Covid-19: Signs and symptoms related to the feeding behavior

Abstract

COVID-19 reached pandemic level in March 2020 and the number of confirmed cases continues to increase worldwide. The clinical course of the disease has not yet been fully characterized, and some specific symptoms related to smell, taste, and feeding behavior require further examination. The present study aimed to assess the presence of symptoms related to the feeding behavior occurred during and/or after COVID-19 in adults residing in Portugal and to link them to disease severity using a multivariate approach. Data were collected from May to September 2020, through a questionnaire answered online containing questions about general and specific symptoms before, during and after COVID-19. 362 participants were included: 201 were symptomatic, being 15 hospitalized and 186 non-hospitalized. Cluster analysis grouped the non-hospitalized participants as mild and severe cases. For these patients, the most frequent symptoms related to the feeding process were smell disorders in 40% and 62%, taste disorders in 37% and 60%, and dry mouth, in 23% and 48% of mild and severe cases, respectively. Dry mouth was significantly associated with difficulty to swallow, pain during swallow, choking when eating or drinking, and preference for mushy/pasty foods (p<0.01; Chi-squared test). Among the severe cases, the incidence of coughing during the meal (31%), difficulty (19%) and pain during swallow (17%), preference for mushy/pasty foods (10%) and choking when eating or drinking (6%) were clinically relevant and may indicate the presence of swallowing disorders. This group also showed a higher frequency of general symptoms, such as fever, headache, abdominal pain, tiredness, diarrhea, nausea, and shortness of breath (p<0.05; Chi-squared test). Smell disorders, taste disorders and dry mouth were the most frequent symptoms related to the feeding behavior for both mild and severe cases. Dry mouth was significantly associated with swallowing difficulties and future research should investigate it as a frequent symptom and as a predictive of the presence of eating and swallowing disorders in COVID-19 cases.

The effect of covid-19 infection on the oral manifestations

“…The location distribution of the oral manifestations of COVID-19, namely salivary glands, palate, gingiva, lips, oral mucosa, cheeks, oropharynx, tongue, sublingual area, submandibular area, jaw, temporomandibular joint, and oral cavity in general. [15][16][17][18][19][20][21][22][23][24][25][26][27]…”

“…16,17,20,21, 24 Xerostomia is generally accompanied by difficulty swallowing or pain when swallowing, 17,19 while taste disturbances are generally associated with lesions of the oral mucosa, pain in the oral cavity, and also xerostomia. 19,20,22,23 There is no significant relationship between age and sex to the oral manifestations that occur. 20,21 However, the incidence of oral/inflammatory lesions in the oral cavity accompanied by xerostomia is more common in men and pain in the jaw or temporomandibular joints, xerostomia, and taste disturbances are more common in women.…”