Zayed Ahmed Mohamed, Afsah Omayma, Elhadidy Tamer, Abou-Elsaad Tamer
Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
Chest Diseases Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Dysphagia. 2025 Mar 5. doi: 10.1007/s00455-025-10810-w.
Oropharyngeal dysphagia (OD) is a prevalent issue in hospitalized COVID-19 patients. This study aimed to determine swallowing abnormalities in post-COVID-19 patients with OD and to determine the potential risk factors of aspiration in patients who have recovered from COVID-19. Screening for OD was done for 310 patients who were discharged from the main university isolation hospital during the study period. A longitudinal descriptive study was carried out on 127 adult post-COVID-19 patients between the ages of 24 and 65 years who failed OD screening at the time of discharge. Instrumental swallowing assessment was done using fiberoptic endoscopic evaluation of swallowing (FEES) at one of two different time points: one-week post-discharge (Group 1) and 3-4 weeks post-discharge (group 2). The prominent swallowing abnormalities were delayed triggering of swallowing reflex, laryngeal penetration, tracheal aspiration, as well as vallecular and pyriform sinuses residue with lower frequencies and milder degrees in group 2 than in group 1 patients. Statistically significant associations were found between the presence of ageusia and anosmia in post-COVID-19 patients and both impaired laryngeal sensation and delayed triggering of the swallowing reflex. Significant associations were detected between aspiration in post-COVID-19 patients and the following factors: higher Eating Assessment Tool (EAT-10) scores, presence of dysphonia, higher respiratory rate, and the longer duration of the use of noninvasive ventilation (NIV) and/or invasive mechanical ventilation (IMV). The combined higher EAT-10 scores and higher respiratory rate predicted aspiration in post-COVID-19 patients by an overall percentage of 87.1.
口咽吞咽困难(OD)是住院COVID-19患者中普遍存在的问题。本研究旨在确定COVID-19后OD患者的吞咽异常情况,并确定从COVID-19康复患者发生误吸的潜在危险因素。在研究期间,对从大学主要隔离医院出院的310名患者进行了OD筛查。对127名年龄在24至65岁之间、出院时OD筛查未通过的成年COVID-19后患者进行了纵向描述性研究。在两个不同时间点之一使用纤维内镜吞咽评估(FEES)进行仪器吞咽评估:出院后1周(第1组)和出院后3 - 4周(第2组)。突出的吞咽异常为吞咽反射触发延迟、喉穿透、气管误吸,以及梨状窝和会厌谷残留,第2组患者出现的频率和程度低于第1组患者。在COVID-19后患者中,味觉减退和嗅觉减退与喉感觉受损和吞咽反射触发延迟之间存在统计学显著关联。在COVID-19后患者的误吸与以下因素之间检测到显著关联:较高的饮食评估工具(EAT-10)评分、存在发声障碍、较高的呼吸频率,以及使用无创通气(NIV)和/或创机械通气(IMV)的时间较长。较高的EAT-10评分和较高的呼吸频率相结合,预测COVID-19后患者误吸的总体百分比为87.1。