Dysphagia, dysphonia and olfactory disease: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition.
Claudio Cordani, Irene Battel, Matteo J Del Furia and 3 others
PMID 36534007WHAT IT FOUND
No Cochrane reviews exist for treating voice or smell loss in post-COVID.
For swallowing, one review of stroke patients suggests behavioral strategies and TMS may help, but evidence quality is low and does not directly prove these treatments work for post-COVID patients.
Key findings
01The search identified no Cochrane systematic reviews addressing rehabilitation for dysphonia or olfactory dysfunction.
02For dysphagia, evidence was limited to a single review of stroke patients, where behavioral interventions and TMS showed some positive effects on swallowing ability, but acupuncture and other stimulations had mixed or null results.
03The authors caution that this evidence is indirect and must be checked against post-COVID specific contraindications like post-exertional symptom exacerbation before application.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The evidence is indirect: the only dysphagia review focused on stroke patients, not post-COVID patients. No Cochrane reviews were found for dysphonia or olfactory dysfunction, leaving a complete gap in evidence for these symptoms. The quality of evidence for dysphagia interventions is generally low to very low, with many outcomes lacking data. The authors note that other high-quality systematic reviews outside the Cochrane Library were not included, potentially missing relevant evidence.
The easy way to misread this
Do not assume that treatments effective for stroke-related dysphagia are automatically safe or effective for post-COVID patients. The paper explicitly states this is indirect evidence and warns that post-exertional symptom exacerbation, a common feature of post-COVID, may be a contraindication for many of these rehabilitation therapies.