Position statement of the Latin American Dysphagia Society for the management of oropharyngeal and esophageal dysphagia during the COVID-19 pandemic

Abstract

Introduction The SARS-CoV-2 virus that causes the COVID-19 disease is transmitted through the inhalation of droplets or aerosols and inoculation via the oronasal or ocular routes, transforming the management of swallowing disorders into a challenge for healthcare teams, given their proximity to the aerodigestive tract and the high probability of aerosol generation during patient evaluation and treatment. Aim To provide essential guidance for Latin American multidisciplinary teams, regarding the evaluation and treatment of oropharyngeal and esophageal dysphagia, at the different levels of healthcare. The position statement was formulated for the purpose of maintaining medical service continuity, in the context of a pandemic, and minimizing the propagation and infection risks of the virus. Methods Thirteen experts in swallowing disorders were summoned by the Latin American Dysphagia Society to formulate a series of clinical suggestions, based on available evidence and clinical experience, for the management of dysphagia, taking the characteristics of Latin American healthcare systems into account. Results The position statement of the Latin American Dysphagia Society provides a series of clinical suggestions directed at the multidisciplinary teams that manage patients with oropharyngeal and esophageal dysphagia. It presents guidelines for evaluation and treatment in different contexts, from hospitalization to home care. Conclusions The present statement should be analyzed by each team or healthcare professional, to reduce the risk for COVID-19 infection and achieve the best therapeutic results, while at the same time, being mindful of the reality of each Latin American country.

Speech-Language Pathology Management for Adults with COVID-19 in the Acute Hospital Setting: What Do We Know?

“…Across all articles, the most commonly discussed topic was administration of endoscopic procedures (recommendation 2.10; [5, 15, 16, 20, 23, 25, 28, 30, 31, 33, 36, 38, 44, 47, 51-54, 57-59, 61-63]). Other commonly discussed topics included: performing point-of-care risk assessments to determine needs for videofluoroscopic swallowing studies (recommendation 2.9; [28,30,33,36,38,47,50,51,53,54,57,58,63]); the implementation of face-to-face procedures only when required (recommendation 2.1; [18,28,29,37,40,47,51,52,54,58,59,63]); being mindful of the length of close contact with patients with COVID-19 (recommendation 2.5; [25, 27-29, 36, 38, 40, 44, 45, 47, 48, 50, 51, 54, 58, 59, 61, 62]); and avoiding testing volitional cough and gag reflex (recommendation 2.6; [16,23,28,31,33,36,45,47,48,50,51,54,57,58,62]). Per Table 5, recommendations specifically supported by empirical ev...…”

“…Per Table 5, recommendations specifically supported by empirical evidence were recommendations 2.1, 2.3, 2.5, 2.6, 2.7, 2.8, 2.10 and 2.11. None of the articles included in this review discussed documenting modifications to clinical procedures (recommendation 2.13) and only two highlighted the differences in assessment of patients with COVID-19 in versus outside of the ICU (recommendation 2.4; [47,49]).…”

Current opinion of presentation of dysphagia and dysphonia in patients with coronavirus disease 2019

“…COVID-19-related dysphagia is associated with endotracheal intubation [ 6 , 35 , 36 ] and frequently results in impaired vocal fold movement [ 32 ]. Dysphonia from intubation is also frequent postextubation [ 37 ], even independent of COVID-19.…”

“…The majority of 2020 and early 2021 publications were consensus statements [1 ▪ ] and researcher- or international association-led expert guidance to support dysphagia multidisciplinary teams to manage patients while protecting against the virus. Nearly every publication described the impact of COVID-19 and resulting limitations on dysphagia and dysphonia practices [2–7,8 ▪▪ ,9,10,11 ▪ ].…”

Características deglutorias de pacientes COVID-19 con y sin intubación. Revisión sistemática exploratoria

“…Por otra parte, es importante comprender al hombre como un ser social, que sin lugar a duda transmite sus necesidades en cada uno de sus actos, siendo la alimentación un acto comunicativo por excelencia, que cumple un papel no solo nutritivo sino social y, por lo tanto, fundamental para las personas y primordial para el abordaje fonoaudiológico. Estudios como los realizados por (Manzano-Aquiahuatl et al 2022;Robba et al 2021;Sanzana Leiva y Parra Reyes 2020;Silva et al 2020), refieren la importancia del actuar del fonoaudiólogo frente a las complicaciones que a nivel comunicativo pueden tener los pacientes con COVID-19.…”