Swallowing Function in COVID-19 Patients After Invasive Mechanical Ventilation

Lindh, Margareta Gonzalez; Mattsson, Gustav; Koyi, Hirsh; Johansson, Monica; Razmi, Robin; Palm, Andreas

doi:10.1016/j.arrct.2021.100177

Cited by 16 publications

(25 citation statements)

References 22 publications

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“…As to the dysphagia assessment method, 2 studies 29,31 majorly adopted instrumental tools assisted with noninstrumental tools for diagnosis; 2 studies 25,26 used noninstrumental tools for primary evaluations in combination with instrumental tools; and 5 studies 24,27,28,30,32 only took nontools as the only mean for dysphagia assessment. The mean duration from extubation to dysphagia assessment ranged from 1 to 4 days 24,26,27,30,32 …”

Section: Resultsmentioning

confidence: 99%

“…Among these identified articles, 418 of them were screened following the removal of duplicates, yielding 67 studies for eligibility evaluation. Eventually, a total of 10 studies [23][24][25][26][27][28][29][30][31][32] were included in the meta-analysis after the exclusion of ineligible articles (Figure 1).…”

Section: Literature Selectionmentioning

confidence: 99%

“…The mean duration from extubation to dysphagia assessment ranged from 1 to 4 days. 24,26,27,30,32 Risk of Bias Assessment and Quality of Evidence…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…Therefore, this may in turn generate insignificant results in patients with COVID-19. 31,32 (Reference group: ≦65 years 27,29,30 ) 0.555 (−0.794, 1.903) 0.688 .420 Major dysphagia assessment method Noninstrumental tool [24][25][26][27][28]30,32 (Reference group: Instrumental tool 29,31 ) −0.255 (−2.130, 1.621) 0.957 .790 Mean intubation duration (days) 23,27,28,30,31 −0.101 (−0.659, 0.457) 0.285 .723 Mean duration from extubation to dysphagia assessment (days) 24,26,27,30,32 0.632 (−0.355, 1.619) 0.504 .210 Tracheostomy (%) [23][24][25][26][27][28][29][30][31] 1.288 (−2.529, 5.104) 1.947 .509…”

Section: The Impact Of Duration From Extubation To Dysphagia Assessmentmentioning

confidence: 99%

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Is Postextubation Dysphagia Underestimated in the Era of COVID‐19? A Systematic Review and Meta‐analysis

Lin

Chiang

Chen

et al. 2023

Otolaryngol.--head neck surg.

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Objective To investigate the incidence rate of postextubation dysphagia (PED) in patients with COVID‐19, as well as relative factors potentially influencing the clinical course of dysphagia. Data Sources Six databases including PubMed, MEDLINE, Embase, ScienceDirect, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched with no restriction on the language. Review Methods The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Data were extracted and cross‐examined among 3 of the authors. The random‐effects model was adopted for the statistical synthesis. The percentage and 95% confidence interval (CI) were adopted as the effect measurements of the PED incidence rate. Subgroup analyses, sensitivity analyses, and metaregression were also performed to identify the heterogeneity among the studies. Results A total of 594 patients were enrolled and analyzed from the 10 eligible studies. The weighted incidence of PED in patients with COVID‐19 was 66.5% (95% CI: 49.7%‐79.9%). Age was the potential factor influencing the incidence rate after heterogeneity was adjusted by the metaregression analysis. Conclusion Compared to the current evidence reporting only 41% of the non‐COVID patients experienced PED, our study further disclosed that a higher 66.5% of COVID‐19 patients suffered from PED, which deserves global physicians' attention. With the association between COVID‐19 and dysphagia having been more clearly understood, future clinicians are suggested to identify intubated patients' risk factors earlier to strengthen PED care programs in the era of COVID‐19.

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Section: Resultsmentioning

confidence: 99%

Section: Literature Selectionmentioning

confidence: 99%

“…The mean duration from extubation to dysphagia assessment ranged from 1 to 4 days. 24,26,27,30,32 Risk of Bias Assessment and Quality of Evidence…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

Section: The Impact Of Duration From Extubation To Dysphagia Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Is Postextubation Dysphagia Underestimated in the Era of COVID‐19? A Systematic Review and Meta‐analysis

Lin

Chiang

Chen

et al. 2023

Otolaryngol.--head neck surg.

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“…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.…”

Section: Pathophysiologymentioning

confidence: 99%

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

Miles

Brodsky

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewDysphagia and dysphonia are common presentations of both acute and long coronavirus disease 2019 (COVID-19). The majority of peer-reviewed publications in 2020 and early 2021 were expert guidance and consensus statements to support dysphagia management in multidisciplinary teams while protecting clinicians and patients from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. This review discusses dysphagia and dysphonia primary data published in 2021–2022, focusing on patient presentations, pathophysiology, and evidence for interventions.Recent findingsClinicians and researchers amassed knowledge of the cross-system presentation of dysphagia and dysphonia in patients with COVID-19, from severe disease requiring ICU stays to those with mild-to-moderate disease presenting to outpatient clinics. Pre-COVID-19 health status, hospitalization experience, presence of neurological symptoms, and impact of the virus to the upper aerodigestive and respiratory system need consideration in patient management. Long-term dysphagia and dysphonia manifested from COVID-19 require otolaryngologist and speech-language pathologist input.SummaryChanges in immunity through population vaccination and variations in COVID-19 from SARS-CoV-2 mutations means prevalence data are challenging to interpret. However, there is no doubt of the presence of long-term dysphagia and dysphonia in our clinics. Long-term dysphagia and dysphonia are complex and a multidisciplinary team with a tailored approach for each patient is required.

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Implications of COVID‐19 in Airway and Swallowing Function

Linquest,

Ackerman,

Dewan

2023

OTO Open

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ObjectiveThe acute treatment and complications of the novel COVID‐19 virus have been well studied, but the implications of this novel virus for swallowing function continue to be investigated. The goal of this study is to retrospectively assess airway and swallowing outcomes for those patients who required intensive care unit(ICU)‐level care for COVID‐19 infection.Study DesignComparison of swallowing outcomes through diet change in COVID‐19 patients in the Ochsner‐Louisiana State University (LSU) Hospital ICU.SettingOchsner‐LSU Hospital (Shreveport, Louisiana).MethodsA retrospective chart review was performed from March 2020 to May 2022 to identify patients with a primary diagnosis of COVID‐19. Variables analyzed include age, gender, length of intubation, length of ventilation, airway interventions, use of extracorporeal membrane oxygenation, and diet prior to, during, and after hospitalization for COVID‐19 infection.ResultsTwo hundred and seven patients fit the inclusion criteria. There was a significant difference in discharge diet between those patients who were intubated and those who were not (P = .007). Thirty percent of patients were discharged on a different diet than their baseline with patients on a nonregular diet significantly more likely to discharge to a facility (P = .043). Negative vaccine status was associated with prolonged ICU stay, prolonged duration of intubation, and prolonged duration of ventilation.ConclusionCOVID‐19 continues to present novel challenges with new implications and outcomes being discovered in the third year of the pandemic. Further research is necessary to determine the most effective treatment approaches with respect to optimized speech and swallow outcomes.

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Swallowing Function in COVID-19 Patients After Invasive Mechanical Ventilation

Cited by 16 publications

References 22 publications

Is Postextubation Dysphagia Underestimated in the Era of COVID‐19? A Systematic Review and Meta‐analysis

Is Postextubation Dysphagia Underestimated in the Era of COVID‐19? A Systematic Review and Meta‐analysis

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

Implications of COVID‐19 in Airway and Swallowing Function

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