80% of patients with covid-19 recover from the disease without requiring hospital treatment, according to the World Health Organization (WHO). However, one in six can develop serious illness with shortness of breath (dyspnea) and loss of voice quality (dysphonia).
According to the Spanish Society of Otolaryngology and Head and Neck Surgery (SEORL), cases in which the disease is more likely to become more complicated occur both in the elderly and in those with certain conditions. Among them, respiratory diseases, immunosuppression, high blood pressure, heart problems or diabetes.
Any respiratory consequences will have effects on the voice. Even protective measures to avoid contagion (using a mask or maintaining interpersonal distance, among others) considerably affect its management, both socially and professionally.
How is Covid-19 spread?
While speaking, respiratory particles are expelled at high speed, even reaching 160 kilometers per hour. They can reach 12 meters away.
During singing, for example, up to 1000 microscopic drops can be thrown. Many of them will stay suspended in the air for up to 8 minutes. In addition, the saliva that accompanies the air in coughing or sneezing can cover an area of about 7 square meters.
Therefore, protecting the oral cavity with a mask and interpersonal distance in any interaction is crucial to contain the spread of the disease.
The British Voice Association has issued special recommendations for choirs as they are a notable source of contagion.
How does covid-19 affect the voice?
General symptoms caused by COVID-19 and described so far, although these vary from patient to patient, include severe (dyspnea, fever and lung damage) or mild (nausea, vomiting, dry cough, fatigue) symptoms. , laryngeal irritation, congestion, headache, or loss of taste or smell).
At the onset of contagion, acute phase or recovery, even for months, a person may have limited breathing capacity. The quality of the voice will also be affected, producing dysphonia.
The symptoms described show loss of voice quality, respiratory fatigue, odynophagia (pain when speaking), a feeling of pressure in the chest or fatigue with the slightest movement. Also hoarseness or dull, choppy, “harsh” or dry voice; laryngeal and chest pain; feeling of stiff throat; pain in the neck or decrease in tone scale.
Why does the virus affect voice quality?
Voice is the expressed air produced by the vocal apparatus and amplified in resonators.
The larynx is made up of cartilage, muscles, and mucous membranes located at the top of the trachea and at the base of the tongue. Sound is created when the vocal cords vibrate from the exhaled air flowing through them. Therefore, without air there is no voice.
If the breathing capacity is affected, the same will happen with the quality of the voice.
Dysphonia is an alteration of the voice in one of its qualities, mainly in the timbre, which allows us to differentiate two sounds.
When you have covid-19, you are likely to experience prolonged and excessive coughing fits. It closely joins the vocal cords to allow a strong expulsion of air. Thus, it removes all mucus from the lungs and throat.
A continuous cough can make the vocal cords swollen, stiff, and less flexible. In this sense, the quality of the voice changes, often turning into a harsher and deeper sound. Maybe no more than an awkward whisper.
Speech therapy intervention in post-covid voice 19
Speech therapy intervention for people with or recovered from covid will be based on the type of symptoms and limitations the person has developed. Also in the strengths it presents.
If the symptoms are mild, the parameters are recovered with rehabilitation and breathing practice.
If, on the contrary, they are severe and the person required intubation, the secondary damage is greater. Their quality of life and their voice are deeply compromised.
In addition, it is important to learn to manage the voice in certain situations. For example, when using a mask, which causes difficulty in breathing, articulating and resonating. Social distancing also influences, which requires adjusting the volume of the voice.
Speech therapy is the scientific discipline in charge of the study, prevention, evaluation and treatment of voice and communication. But not only that, it also takes into account hearing, language, and non-verbal oral functions (breathing, chewing, sucking and swallowing).
In these times of crisis, it is even more necessary to trust the discipline and its specialists, avoiding any professional intrusion.
The Spanish Association of Speech-Language Pathology, Phoniatrics and Audiology (AELFA-IF) offers access to scientific support.
* This article was published on The Conversation and reproduced here under the Creative Commons license. Click here to read the original version.
* Lidia Rodríguez García is professor and researcher in speech therapy / President of AELFA-IF., University of Castilla-La Mancha