The University of Auckland, Auckland, New Zealand.
Department of Physical Medicine and Rehabilitation; Department of Medicine, Division of Pulmonary and Critical Care Medicine; Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland, USA.
Curr Opin Otolaryngol Head Neck Surg. 2022 Dec 1;30(6):393-399. doi: 10.1097/MOO.0000000000000836. Epub 2022 Aug 3.
Dysphagia and dysphonia are common presentations of both acute and long coronavirus disease 2019 (COVID-19). The majority of peer-reviewed publications in 2020 and early 2021 were expert guidance and consensus statements to support dysphagia management in multidisciplinary teams while protecting clinicians and patients from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. This review discusses dysphagia and dysphonia primary data published in 2021-2022, focusing on patient presentations, pathophysiology, and evidence for interventions.
Clinicians and researchers amassed knowledge of the cross-system presentation of dysphagia and dysphonia in patients with COVID-19, from severe disease requiring ICU stays to those with mild-to-moderate disease presenting to outpatient clinics. Pre-COVID-19 health status, hospitalization experience, presence of neurological symptoms, and impact of the virus to the upper aerodigestive and respiratory system need consideration in patient management. Long-term dysphagia and dysphonia manifested from COVID-19 require otolaryngologist and speech-language pathologist input.
Changes in immunity through population vaccination and variations in COVID-19 from SARS-CoV-2 mutations means prevalence data are challenging to interpret. However, there is no doubt of the presence of long-term dysphagia and dysphonia in our clinics. Long-term dysphagia and dysphonia are complex and a multidisciplinary team with a tailored approach for each patient is required.
吞咽困难和发音障碍是急性和长期新型冠状病毒病 2019（COVID-19）的常见表现。2020 年和 2021 年初的大多数同行评议出版物都是专家指导和共识声明，以支持多学科团队的吞咽困难管理，同时保护临床医生和患者免受严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）病毒的侵害。这篇综述讨论了 2021-2022 年发表的吞咽困难和发音障碍的主要数据，重点讨论了患者表现、病理生理学和干预措施的证据。
临床医生和研究人员积累了关于 COVID-19 患者吞咽困难和发音障碍跨系统表现的知识，从需要 ICU 入住的重症疾病到轻症至中度疾病到门诊就诊的患者。在患者管理中需要考虑 COVID-19 前的健康状况、住院经历、神经系统症状的存在以及病毒对上呼吸道和呼吸系统的影响。COVID-19 引起的长期吞咽困难和发音障碍需要耳鼻喉科医生和言语病理学家的参与。
人群疫苗接种导致的免疫变化和 SARS-CoV-2 突变导致的 COVID-19 变化意味着流行数据难以解释。然而，毫无疑问，我们的诊所存在长期的吞咽困难和发音障碍。长期吞咽困难和发音障碍是复杂的，需要多学科团队针对每个患者采用量身定制的方法。
