Ceruti Samuele, Glotta Andrea, Galli Anna, Biggiogero Maira, Bona Giovanni, Mauri Romano, Saporito Andrea, Capdevila Xavier
Clinica Luganese Moncucco, Critical Care Department, Via Moncucco, 10 - 6900, Lugano, Switzerland.
Clinica Luganese Moncucco, Physiotherapy Service, Via Moncucco, 10 - 6900, Lugano, Switzerland.
Ann Med Surg (Lond). 2021 Sep;69:102837. doi: 10.1016/j.amsu.2021.102837. Epub 2021 Sep 8.
COVID-19 is a multisystem disease complicated by respiratory failure requiring sustanined mechanical ventilation (MV). Prolongued oro-tracheal intubation is associated to an increased risk of dysphagia and bronchial aspiration. Purpose of this study was to investigate swallowing disorders in critically ill COVID-19 patients.
This was a retrospective study analysing a consecutive cohort of COVID-19 patients admitted to the Intensive Care Unit (ICU) of our hospital. Data concerning dysphagia were collected according to the and related to demographic characteristics, clinical data, ICU Length-Of-Stay (LOS) and MV parameters.
From March 2 to April 30, 2020, 31 consecutive critically ill COVID-19 patients admitted to ICU were evaluated by speech and language therapists (SLT). Twenty-five of them were on MV (61% through endotracheal tube and 19% through tracheostomy); median MV length was 11 days. Seventeen (54.8%) patients presented dysphagia; a correlation was found between first GUSS severity stratification and MV days (p < 0.001), ICU LOS (p < 0.001), age (p = 0.03) and tracheostomy (p = 0.042). No other correlations were found. At 16 days, 90% of patients had fully recovered; a significant improvement was registered especially during the first week (p < 0.001).
Compared to non-COVID-19 patiens, a higher rate of dysphagia was reported in COVID-19 patients, with a more rapid and complete recovery. A systematic early SLT evaluation of COVID-19 patients on MV may thus be useful to prevent dysphagia-related complications.
新型冠状病毒肺炎（COVID-19）是一种多系统疾病，常并发呼吸衰竭，需要持续机械通气（MV）。长时间经口气管插管会增加吞咽困难和支气管误吸的风险。本研究旨在调查重症COVID-19患者的吞咽障碍情况。
这是一项回顾性研究，分析了我院重症监护病房（ICU）收治的连续一批COVID-19患者。根据相关标准收集吞咽困难的数据，并与人口统计学特征、临床数据、ICU住院时间（LOS）和MV参数相关联。
2020年3月2日至4月30日，31例连续入住ICU的重症COVID-19患者接受了言语和语言治疗师（SLT）的评估。其中25例接受MV（61%通过气管内插管，19%通过气管切开术）；MV的中位时长为11天。17例（54.8%）患者出现吞咽困难；首次GUSS严重程度分层与MV天数（p<0.001）、ICU住院时间（p<0.001）、年龄（p=0.03）和气管切开术（p=0.042）之间存在相关性。未发现其他相关性。在第16天时，90%的患者已完全康复；尤其是在第一周有显著改善（p<0.001）。
与非COVID-19患者相比，COVID-19患者吞咽困难的发生率更高，但恢复更快且更完全。因此，对接受MV的COVID-19患者进行系统的早期SLT评估可能有助于预防吞咽困难相关并发症。
