Lindh MG, Mattsson G, Koyi H, Johansson MB, Razmi R, Palm A
Arch Rehabil Res Clin Transl - (-) 100177 [2022-01-11; online 2022-01-11]
To explore swallowing function and risk factors associated with delayed recovery of swallowing in COVID-19 patients post invasive mechanical ventilation using the Functional Oral Intake Scale (FOIS). Longitudinal cohort study. 3 secondary-level hospitals. Invasively ventilated patients (n=28), hospitalized with severe COVID-19 who were referred to the Speech and Language Pathology (SLP) departments post mechanical ventilation between March 5 and July 5 2020 for an evaluation of swallowing function before commencing oral diet. SLP assessment, advice and therapy for dysphagia. Oral intake levels at baseline and hospital discharge according to the Functional Oral Intake Scale (FOIS). Patients were stratified according to FOIS (1-5=dysphagia, 6-7= functional oral intake). Data regarding comorbidities, frailty, intubation and tracheostomy, proning and SLP evaluation were collected. Dysphagia was found in 71% of the patients at baseline (in total 79% male, age 61 ±12 years, BMI 30 ±8 kg/m2). Median FOIS score at baseline was 2 (IQR 1) vs 5 (IQR 2.5) at hospital discharge. Patients with dysphagia were older (64 ±8.5 vs 53 ±16 years; p= 0.019), had a higher incidence of hypertension (70% vs 12%; p=0.006) were ventilated invasively longer (16 ±7 vs 10 ±2 days; p=0.017) or with tracheostomy (9 ±9 vs 1 ±2 days; p=0.03) longer. A negative association was found between swallowing dysfunction at bedside and days hospitalized (r=-0.471, p=0.01), and number of days at the Intensive Care Unit (ICU) (r=-0.48, p=0.01). Dysphagia is prevalent in COVID-19 patients post invasive mechanical ventilation and is associated with number of days in hospital and number of days in the ICU. Swallowing function and tolerance of oral diet improved at discharge (p<0.001).