Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul 02500, Republic of Korea.
Medicina (Kaunas). 2023 Oct 18;59(10):1851. doi: 10.3390/medicina59101851.
Patients recovering from mild coronavirus disease (COVID-19) reportedly have dysphagia or difficulty in swallowing. We compared the prevalence of dysphagia between patients diagnosed with mild COVID-19 and those diagnosed with aspiration pneumonia alone. A retrospective study was conducted from January 2020 to June 2023 in 160 patients referred for a videofluoroscopic swallowing study (VFSS) to assess for dysphagia. The cohort included 24 patients with mild COVID-19 and aspiration pneumonia, 30 with mild COVID-19 without aspiration pneumonia, and 106 with aspiration pneumonia alone. We reviewed the demographic data, comorbidities, and VFSS results using the penetration-aspiration scale (PAS) and functional dysphagia scale (FDS). In a study comparing patients with mild COVID-19 (Group A) and those with aspiration pneumonia alone (Group B), no significant differences were observed in the baseline characteristics, including the prevalence of dysphagia-related comorbidities between the groups. Group A showed milder dysphagia, as evidenced by lower PAS and FDS scores, shorter oral and pharyngeal transit times ( = 0.001 and = 0.003, respectively), and fewer residues in the vallecula and pyriform sinuses ( < 0.001 and < 0.03, respectively). When Group A was subdivided into those with COVID-19 with (Group A1) and without aspiration pneumonia (Group A2), both subgroups outperformed Group B in terms of specific VFSS metrics, such as oral transit time ( = 0.01), pharyngeal transit time ( = 0.04 and = 0.02, respectively), and residue in the vallecula ( = 0.04 and = 0.02, respectively). However, Group B showed improved triggering of the pharyngeal swallowing reflex compared with Group A2 ( = 0.02). Mild COVID-19 patients showed less severe dysphagia than those with aspiration pneumonia alone. This finding was consistent across VFSS parameters, even when the COVID-19 group was subdivided based on the status of aspiration pneumonia.
据报道,轻症冠状病毒病(COVID-19)患者存在吞咽困难或吞咽困难。我们比较了确诊为轻度 COVID-19 患者和单独确诊为吸入性肺炎患者之间吞咽困难的发生率。这项回顾性研究于 2020 年 1 月至 2023 年 6 月在 160 名因吞咽困难而行视频荧光透视检查(VFSS)的患者中进行。该队列包括 24 名轻度 COVID-19 合并吸入性肺炎患者、30 名轻度 COVID-19 无吸入性肺炎患者和 106 名单纯吸入性肺炎患者。我们使用渗透-吸入量表(PAS)和功能性吞咽困难量表(FDS)回顾了人口统计学数据、合并症和 VFSS 结果。在一项比较轻度 COVID-19 患者(A 组)和单纯吸入性肺炎患者(B 组)的研究中,两组之间的基线特征(包括与吞咽困难相关的合并症的患病率)无显著差异。A 组表现出较轻的吞咽困难,表现为 PAS 和 FDS 评分较低、口腔和咽部通过时间较短(分别为 = 0.001 和 = 0.003),以及 vallecula 和梨状窦中的残留物较少(分别为 < 0.001 和 < 0.03)。当 A 组进一步分为伴有 COVID-19 的患者(A1 组)和无吸入性肺炎的患者(A2 组)时,两组在特定的 VFSS 指标方面均优于 B 组,例如口腔通过时间( = 0.01)、咽部通过时间(分别为 = 0.04 和 = 0.02)和 vallecula 中的残留物(分别为 = 0.04 和 = 0.02)。然而,与 A2 组相比,B 组的咽吞咽反射触发得到改善( = 0.02)。轻度 COVID-19 患者的吞咽困难程度低于单纯吸入性肺炎患者。这一发现与 VFSS 各项参数一致,即使 COVID-19 组根据吸入性肺炎的状况进一步细分。