COVID-19-related voice disorders: a scoping review.
Aline de Souza Silva, Rodrigo Dornelas, José Roberto Lapa E Silva
Hoarseness and vocal fatigue were the most common complaints in non-intubated adults with mild to moderate COVID-19, persisting in 17.1% after recovery.
Maximum phonation time was shorter than in healthy controls. This maps the evidence; it does not test a treatment.
Key findings
1Dysphonia (hoarseness) was the most frequently reported vocal symptom across the included studies, with prevalence ranging from 25% to 79% depending on the study. One meta-analysis within the review estimated 25.1% prevalence during the acute phase and 17.1% persistence after recovery.
2Acoustic analyses across multiple studies showed increased jitter and shimmer (measures of vocal instability) and reduced maximum phonation time. In one study, post-COVID patients sustained a vowel for 11.9 seconds versus 16.4 seconds in healthy controls. In another, patients with severe pneumonia sustained 8.9 seconds and those with moderate pneumonia 10.7 seconds, compared with 16.2 seconds in controls.
3Participants reported persistent vocal fatigue, difficulty projecting their voice, and a feeling of effort when speaking. Self-report questionnaires (VHI-10, V-RQOL) confirmed that these changes negatively affected quality of life, particularly in people who use their voice for work.
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What it does not show
The 19 included studies used different vocal assessment protocols, instruments, inclusion criteria, and follow-up periods, making direct comparison difficult. Most studies had short-term follow-up and small samples, so the long-term course of vocal changes is unclear. No formal quality assessment of the included studies was performed. The search was limited to English, Portuguese, and Spanish. None of the included studies reported race or ethnicity, so the review cannot address whether vocal impact differs across racial groups. The sample was predominantly male, and 7 of the 19 studies were conducted in Iran. Two of the 19 included studies were case reports, so findings from them (such as vocal fold paralysis) describe individual cases, not a pattern.
Declared interests
Funded by CAPES (Brazilian government agency, grant 88887.968320/2024-00). No industry funding or conflicts of interest were declared.
The easy way to misread this
Do not read the 25% to 79% dysphonia range as a single prevalence figure. The 19 studies used different populations, assessment tools, and follow-up periods, so the numbers are not directly comparable. The review also recommends speech therapy and multidisciplinary follow-up, but it does not test whether those interventions work.
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