Teen suffers ‘first-of-its-kind’ vocal cord paralysis from COVID

Health

By Alex Mitchell

A 15-year-old girl in Massachusets has suffered paralysis of her vocal cords after contracting COVID-19 in a “first-of-its-kind” adolescent case.

The otherwise healthy teen went to the emergency room at Massachusetts General Hospital nine days after her COVID-19 diagnosis, and medical experts determined she had lost all mobility of her larynx due to a condition called bilateral vocal cord paralysis.

It was a “downstream effect” from COVID-19, according to a release on the unique case, which was published Tuesday in the medical journal Pediatrics.

“Given how common this virus is among children, this newly recognized potential complication should be considered in any child presenting with a breathing, talking or swallowing complaint after a recent COVID-19 diagnosis,” said first author Danielle Reny Larrow, a resident at Mass Eye and Ear.

“This is especially important as such complaints could be easily attributed to more common diagnoses such as asthma.”

The girl was given a full battery of testing ranging from blood work to cerebrospinal fluid analysis.

After speech therapy yielded no positive results, she underwent tracheostomy — in which doctors created an airway from the neck — and relied on this artificial breathing measure for 15 months. It was not revealed exactly when she was diagnosed and treated.

“To have a young, healthy, vibrant high schooler all of a sudden lose one of their important cranial nerves such that they can’t breathe is highly unusual and took some parsing,” said senior author Dr. Christopher Hartnick, also director of the Division of Pediatric Otolaryngology and Pediatric Airway, Voice and Swallowing Center at Mass Eye and Ear.

Researchers noted she was breathing without the device just in time for her high school graduation and prom 15 months after the procedure.

“She was having her senior prom a year and a quarter to the date of when she lost her function, and she told me she was not going to go to the prom with her tracheostomy in place,” Hartnick added.

“We decided to intervene so that she could graduate high school and go to her prom tracheostomy-free, which she did.”

However, this sort of vocal cord paralysis is more common in adults and is often caused by COVID-19 through a series of nerve-damaging conditions called post-viral neuropathy.

This happens to be the first case of a teen losing their speech under the circumstances and it presents previously unexpected complications that could arise from youth COVID-19 cases.

“The fact that kids can actually have long-term neurotrophic effects from COVID-19 is something that is important for the broader pediatric community to be aware of in order to be able to treat our kids well,” said Hartnick.