new delhi: Researchers have described the first pediatric case of vocal cord paralysis following Covid 19 infection in a new study. The physician researchers at Massachusetts Eye and Ear hospital in the US have concluded that the paralysis was likely a downstream effect of the viral infection, and that it may be another addition to the well established nervous system related or neuropathic complications observed in children and adults. The patient, an otherwise healthy 15 year old female, was presented to the emergency department 13 days after diagnosis of SARS CoV 2 infection with acute onset shortness of breath, the researchers described in their study published in the journal Pediatrics. She had a history of asthma and anxiety. An endoscopic examination revealed bilateral vocal cord paralysis, which refers to an immobility of both vocal cords found in the voice box or the larynx , the researchers said. Given how common this virus is among children, this newly recognised potential complication should be considered in any child presenting with a breathing, talking or swallowing complaint after a recent Covid 19 diagnosis, said first author Danielle Reny Larrow, a resident in the Department of Otolaryngology Head and Neck Surgery at Massachusetts Eye and Ear.
This is especially important as such complaints could be easily attributed to more common diagnoses such as asthma, said Larrow. While at the hospital, the patient underwent a detailed battery of diagnostic tests, including blood work, imaging, cerebrospinal fluid analysis and consultations with otolaryngology medicine specialty dealing with diseases of ear, nose and throat , neurology, psychiatry, speech language pathology and neurosurgery, the researchers said. When speech therapy failed to relieve the patient s symptoms, the physicians performed a tracheostomy a surgically created opening in the windpipe to relieve the patient s breathing difficulties. They reported that she remained tracheostomy dependent for more than 13 months after initial treatment, suggesting that this type of nerve complication may not be temporary. They said were able to remove it fifteen months after insertion following a case report submission. Describing it as highly unusual , the team said that this was the first report of an adolescent experiencing post viral neuropathy, which is known to cause vocal cord paralysis, even as several adults have reported this complication as a result of Covid 19 infection. The fact that kids can actually have long term neurotrophic effects from Covid 19 is something that it s important for the broader pediatric community to be aware of in order to be able to treat our kids well, said senior author Christopher Hartnick, director of the Division of Pediatric Otolaryngology and Pediatric Airway, Voice, and Swallowing Center at Massachusetts Eye and Ear.
New Covid variant JN.1, that has been causing a spike in cases in US since September this year, has now been detected in India. Found in Kerala during a routine surveillance, the variant is currently under close monitoring. According to an Indian Express report, around 15 cases of the JN.1 variant have been found in samples from Goa. A descendant of BA.2.86 variant, JN.1 has a single mutation in the spike protein compared to Pirola. Union health ministry in India has urged states to step up Covid surveillance to prevent spread. Considering the spread of variant, it may either be more transmissible or better at evading our immune systems, experts feel. While it s not clear if JN.1 variant is a cause of worry yet, India, has witnessed a spike in infection numbers and around 252 new infections were reported across the country in the week ended December 17, according to HT s Covid 19 dashboard. It s a huge jump from 125 a week ago, and 59 a week before that. The emergence of Covid s JN.1 variant has heightened global concern. This virus is a subvariant of BA.2.86 and was initially detected in Kerala, India, emphasizing the need for vigilance.
Kerala s case was diagnosed through genome sequencing, with no reported hospitalizations or severe illnesses thus far, alleviating immediate worry. The situation is under close monitoring, says Dr RR Dutta, HOD Internal Medicine, Paras Health, Gurugram. The Covid 19 pandemic has entered its fourth calendar year, and the virus continues to circulate in the form of newer variants of concern that demand vigilant surveillance. The latest iteration causing growing worry across parts of India is the JN.1 variant which descends from the Omicron XBB subvariant. While the current JN.1 variant may seem to cause only minor symptoms like runny noses, sore throats, and dry coughs, we must not underestimate its potential threat. It is essential to stay informed about the situation and be alert to key warning signs, says Dr Nikhil Modi, Senior Consultant, Respiratory and Critical Care Medicine, Indraprastha Apollo Hospitals.
