Dysphagia in patients with coronavirus disease undergoing orotracheal intubation

Abstract Objective To assess the incidence and the risk factors for the development of dysphagia in patients with coronavirus disease 2019 (COVID‐19) undergoing orotracheal intubation. Study Design Prospective cohort study. Methods In this prospective cohort study, we evaluated consecutive patients...

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Main Authors: Vinícius Pereira Barbosa Almeida, Letícia Félix, Tracy Lima Tavares, Mariana Marques daSilva Castro, Romualdo Suzano Louzeiro Tiago
Format: Article
Language:English
Published: Wiley 2022-10-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.886
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author Vinícius Pereira Barbosa Almeida
Letícia Félix
Tracy Lima Tavares
Mariana Marques daSilva Castro
Romualdo Suzano Louzeiro Tiago
author_facet Vinícius Pereira Barbosa Almeida
Letícia Félix
Tracy Lima Tavares
Mariana Marques daSilva Castro
Romualdo Suzano Louzeiro Tiago
author_sort Vinícius Pereira Barbosa Almeida
collection DOAJ
description Abstract Objective To assess the incidence and the risk factors for the development of dysphagia in patients with coronavirus disease 2019 (COVID‐19) undergoing orotracheal intubation. Study Design Prospective cohort study. Methods In this prospective cohort study, we evaluated consecutive patients diagnosed with COVID‐19 and underwent orotracheal intubation were evaluated. During hospitalization, extubated patients were classified as dysphagic and nondysphagic based on bedside functional assessment of swallowing. Patients discharged from hospital were asked to complete the Eating Assessment Tool‐10 (EAT‐10) questionnaire, followed by an endoscopic examination to identify laryngotracheal lesions, and a fiberoptic endoscopic evaluation of swallowing (FEES). The food consistencies used for FEES were moderately thick, extremely thick, thin, and regular. Results Based on the functional assessment of swallowing, performed a mean of 5.3 days and a median of 4 days after extubation, the incidence of dysphagia in patients with COVID‐19 undergoing orotracheal intubation was 53.6%. In the late evaluation, performed a mean of 102 days after extubation, 12.8% of patients had an EAT‐10 score >2. Orotracheal intubation (OTI) duration and tracheostomy were risk factors for the development of dysphagia. There was an association between EAT‐10 > 2 and the presence of laryngotracheal lesion, with no difference between lesion type and EAT score >2. Conclusions The incidence of dysphagia varied according to the time of assessment, being higher the earlier the assessment after extubation. OTI duration and tracheostomy were risk factors for the development of dysphagia, and the presence of laryngotracheal lesions demonstrated an association with dysphagia. Level of Evidence 3.
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spelling doaj.art-44a0f0ac45d04446b8d31d0bc25f79bb2022-12-22T03:32:49ZengWileyLaryngoscope Investigative Otolaryngology2378-80382022-10-01751474148010.1002/lio2.886Dysphagia in patients with coronavirus disease undergoing orotracheal intubationVinícius Pereira Barbosa Almeida0Letícia Félix1Tracy Lima Tavares2Mariana Marques daSilva Castro3Romualdo Suzano Louzeiro Tiago4Otorhinolaryngology Service, Department of Laryngology and Cervicofacial Surgery Institute of Medical Assistance to the State Public Servant (IAMSPE) São Paulo BrazilOtorhinolaryngology Service, Department of Laryngology and Cervicofacial Surgery Institute of Medical Assistance to the State Public Servant (IAMSPE) São Paulo BrazilOtorhinolaryngology Service, Department of Laryngology and Cervicofacial Surgery Institute of Medical Assistance to the State Public Servant (IAMSPE) São Paulo BrazilOtorhinolaryngology Service, Department of Laryngology and Cervicofacial Surgery Institute of Medical Assistance to the State Public Servant (IAMSPE) São Paulo BrazilOtorhinolaryngology Service, Department of Laryngology and Cervicofacial Surgery Institute of Medical Assistance to the State Public Servant (IAMSPE) São Paulo BrazilAbstract Objective To assess the incidence and the risk factors for the development of dysphagia in patients with coronavirus disease 2019 (COVID‐19) undergoing orotracheal intubation. Study Design Prospective cohort study. Methods In this prospective cohort study, we evaluated consecutive patients diagnosed with COVID‐19 and underwent orotracheal intubation were evaluated. During hospitalization, extubated patients were classified as dysphagic and nondysphagic based on bedside functional assessment of swallowing. Patients discharged from hospital were asked to complete the Eating Assessment Tool‐10 (EAT‐10) questionnaire, followed by an endoscopic examination to identify laryngotracheal lesions, and a fiberoptic endoscopic evaluation of swallowing (FEES). The food consistencies used for FEES were moderately thick, extremely thick, thin, and regular. Results Based on the functional assessment of swallowing, performed a mean of 5.3 days and a median of 4 days after extubation, the incidence of dysphagia in patients with COVID‐19 undergoing orotracheal intubation was 53.6%. In the late evaluation, performed a mean of 102 days after extubation, 12.8% of patients had an EAT‐10 score >2. Orotracheal intubation (OTI) duration and tracheostomy were risk factors for the development of dysphagia. There was an association between EAT‐10 > 2 and the presence of laryngotracheal lesion, with no difference between lesion type and EAT score >2. Conclusions The incidence of dysphagia varied according to the time of assessment, being higher the earlier the assessment after extubation. OTI duration and tracheostomy were risk factors for the development of dysphagia, and the presence of laryngotracheal lesions demonstrated an association with dysphagia. Level of Evidence 3.https://doi.org/10.1002/lio2.886COVID‐19dysphagiaendotracheal intubationlarynxSARS‐CoV‐2
spellingShingle Vinícius Pereira Barbosa Almeida
Letícia Félix
Tracy Lima Tavares
Mariana Marques daSilva Castro
Romualdo Suzano Louzeiro Tiago
Dysphagia in patients with coronavirus disease undergoing orotracheal intubation
Laryngoscope Investigative Otolaryngology
COVID‐19
dysphagia
endotracheal intubation
larynx
SARS‐CoV‐2
title Dysphagia in patients with coronavirus disease undergoing orotracheal intubation
title_full Dysphagia in patients with coronavirus disease undergoing orotracheal intubation
title_fullStr Dysphagia in patients with coronavirus disease undergoing orotracheal intubation
title_full_unstemmed Dysphagia in patients with coronavirus disease undergoing orotracheal intubation
title_short Dysphagia in patients with coronavirus disease undergoing orotracheal intubation
title_sort dysphagia in patients with coronavirus disease undergoing orotracheal intubation
topic COVID‐19
dysphagia
endotracheal intubation
larynx
SARS‐CoV‐2
url https://doi.org/10.1002/lio2.886
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