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严重急性呼吸综合征冠状病毒2与吞咽困难:对患有吞咽障碍的2019冠状病毒病患者的回顾性分析

SARS-CoV-2 and Dysphagia: A Retrospective Analysis of COVID-19 Patients with Swallowing Disorders.

作者信息

Molino Christopher, Bergantini Laura, Santucci Silvia, Pitinca Marialuigia Tomai, d'Alessandro Miriana, Cameli Paolo, Taddei Sabrina, Bargagli Elena

机构信息

Department of Medical Sciences, Surgery and Neurosciences, Respiratory Disease and Lung Transplant Unit, University Hospital of Siena (Azienda Ospedaliera Universitaria Senese, AOUS), Siena University, Viale Bracci, Siena, 53100, Italy.

U.O.P. della Riabilitazione, AOUS, Siena, Italy.

出版信息

Dysphagia. 2025 Feb;40(1):162-168. doi: 10.1007/s00455-024-10715-0. Epub 2024 May 23.

Abstract

BACKGROUND

COVID-19 can lead to impairment of neural networks involved in swallowing, since the act of swallowing is coordinated and performed by a diffuse brain network involving peripheral nerves and muscles. Dysphagia has been identified as a risk and predictive factor for the severest form of SARS-CoV-2 infection.

OBJECTIVES

To investigate the association between swallowing disorders and COVID-19 in patients hospitalized for COVID-19.

METHODS

We collected demographic data, medical information specific to dysphagia and data on medical treatments of patients with COVID-19.

RESULTS

A total of 43 hospitalized COVID-19 patients were enrolled in the study. Twenty (46%) were evaluated positive for dysphagia and 23 (54%) were evaluated negative. Neurocognitive disorders and diabetes were mostly associated with patients who resulted positive for dysphagia. Respiratory impairment caused by COVID-19 seems to be a cause of dysphagia, since all patients who needed oxygen-therapy developed symptoms of dysphagia, unlike patients who did not. In the dysphagic group, alteration of the swallowing trigger resulted in the severest form of dysphagia. An association was found between the severest form of COVID-19 and dysphagia. This group consisted predominantly of males with longer hospitalization.

CONCLUSIONS

Identification of COVID-19 patients at risk for dysphagia is crucial for better patient management.

摘要

背景

新型冠状病毒肺炎(COVID-19)可导致参与吞咽的神经网络受损,因为吞咽动作是由一个涉及周围神经和肌肉的弥散性脑网络协调并执行的。吞咽困难已被确定为最严重形式的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的一个风险因素和预测因素。

目的

调查因COVID-19住院患者吞咽障碍与COVID-19之间的关联。

方法

我们收集了COVID-19患者的人口统计学数据、吞咽困难的特定医学信息以及治疗数据。

结果

共有43例COVID-19住院患者纳入本研究。20例(46%)吞咽困难评估为阳性,23例(54%)评估为阴性。神经认知障碍和糖尿病大多与吞咽困难评估为阳性的患者相关。COVID-19引起的呼吸功能损害似乎是吞咽困难的一个原因,因为所有需要吸氧治疗的患者都出现了吞咽困难症状,而未吸氧的患者则没有。在吞咽困难组中,吞咽触发改变导致了最严重形式的吞咽困难。在最严重形式的COVID-19与吞咽困难之间发现了关联。这组患者主要为男性,住院时间较长。

结论

识别有吞咽困难风险的COVID-19患者对于更好地管理患者至关重要。

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本文引用的文献

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Risk Factors for Dysphagia in Patients Hospitalized with COVID-19.COVID-19 住院患者吞咽困难的危险因素。
Dysphagia. 2023 Jun;38(3):933-942. doi: 10.1007/s00455-022-10518-1. Epub 2022 Sep 15.
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Swallowing Function in COVID-19 Patients After Invasive Mechanical Ventilation.新型冠状病毒肺炎患者有创机械通气后的吞咽功能
Arch Rehabil Res Clin Transl. 2022 Mar;4(1):100177. doi: 10.1016/j.arrct.2021.100177. Epub 2022 Jan 11.
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Dysphagia in non-intubated patients affected by COVID-19 infection.非插管 COVID-19 感染患者的吞咽困难。
Eur Arch Otorhinolaryngol. 2022 Jan;279(1):507-513. doi: 10.1007/s00405-021-07062-3. Epub 2021 Sep 1.

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