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Background: SARS-CoV-2 infection has many manifestations, including otolaryngological symptoms. Case presentation: A 60-year-old man with severe dyspnea underwent endotracheal intubation followed by 68 h of mechanical ventilation. After extubation, he left the ICU without any significant complications. Four days after the extubation, he developed dyspnea, which deteriorated the next 2 days, and stridor became evident. A fiberoptic laryngoscope revealed bilateral vocal cord edema and paralysis, which required an emergency airway. We decided to perform an awake tracheostomy under local anesthesia while considering protection for airborne infection to healthcare providers. The tracheostomy was closed when the edema and paralysis of the vocal cords were ameliorated. Conclusions: A COVID-19 patient who underwent injurious ventilation developed vocal cord paralysis and edema 6 days after extubation, leading to an emergency tracheostomy. Close attention to the upper airway of COVID-19 patients is essential since the pathophysiology of the present incident may be specific to the viral infection. [ABSTRACT FROM AUTHOR]

Background: Post‐extubation dysphagia reportedly occurs in 3%–60% of patients and is independently associated with poor patient outcomes. Aim: The aim of this study was to investigate the frequency of post‐extubation dysphagia, as diagnosed using our novel nurse‐performed swallowing screening protocol, and to evaluate patient outcomes, including the frequency of discharge home, the length of the intensive care unit and hospital stays, the frequency of hospital‐acquired pneumonia and death in the intensive care unit and hospital. Design This was a prospective cohort study. Methods: This study was conducted in a mixed intensive care unit in a critical care hospital in Japan. Between October 2016 and September 2017, the swallowing functions of 216 patients were assessed using our novel screening protocol. To investigate the correlation between dysphagia and patient outcomes, we compared a dysphagia group with a no dysphagia group. Results: Twenty‐five patients (11·6%) were diagnosed with dysphagia. The frequency of discharge home, which was the primary outcome, was significantly lower in the patients with dysphagia (60% versus 87·4%, P = 0·002). Dysphagia was also correlated with longer hospital stay and higher mortality. A binomial logistic regression analysis, including the variables of dysphagia, Acute Physiology and Chronic Health Evaluation II score and duration of ventilator use, showed that dysphagia was an independent risk factor for a lower incidence of discharge home. Conclusion: Among patients admitted to a mixed intensive care unit, post‐extubation dysphagia was correlated with a poor prognosis. Relevance to clinical practice: The current study emphasizes the poor prognosis of patients with dysphagia after extubation. Dysphagia developed in more than 1 in 10 patients post‐extubation; therefore, monitoring for a swallowing disorder is crucial in daily nursing in the intensive care unit. [ABSTRACT FROM AUTHOR]