Background: A voice problem known as dysphonia has been identified as a potential adverse effect of COVID-19
infection.
Objective: This study aimed to assess the prevalence of dysphonia in COVID-19 patients and the impact of his/her
voice disorder upon daily activities using the Voice Handicap Index (VHI-30).
Patients and methods: This prospective study was conducted on a cohort of 231 COVID-19 patients selected from the
Otorhinolaryngology Department, Benha University Hospital. Patient evaluation included comprehensive history
taking, physical and local examinations, laboratory investigation, voice assessments using (VHI-30), auditory perceptual
analysis and local laryngeal examination by indirect rigid laryngoscopy.
Results: Among the enrolled patients, 46.8% were males and 53.2% were females, with a mean age of 48.73 ± 11.58
years. The most prevalent symptoms reported were fever (93.5%), exhaustion (83.1%), and cough (76.2%). Dysphonia
was found in 37.6% of the patients, with 58.6% experiencing mild dysphonia, 28.7% moderate dysphonia, and 12.6%
severe dysphonia. The Voice Handicap Index (VHI) scores, which mean that physical VHI was 18.82 ± 4.69, mean
functional VHI was 17.42 ± 3.73, and mean emotional VHI was 14.97 ± 4.67. While mean total VHI was 36.02 ± 13.62
and the result explained the positive relation between total mean VHI score and grade of dysphonia. The mild grade was
total mean 25.49 ± 5.11, moderate grade was total mean 42.56 ± 5.3 and severe grade was total mean 61.54 ± 8.16. Our
findings showed that the more severe the COVID-19 infection, the higher the scores of total VHI-30. Laryngoscope
findings revealed laryngeal mucosa congestion and edema as the most common finding (35.5%), followed by early
starting nodules (20.8%), vocal fold immobility (1%), Vocal fold polyp (haemorrhagic polyp) (1%) and normal
laryngeal mucosa (42%). The most prevalent cause of dysphonia is organic lesion (22.8%) followed by nonorganic
(functional) (15.5%).
Conclusion: Our study revealed a considerable prevalence of dysphonia among COVID-19 patients in Benha University
Hospitals. The VHI scores indicated the negative impact of dysphonia on physical, functional, and emotional aspects of
patients' lives.