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COVID-19 Long Haulers: Persistent Shortness of Breath Due to Treatable Nerve Injury
By Jonathan Aviv M.D. & Suiana Chandrasekhar M.D.
A treatable, virus-related vagus nerve injury may be the cause of persistent shortness of breath in some COVID-19 long haulers.
Persistent shortness of breath in COVID-19 long haulers may be due to a treatable nerve injury. This is a reminder that shortness of breath is not always pulmonary.
Sandy’s story
Sandy is a 42-year-old previously healthy woman who presented with a four-month history of an inability to have conversations or do Zoom meetings without feeling out of breath.
Her chest X-ray (CXR) and chest computerized tomography (CT) scan were normal. However, she had an unusual abnormality on her spirometry lung breathing test with flattening of the inspiratory curve.
She had clinical symptoms of mild COVID-19 disease in March 2020. However, she was not tested due to lack of access.
An ear, nose, and throat (ENT) examination of her larynx (voice box) in July 2020 showed abnormal closing of her vocal cords during quiet breathing. This is a time when they should have been open. This was identified as a paradoxical vocal fold movement disorder.
