Swallowing and voice outcomes in patients hospitalised with COVID-19

xlomafota13 shared this article with you from Inoreader Swallowing and voice outcomes in patients hospitalised with COVID-19: An observational cohort study. Via swallowing exercises Related Articles Swallowing and voice outcomes in patients hospitalised with COVID-19: An observational cohort study. Arch Phys Med Rehabil. 2021 Jan 30;: Authors: Archer SK, Iezzi CM, Gilpin L Abstract OBJECTIVE: To evaluate the presentations and outcomes of inpatients with COVID-19 presenting with dysphonia and dysphagia in order to investigate trends and inform potential pathways for ongoing care. DESIGN: Observational cohort study. SETTING: An inner city NHS Hospital Trust in London, UK. PARTICIPANTS: All adult inpatients hospitalised with COVID-19 who were referred to Speech and Language Therapy (SLT) for voice and/or swallowing assessment for 2 months from April 2020. INTERVENTIONS: SLT assessment, advice and therapy for dysphonia and dysphagia. MAIN OUTCOME MEASURES: Evidence of delirium, neurological presentation, intubation, tracheostomy and proning history were collected, along with type of SLT provided and discharge outcomes. Therapy Outcome Measures (TOMs) were recorded for swallowing and tracheostomy pre/post SLT intervention and GRBAS for voice. RESULTS: 164 patients (104M), age 56.8±16.7y were included. Half (52.4%) had a tracheostomy, 78.7% had been intubated (mean 15±6.6days), 13.4% had new neurological impairment and 69.5% were delirious. Individualised compensatory strategies were trialled in all and direct exercises with 11%. Baseline assessments showed marked impairments in dysphagia and voice but there was significant improvement in all during the study (p<0.0001). On average patients started some oral intake 2 days after initial SLT assessment (IQR 0-8) and were eating and drinking normally on discharge but 29.3%(n=29)of those with dysphagia and 56.1% (n=37) of those with dysphonia remained impaired at hospital discharge. 70.9% tracheostomised patients were decannulated, median (IQR) time to decannulation 19 days(16-27).Across all (n=164), 37.3% completed SLT input while inpatients, 23.5% were transferred to another hospital, 17.1% had voice and 7.8% required community follow-up for dysphagia. CONCLUSIONS: Inpatients with COVID-19 present with significant impairments of voice and swallowing, justifying responsive SLT. Prolonged intubations and tracheostomies were the norm and a minority had new neurological presentations. Patients typically improved with assessment that enabled treatment with individualised compensatory strategies. Services preparing for COVID-19 should target resources for tracheostomy weaning and to enable responsive management of dysphagia and dysphonia with robust referral pathways. PMID: 33529610 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.