Study Investigates Difficulty Swallowing In Critically Ill C
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An analysis was conducted in order to determine the swallowing problems of COVID-19 patients who had tracheostomy or mechanical ventilation. These patients had a higher incidence of swelling disorders, but they also recovered quickly and completely.

The researchers conducted a retrospective study of hospitalized patients admitted between March and April 2020. The patients were evaluated by speech and language therapists using the Gugging Swallowing Screen (GUSS). The test has a scoring system that categorizes swallowing disorders based on severity, with scores ranging from 0 for severe dysphagia to 20 for no dysphagia.

The assessment was performed once every week for four weeks, both in the intensive care unit and when the patients were transferred out. Of the 31 patients evaluated in the study, 25 underwent invasive mechanical ventilation and 19 underwent tracheostomy. Patients received mechanical ventilation for a median 11 days.

The team found no correlation between the GUSS scores and ventilation duration, tracheostomy, and length of stay in the intensive care unit in the first assessment conducted on day 0. Similarly, there was no correlation between the scores and demographics or other underlying conditions.

A week after the first assessment, the GUSS scores of all the patients improved. About 6% had severe dysphagia and about 74% had no dysphagia. As assessment continued for the next three weeks, the prevalence of severe dysphagia reduced to 0% and dysphagia decreased as the weeks passed, with almost 97% having no dysphagia after 28 days. By day 16, 90% of the patients had completely recovered from swallowing disorders. However, after hospital discharge, seven patients still had mild dysphagia.

~ Fast recovery

The results show that about half the patients had swallowing disorders at the first evaluation. In patients undergoing ventilation for more than 10 days, the prevalence of dysphagia was higher, about 95%. This suggests there is a high occurrence of dysphagia in COVID-19 patients even at an early stage. This could be because of the intense inflammatory response to the virus leading to general muscle impairment, including the throat muscles.

This is also supported by the correlation between disease severity and degree of dysphagia assessed the first time. Patient age was the only factor that acted as a predictor for a faster and higher loss of muscle activity.

Source:
https://www.medrxiv.org/content/10.1101/2021.06.20.21258947v1
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