Swallowing Evaluation in Post-COVID-19 Patients with Oropharyngeal Dysphagia.

Abstract

Oropharyngeal dysphagia (OD) is a prevalent issue in hospitalized COVID-19 patients. This study aimed to determine swallowing abnormalities in post-COVID-19 patients with OD and to determine the potential risk factors of aspiration in patients who have recovered from COVID-19. Screening for OD was done for 310 patients who were discharged from the main university isolation hospital during the study period. A longitudinal descriptive study was carried out on 127 adult post-COVID-19 patients between the ages of 24 and 65 years who failed OD screening at the time of discharge. Instrumental swallowing assessment was done using fiberoptic endoscopic evaluation of swallowing (FEES) at one of two different time points: one-week post-discharge (Group 1) and 3-4 weeks post-discharge (group 2). The prominent swallowing abnormalities were delayed triggering of swallowing reflex, laryngeal penetration, tracheal aspiration, as well as vallecular and pyriform sinuses residue with lower frequencies and milder degrees in group 2 than in group 1 patients. Statistically significant associations were found between the presence of ageusia and anosmia in post-COVID-19 patients and both impaired laryngeal sensation and delayed triggering of the swallowing reflex. Significant associations were detected between aspiration in post-COVID-19 patients and the following factors: higher Eating Assessment Tool (EAT-10) scores, presence of dysphonia, higher respiratory rate, and the longer duration of the use of noninvasive ventilation (NIV) and/or invasive mechanical ventilation (IMV). The combined higher EAT-10 scores and higher respiratory rate predicted aspiration in post-COVID-19 patients by an overall percentage of 87.1.