Acute epiglottitis caused by COVID-19: A systematic review

Abstract

The COVID-19 pandemic has caused substantial population infections worldwide. COVID-19 has been reported to cause acute epiglottitis (AE); nonetheless, COVID-19-related AE is poorly understood by healthcare workers because of the disease’s low occurrence. This systematic review aimed to improve knowledge of the clinical characteristics of COVID-19-related AE. We conducted a comprehensive search of the literature databases PubMed, Web of Science, Embase, and Scopus, using various keywords and descriptors such as "COVID-19," "SARS-CoV-2," and "AE" in combination with the AND/OR operator. This review included 11 patients with COVID-19-related AE, all of whom were adults except for one 15-year-old girl. COVID-19-related AE was more prevalent in males, who accounted for 81.8% of patients. Patients with COVID-19-related AE experienced symptoms such as hoarseness, dysphagia, odynophagia, sore throat, and dyspnea. Hoarseness may be one of the typical symptoms of COVID-19-related AE. Five patients with COVID-19-related AE had coexisting diseases, including hypertension, obesity, diabetes, obstructive sleep apnea, Wolff-Parkinson-White syndrome, and intracranial tumors. Antibiotics and steroids were commonly administered. Five patients with COVID-19-related AE underwent intubation and cricothyroidotomy airway management. Due to the low success rate of intubation, emergency tracheotomy is the recommended option for patients with COVID-19-related AE who present with more severe dyspnea. AE could be an uncommon manifestation of COVID-19, and SARS-CoV-2 infection should be considered as a possible cause of AE. Healthcare workers should be vigilant in recognizing COVID-19-related AE.