• Jeffrey C Mecham, Olivia J Thomas, Phillip Pirgousis, and Jeffrey R Janus.
• Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, U.S.A.
• Laryngoscope. 2020 Nov 1; 130 (11): 2546-2549.

IntroductionPatients who become severely ill from coronavirus disease 2019 (COVID-19) have a high likelihood of needing prolonged intubation, making tracheostomy a likely consideration. The infectious nature of COVID-19 poses an additional risk of transmission to healthcare workers that should be taken into consideration.MethodsWe explore current literature and recommendations for tracheostomy in patients with COVID-19 and look back at previous data from severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), the virus responsible for the SARS outbreak of 2003.ResultsGiven the severity and clinical uncertainty of patients with COVID-19 and the increased risk of transmission to clinicians, careful consideration should be taken prior to performing tracheostomy. If tracheostomy is performed, we recommend a bedside approach to limit exposure time and number of exposed personnel. Bronchoscopy use with a percutaneous approach should be limited in order to decrease viral exposure.ConclusionThorough preprocedural planning, use of experienced personnel, enhanced personal protective equipment where available, and a thoughtful anesthesia approach are instrumental in maximizing positive patient outcomes while successfully protecting the safety of healthcare personnel. Laryngoscope, 130:2546-2549, 2020.© 2020 The American Laryngological, Rhinological and Otological Society, Inc.

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