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. 2021 Sep:69:102837.
doi: 10.1016/j.amsu.2021.102837. Epub 2021 Sep 8.

Dysphagic disorder in a cohort of COVID-19 patients: Evaluation and evolution

Samuele Ceruti  1 , Andrea Glotta  1 , Anna Galli  2 , Maira Biggiogero  3 , Giovanni Bona  3 , Romano Mauri  1 , Andrea Saporito  4   5 , Xavier Capdevila  6
Affiliations

Dysphagic disorder in a cohort of COVID-19 patients: Evaluation and evolution

Samuele Ceruti et al. Ann Med Surg (Lond). 2021 Sep.

Abstract

Background: COVID-19 is a multisystem disease complicated by respiratory failure requiring sustanined mechanical ventilation (MV). Prolongued oro-tracheal intubation is associated to an increased risk of dysphagia and bronchial aspiration. Purpose of this study was to investigate swallowing disorders in critically ill COVID-19 patients.

Material and methods: This was a retrospective study analysing a consecutive cohort of COVID-19 patients admitted to the Intensive Care Unit (ICU) of our hospital. Data concerning dysphagia were collected according to the Gugging Swallowing Screen (GUSS) and related to demographic characteristics, clinical data, ICU Length-Of-Stay (LOS) and MV parameters.

Results: From March 2 to April 30, 2020, 31 consecutive critically ill COVID-19 patients admitted to ICU were evaluated by speech and language therapists (SLT). Twenty-five of them were on MV (61% through endotracheal tube and 19% through tracheostomy); median MV length was 11 days. Seventeen (54.8%) patients presented dysphagia; a correlation was found between first GUSS severity stratification and MV days (p < 0.001), ICU LOS (p < 0.001), age (p = 0.03) and tracheostomy (p = 0.042). No other correlations were found. At 16 days, 90% of patients had fully recovered; a significant improvement was registered especially during the first week (p < 0.001).

Conclusion: Compared to non-COVID-19 patiens, a higher rate of dysphagia was reported in COVID-19 patients, with a more rapid and complete recovery. A systematic early SLT evaluation of COVID-19 patients on MV may thus be useful to prevent dysphagia-related complications.

Keywords: Deglutition disorders; Dysphagia; Intensive care units; Mechanical ventilation; Tracheostomy.

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Conflict of interest statement

The authors declare that they have no conflict of interest for this article.

Figures

Fig. 1
Fig. 1
SLT evaluation and MV days. Linear regression between first SLT evaluation (day 0) and of MV days (r2 = 0.616).
Fig. 2
Fig. 2
Temporal evolution of dysphagia. According to GUSS value, temporal evolution of dysphagia was stratified into four semi-quantitative groups at different evaluation timepoints. GUSS evolution between day 0 and 7 and between day 7 and 14 were statistically significant (p < 0.0001 and p = 0.01 respectively).
Fig. 3
Fig. 3
Improvement of swallowing disorder. Improvement in patients swallowing disorder (GUSS = 20, no dysphagia) from first SLT evaluation at day 0 up to day 31 of follow up.
See this image and copyright information in PMC

References

    1. Hopkins University and Medicine John. John Hopkins Coronavirus Resour. Cent; 2020. COVID-19 Map - Johns Hopkins Coronavirus Resource Center.
    1. Ranieri V.M., Rubenfeld G.D., Thompson B.T., Ferguson N.D., Caldwell E., Fan E., Camporota L., Slutsky A.S. Acute respiratory distress syndrome: the Berlin definition. JAMA, J. Am. Med. Assoc. 2012;307:2526–2533. doi: 10.1001/jama.2012.5669. - DOI - PubMed
    1. Alhazzani W., Møller M.H., Arabi Y.M., Loeb M., Gong M.N., Fan E., Oczkowski S., Levy M.M., Derde L., Dzierba A., Du B., Aboodi M., Wunsch H., Cecconi M., Koh Y., Chertow D.S., Maitland K., Alshamsi F., Belley-Cote E., Greco M., Laundy M., Morgan J.S., Kesecioglu J., McGeer A., Mermel L., Mammen M.J., Alexander P.E., Arrington A., Centofanti J.E., Citerio G., Baw B., Memish Z.A., Hammond N., Hayden F.G., Evans L., Rhodes A. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19) Intensive Care Med. 2020;46:854–887. doi: 10.1007/s00134-020-06022-5. - DOI - PMC - PubMed
    1. McGrath B.A., Brenner M.J., Warrillow S.J., Pandian V., Arora A., Cameron T.S., Añon J.M., Hernández Martínez G., Truog R.D., Block S.D., Lui G.C.Y., McDonald C., Rassekh C.H., Atkins J., Qiang L., Vergez S., Dulguerov P., Zenk J., Antonelli M., Pelosi P., Walsh B.K., Ward E., Shang Y., Gasparini S., Donati A., Singer M., Openshaw P.J.M., Tolley N., Markel H., Feller-Kopman D.J. Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. Lancet Respir. Med. 2020;2600:1–8. doi: 10.1016/s2213-2600(20)30230-7. - DOI - PMC - PubMed
    1. Skoretz S.A., Anger N., Wellman L., Takai O., Empey A. Dysphagia; 2020. A systematic review of tracheostomy modifications and swallowing in adults. - DOI - PMC - PubMed