular, emergency department, general pediatricians and ICU physicians should be aware of this diagnosis. It is imperative to diagnose VCD as it will lead to unnecessary intubations and treatments with bronchodilators and corticosteroids as opposed to behavioral and speech training to learn effective voluntary control over the vocal cords.