To evaluate the risk factors for the development of laryngotracheal injuries in patients with coronavirus disease 2019 (COVID-19) undergoing orotracheal intubation (OTI).

A cohort study was performed with intubated patients diagnosed with COVID-19, hospitalized from March 1st to October 31st, 2020. They were called for outpatient follow-up after being discharged from the hospital.

There were 421 patients with COVID-19 (31%) who required OTI, of which the outcome was: hospital discharge for 172 (40.9%) and death for 249 (59.1%). Outpatient videoendoscopy was performed in 95 patients (55.2%).

We observed a greater risk for the development of laryngotracheal injury in patients who presented an increase in leukocyte count at hospital admission with lymphopenia, hypoalbuminemia, increased arterial lactate, troponin, and total bilirubin, as well as endotracheal tube with larger caliber and pronation. Furthermore, patients who at the time of OTI showed greater inflammatory reactivity or developed coagulation disorders were also at greater risk.

LF: study concept, data acquisition, data analysis and interpretation, writing – original draft, writing – review & editing, accountability for accuracy and integrity of the work; GSM: data acquisition, data analysis and interpretation, writing – original draft, writing – review & editing, accountability for accuracy and integrity of the work; LFB: data acquisition, data analysis and interpretation, writing – original draft, writing – review & editing, accountability for accuracy and integrity of the work; RSLT: study concept, data acquisition, data analysis and interpretation, writing – original draft, writing – review & editing, accountability for accuracy and integrity of the work; SRN: data analysis and interpretation, writing – original draft, writing – review & editing, accountability for accuracy and integrity of the work.

Data supporting the results of this study are available upon a reasonable request from the corresponding author.

Data will be available upon request to the corresponding author.

Editor-in-Chief: Geraldo Pereira Jotz.

Received: 16 November 2024

Accepted: 15 August 2025

Article published online:
03 March 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Leticia Felix, Gabriel de Souza Mares, Lara Freire Bezerril Soares, Romualdo Suzano Louzeiro Tiago, Sergio Roberto Nacif. Larynx Injuries After Orotracheal Intubation: What are Risk Factors Observed in Patients with Covid?. Int Arch Otorhinolaryngol 2026; 30: s00451812320.
DOI: 10.1055/s-0045-1812320