Dysphagia Prevalence and Outcomes Associated with the Evolution of COVID-19 and Its Variants in Critically Ill Patients.
Nicola A Clayton, Amy Freeman-Sanderson, Elizabeth Walker
PMID 37347254WHAT IT FOUND
In critically ill COVID-19 patients referred to speech pathology, 94% had dysphagia at initial assessment.
Most recovered by discharge, but 29% still had swallowing problems. Longer time on a ventilator or tracheostomy was linked to slower recovery.
Key findings
01Dysphagia was present in 94% of patients at their first speech pathology assessment, with profound swallowing impairment (nothing by mouth) in 45%.
02While 71% recovered swallowing function by hospital discharge, 29% had persistent dysphagia at that point.
03The time it took to start eating orally and to recover swallowing function was strongly associated with how long the patient was intubated, had a tracheostomy, or was in the ICU.
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 study was pragmatic and only included patients referred to SLP, meaning the true prevalence of dysphagia in all ICU patients may be different (likely higher, as not everyone was screened). Instrumental assessments (VFSS/FEES) were performed in only a small fraction of patients, limiting detailed physiological data on swallowing impairment. Dysphagia rehabilitation was provided to only 24% of patients, and the specific impact of different therapeutic strategies on recovery cannot be determined from this observational design. The study compares outcomes across different pandemic waves (Alpha vs Delta/Omicron), but the small comparison cohort (n=27) limits the strength of conclusions about variant-specific differences.
Declared interests
The study was funded by the University of Sydney. No specific commercial conflicts of interest are declared in the text provided.
The easy way to misread this
Do not assume that the high recovery rate (71%) means most patients leave the hospital with normal swallowing. Nearly one-third (29%) still had dysphagia at discharge. Also, because only patients referred to SLP were included, these results do not represent all ICU patients, and the actual prevalence of swallowing problems in the broader population may be different.