Factors associated with oropharyngeal dysphagia in individuals with cardiovascular disease and COVID-19.
Tatiana Magalhães de Almeida, Raquel Gama Fernandes, Vitor Della Rovere Binhardi and 3 others
PMID 39166598WHAT IT FOUND
51.4% of hospitalized adults with cardiovascular disease and COVID-19 had swallowing impairment.
Older age and prone positioning stayed linked to it after accounting for other factors. Oxygen support and ICU care were less certain.
Key findings
0137 of the 72 evaluated patients had some degree of oropharyngeal dysphagia, with 22 mild, 12 moderate, and 3 severe.
02Age and prone position were independently associated with oropharyngeal dysphagia, with adjusted odds ratios of 1.07 and 8.91.
03Oxygen support and ICU admission were associated with dysphagia in the univariate analysis, but adjusted p-values were 0.145 and 0.175.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was retrospective and done at one public referral cardiology hospital, so its patients may not represent all people with cardiovascular disease and COVID-19. Only patients referred for speech-language therapy were evaluated, so the dysphagia rate applies to that referred group, not to every hospitalized patient. Stroke and general complications were removed from the logistic model because all patients with dysphagia had a general complication and all patients with stroke had dysphagia, so their independent effects could not be tested. Swallowing was assessed by clinical protocol only, and the authors state that further studies with instrumental swallowing exams are needed. The tracheostomy group had only 7 patients, so the study cannot show much about tracheostomy. Prone positioning was linked to severe respiratory care and intubation, so it may mark sicker patients rather than directly cause dysphagia. The mortality result was reported as p=0.051, and the study set its significance level at 0.05.
Declared interests
No financial support was declared.
The easy way to misread this
Do not conclude that prone positioning caused dysphagia. The study is retrospective, and prone positioning was linked to severe respiratory care and intubation, so it may mark sicker patients rather than directly harm swallowing.