CHSJ

Curr Health Sci J, vol. 47, no. 2, 2021

Dysphagia Severity and Management in Patients with COVID-19

[Review]

A. PRINTZA(1), M. TEDLA(2,3), Z. FRAJKOVA(2,4), K. SAPALIDIS(5), S. TRIARIDIS(1)


(1)1st Otorhinolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece;
(2)Department of ENT and HNS, Faculty of Medicine, Comenius University, University Hospital Bratislava, Slovakia;
(3)Institute of Cancer and Genomic Sciences, University of Birmingham, UK;
(4)Department of Communication Disorders, Faculty of Education, Comenius University, Bratislava, Slovakia;
(5)3rdSurgery Department, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Greece


Abstract:

COVID-19 has resulted in unprecedented numbers of patients treated at intensive care units (ICUs). Dysphagia is a key concern in critical illness survivors. We investigated the severity of dysphagia in COVID-19 and the need to adapt practices to provide efficient care. We reviewed the literature on COVID-19, post-critical-illness dysphagia, and dysphagia and tracheostomy guidelines during the pandemic. Critically ill COVID-19 patients present a high incidence of dysphagia, aggravated by respiratory distress, deconditioning, and neurological complications. Mechanical ventilation (MV), delirium, sedation and weakness are worse in COVID-19 than in other etiologies of critical care. In awake patients, respiratory compromise impairs breathing-swallowing-coughing coordination. Tracheostomy reduces laryngopharyngeal trauma, sedation, delirium, ICU stay and improves swallowing rehabilitation. Tracheostomy weaning and swallowing evaluation is complex in COVID-19 due to respiratory instability and a team discussion will guide adaptations. Patients assessed in the ICU were 67% recommended to be nil by mouth (were aspirating). Two months following hospital discharge, 83% of those who had undergone tracheostomy were managing a normal diet. Severely ill COVID-19 patients are expected to regain swallow function. Dysphagia care is based on adaptation of practices to the patients’ multiple impairments.


Keywords: Dysphagia, COVID-19, Swallowing, Critically ill, Tracheostomy



Corresponding: Athanasia Printza: 1st Otorhinolaryngology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece, e-mail: aprintza@auth.gr


DOI 10.12865/CHSJ.47.02.01 - Download PDF
current issue cover Download cover
Download contents

Journal archive