Dysphagia Is an Underrecognized Risk Factor for Viral Pneumonia Severity.
Michael S Pulia, Rachelle Herrin, Raele Donetha Robison and 5 others
PMID 38676776WHAT IT FOUND
In adults aged 50 years or older with symptomatic COVID-19, prior dysphagia was linked to more severe disease within 30 days (65.0% vs 41.3%).
The link remained when age, obesity, and other risk factors were taken into account.
Key findings
01Patients with prior dysphagia were more likely to develop severe COVID-19 disease than patients without prior dysphagia (65.0% vs 41.3%).
02After adjustment for age, obesity, cardiovascular disease, and pulmonary disease, pre-existing dysphagia was associated with severe COVID-19 (odds ratio 2.38, 95% CI 1.05-5.42; p=0.038).
03The detailed chart review included 126 patients without documented prior dysphagia and 40 patients with prior dysphagia, all aged 50 years or older.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study only included adults aged 50 years or older with symptomatic COVID-19, so it does not answer what happens in younger adults or people without symptoms. It used records from two emergency departments in one health care system, so the findings may not apply to other settings. Dysphagia was identified from chart review, and not all patients had formal speech-language pathology evaluations or instrumental swallowing studies. Some patients counted as not having dysphagia may have had undiagnosed swallowing problems. The dysphagia group had only 40 patients, and the adjusted model may have been overfit. Most documented dysphagia severity was mild or moderate, so the study could not directly test whether worse swallowing predicts worse disease. This was an observational association study, not a test of whether dysphagia caused severe disease or whether treatment would change outcomes.
Declared interests
The authors reported no conflicts of interest for any author.
The easy way to misread this
Do not conclude that treating dysphagia will reduce COVID-19 severity. This retrospective chart study found an association in older adults with symptomatic infection, but it did not test a swallowing intervention and cannot show that dysphagia caused severe disease.