Researchers from Switzerland conducted a study to determine the swallowing problems of corona patients who underwent a tracheostomy or mechanical ventilation. These patients had a higher rate of swelling disorders, but they also recovered quickly and completely.
Severely ill Corona patients often require ventilation support to breathe, and sometimes ventilation is provided using invasive methods, which if necessary for a long time will need to be done by opening an opening in the front of the neck so that a tube can be inserted into the trachea, which is An operation called a tracheostomy.
However, mechanical ventilation and prolonged tracheal puncture can lead to dysfunction of the pharyngeal muscles causing difficulty swallowing (dysphagia) and swelling disorders, and these are associated with other complications, resulting in increased intensive care, prolonged hospital stay, and even death.
Researchers from Clinica Luganese Moncucco and the Bellinzona Regional Hospital in Switzerland investigated the prevalence of swelling disorders in critically ill COVID-19 patients and reported their findings in a paper published on the preprint website medRxiv*.
Swallowing Disorders Assessment
The researchers conducted a retrospective study of patients who were admitted to the hospital between March and April 2020, according to the medical website “Medical”. The patients were evaluated by speech and language therapists using a swallowing screen (GUSS). The test contains a scoring system that ranks swallowing disorders based on their severity. The scores range from 0 for severe dysphagia to 20 in the absence of dysphagia.
The assessment was performed once every week for four weeks, either in the intensive care unit or when patients were taken abroad. The team also looked at demographics and other pre-existing diseases such as diabetes, hypertension and chronic obstructive pulmonary disorder.
Of the 31 patients evaluated in the study, 25 underwent invasive mechanical ventilation, 19 underwent tracheostomy, and patients received mechanical ventilation for an average of 11 days.
The team found no association between swallowing scores, duration of ventilation, tracheostomy, and length of stay in the ICU at the first assessment made on day 0. Likewise, there was no association between scores and other demographics or baseline conditions, and the mean swallowing score was 15, less than half of the patients had dysphagia and 19% had severe dysphagia.
One week after the first evaluation, all patients' swallowing scores had improved, about 6% had severe dysphagia and about 74% had no dysphagia.
As evaluation continued for the next 3 weeks, the prevalence of severe dysphagia decreased to 0% and dysphagia decreased as the weeks passed, with no dysphagia of approximately 97% after 28 days, and by the 16th day, 90% of patients had fully recovered from their swallowing disorders . However, after hospital discharge, seven patients still had mild dysphagia.
Get well soon
The results showed that about half of the patients experienced swallowing disorders at the first evaluation, and in patients who were subjected to ventilation for more than 10 days, the prevalence of dysphagia was higher, at about 95%, and this indicates a higher incidence of dysphagia in patients with corona even at the stage of This may be due to the severe inflammatory response to the virus resulting in a general weakness of the muscles, including the muscles of the throat.
Although the incidence of dysphagia was high during hospitalization, recovery was also rapid with speech and language therapy, with all severe cases improving after 12 days, and this indicates that speech and language therapy may help Corona patients, improving recovery from Any disturbances in swallowing.
However, as this study was just one central study, more studies will be needed to understand and manage swallowing disorders in COVID-19 patients.
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