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. 2022 Jan;279(1):507-513.
doi: 10.1007/s00405-021-07062-3. Epub 2021 Sep 1.

Dysphagia in non-intubated patients affected by COVID-19 infection

Gianluigi Mariano Grilli  1 , Rossana Giancaspro  2 , Anna Del Colle  3 , Carla Maria Irene Quarato  3 , Donato Lacedonia  3 , Maria Pia Foschino Barbaro  3 , Michele Cassano  1
Affiliations

Dysphagia in non-intubated patients affected by COVID-19 infection

Gianluigi Mariano Grilli et al. Eur Arch Otorhinolaryngol. 2022 Jan.

Abstract

Purpose: Patients affected by COVID-19 are assumed to be at high risk of developing swallowing disorders. However, to our best knowledge, data on the characteristics and incidence of dysphagia associated with COVID-19 are lacking, especially in non-intubated patients. Therefore, we investigated the onset of swallowing disorders in patients with laboratory-confirmed COVID-19 infection who have not been treated with invasive ventilation, in order to evaluate how the virus affected swallowing function regardless of orotracheal intubation.

Methods: We evaluated 41 patients admitted to the COVID department of our Hospital when they had already passed the acute phase of the disease and were therefore asymptomatic but still positive for SARS-CoV-2 RNA by RT-PCR. We examined patients' clinical history and performed the Volume-Viscosity Swallow Test (VVST). Each patient also answered the Swallowing Disturbance Questionnaire (SDQ). After 6 months, we performed a follow-up in patients with swallowing disorders.

Results: Eight of 41 patients (20%) presented with dysphagia symptoms during hospitalization and 2 of them (25%) still presented a SDQ high score and swallowing disorders with liquid consistency after 6 months.

Conclusion: Non-intubated patients can experience various grades of swallowing impairment that probably directly related to pulmonary respiratory function alterations and viral direct neuronal lesive activity. Although these symptoms show natural tendency to spontaneous resolution, their impact on a general physical impaired situation should not be underestimated, since it can adversely affect patients' recovery from COVID-19 worsening health outcomes.

Keywords: COVID-19; DSQ; Deglutition; Deglutition disorders; Dysphagia; SARS-CoV-2; Swallowing; VVST.

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Conflict of interest statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Swallowing disturbances questionnaire
Fig. 2
Fig. 2
Volume-viscosity swallow test algorithm
Fig. 3
Fig. 3
Positive patients for swallowing disorders on the VVST for three different viscosity (liquid, nectar and pudding) at T0
Fig. 4
Fig. 4
VVST at 6 months follow-up (T1) for positive patients for swallowing disorders at T0
Fig. 5
Fig. 5
Comparison between the age of positive and negative patients. Positive patients are statistically significantly younger than negative ones (p < 0.001)
Fig. 6
Fig. 6
Incidence of chronic respiratory disease in positive and negative group of patients. Patients who were detected as positive for swallowing disorders have more previous chronic respiratory diseases than the negative ones (p < 0.003)
See this image and copyright information in PMC

Comment in

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