Considerations for speech and language therapy management of dysphagia in patients who are critically ill with COVID-19: a single centre case series. (2nd February 2022)

• Record Type: Journal Article
• Authors: Clunie, Gemma M; Bolton, Lee; Lovell, Lindsay; Bradley, Elizabeth; Bond, Cara; Bennington, Sarah; Roe, Justin
• Is Part Of: International journal of therapy and rehabilitation. Volume 29:Number 2(2022)
• Page Start: 1
• Page End: 13
• Publication Date: 2022-02-02
• Subjects: COVID-19 -- Deglutition -- Deglutition disorders -- Dysphagia -- Tracheostomy; Therapeutics -- Periodicals; Medical rehabilitation -- Periodicals; 615.505
• DOI: 10.12968/ijtr.2021.0078
• Languages: English
• ISSNs: 1741-1645

Abstract

Abstract : Background/Aims: Patients treated with intubation and tracheostomy for COVID-19 infection are at risk of increased incidence of laryngeal injury, dysphagia and dysphonia. Because of the novelty of the SARS-CoV-2 virus, little is known about the type of dysphagia patients experience as a result of infection and critical illness. The aim of this case series report was to progress understanding of COVID-19 and dysphagia following admission to an intensive care unit and to guide speech and language therapy clinical practice in the ongoing pandemic. Methods: A retrospective case review was conducted of all patients at Imperial College Healthcare NHS Trust, London who underwent a tracheostomy because of COVID-19 and received an instrumental assessment of swallowing in the early stages of the pandemic. Results: A total of 11 patients were identified, and descriptive statistics were used to present demographic data, with a narrative account of their dysphagia profile used to describe presentation. Causes and presentation of dysphagia were heterogenous, with each patient requiring individualised clinical management to maximise outcome. A positive trend was seen in terms of recovery trajectory and progressing to oral intake. Conclusions: This study reports on early experience of the presentation of dysphagia in patients with COVID-19 and demonstrates the value of instrumental assessment. It indicates the need for further research to consolidate knowledge and guide clinical practice.