Persistent Dysphonia in Hospitalized COVID-19 Patients.

The study design cannot determine causation; it is unclear whether the dysphonia was caused by the virus itself, the treatments (like intubation or steroids), or other factors. There is potential survival bias, as the high mortality rate in ICU patients might mean that the most severely affected individuals did not survive to be included, potentially underestimating the true frequency of dysphonia. Some data were missing from medical records, such as BMI, and some patients had already received treatment for their voice issues, making certain measurements (like MPT and s/z ratio) unassessable or unreliable for those individuals. The sample size for the ward group with persistent dysphonia was very small (n=4), limiting the ability to draw firm conclusions about this subgroup. Recall bias is possible because patients reported symptoms and history via telephone interviews, although researchers attempted to cross-check this with medical records.

No specific funding source or conflict of interest declaration is provided in the text.

Do not assume that intubation is the sole cause of persistent voice problems in these patients. While all ICU patients with dysphonia had been intubated, the study could not separate the effects of the virus, the intubation, and other treatments like inhaled steroids. Additionally, the lack of a significant statistical difference in dysphonia rates between ICU and ward patients (P = 0.139) means we cannot definitively say ICU care alone predicts worse voice outcomes compared to ward care in this sample.