The Effect of COVID-19 on Voice Quality:A Systematic ReviewOA

Objectives:To determine the effect of COVID-19 on voice by evaluating acoustic,aerodynamic,auditory-perceptual,and patient-reported measurements for COVID-19 patients compared to controls.Data Sources:A systematic review was conducted using PubMed and Embase.Review Methods:Studies were reviewed for acoustic,aerodynamic,auditory-perceptual,and patient-reported outcomes.Results:Seven studies met criteria.There were 790 patients diagnosed with COVID-19 and 484 controls.Acoustic measurements revealed that COVID-19 patients had an increased harmonic-to-noise ratio(HNR)(27.14 vs.41.37 dB),and increased fundamental frequency(177.66 vs.172.81 Hz),jitter(0.73 vs.0.31),and shimmer(4.43 vs.3.42).Auditory-perceptual measurements indicated that COVID-19 patients had an increased Consensus Auditory-Perceptual Evaluation of Voice(CAPE-V)score(11.46 vs.2.15).COVID-19 patients also had an increased Voice Handicap Index(VHI-10)score(4.89 vs.1.59).Finally,COVID-19 patients had a statistically significant decrease in maximum phonation time compared to controls(9.94 s vs.16.32 s,p=0.01).Conclusions:Although maximum phonation time was the only statistically significant measurement,other measurements were worse for COVID-19 patients.The current research suggests negative effects of COVID-19 on the voice;however,this is the first systematic review to summarize its effects with measurable outcomes.More studies with vocal measurements taken at different time points following infection are needed to understand the full long-term effect of COVID-19 on the voice.Additionally,studies evaluating voice quality for mild cases of COVID-19 with comparison to healthy controls are needed to understand its prevalence and effect as the severity of COVID-19 decreases.