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. 2021 Jan 22;3(1):e0332.
doi: 10.1097/CCE.0000000000000332. eCollection 2021 Jan.

Dysphagia in Patients With Severe Coronavirus Disease 2019-Potential Neurologic Etiologies

Rainer Dziewas  1 , Lisa-Marie Hufelschulte  1 , Johannes Lepper  2 , Jan Sackarnd  2 , Jens Minnerup  1 , Inga Teismann  3 , Sigrid Ahring  1 , Inga Claus  1 , Bendix Labeit  1 , Paul Muhle  1 , Sonja Suntrup-Krüger  1 , Tobias Warnecke  1 , Jan-Sören Padberg  2
Affiliations

Dysphagia in Patients With Severe Coronavirus Disease 2019-Potential Neurologic Etiologies

Rainer Dziewas et al. Crit Care Explor. .

Abstract

Importance: Dysphagia is a common complication of critical illness, and many known risk factors are also present in critically ill coronavirus disease 2019 victims.

Objectives: To investigate dysphagia in patients with severe coronavirus disease 2019.

Design setting and participants: In this case series, we report results of dedicated evaluation of swallowing function in six consecutive, tracheotomized coronavirus disease 2019 patients after they had survived acute respiratory distress syndrome and were weaned from the respirator.

Main outcomes and measures: Dysphagia was assessed with flexible endoscopic evaluation of swallowing.

Results: Three patients suffered from severe dysphagia and airway compromise precluding decannulation, whereas in the other, three swallowing was less critically impaired, and the tracheal cannula could be removed. Four patients presented with additional laryngeal dysfunctions not typically seen in acute respiratory distress syndrome survivors.

Conclusion and relevance: Dysphagia with impaired airway protection is a key feature in coronavirus disease 2019 acute respiratory distress syndrome survivors. Apart from critical illness polyneuropathy, coronavirus disease 2019-related involvement of the peripheral and central nervous system may contribute to swallowing impairment and laryngeal dysfunction.

Keywords: acute respiratory distress syndrome; coronavirus disease 2019; dysphagia; flexible endoscopic evaluation of swallowing; tracheostomy.

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Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

References

    1. Johns Hopkins University & Medicine: COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU), 2020. Available at: https://coronavirus.jhu.edu/map.html. Accessed July 30, 2020
    1. Pascarella G, Strumia A, Piliego C, et al. COVID-19 diagnosis and management: A comprehensive review. J Intern Med. 2020; 288:192–206 - PMC - PubMed
    1. Schefold JC, Berger D, Zürcher P, et al. Dysphagia in mechanically ventilated ICU patients (DYnAMICS): A prospective observational trial. Crit Care Med. 2017; 45:2061–2069 - PubMed
    1. Brodsky MB, Huang M, Shanholtz C, et al. Recovery from dysphagia symptoms after oral endotracheal intubation in acute respiratory distress syndrome survivors. A 5-year longitudinal study. Ann Am Thorac Soc. 2017; 14:376–383 - PMC - PubMed
    1. Zuercher P, Schenk NV, Moret C, et al. Risk factors for dysphagia in ICU patients after invasive mechanical ventilation. Chest. 2020; 158:1983–1991 - PubMed