Best Practice in Swallowing Assessment in COVID-19

Area of Science:

• Medical Sciences
• Clinical Practice
• Public Health

Background:

• The COVID-19 pandemic disrupted essential healthcare services, including instrumental dysphagia assessments.
• Discontinuation of these evaluations left clinicians without definitive methods to assess swallowing function.
• This created a critical need to re-establish safe and effective assessment protocols.

Purpose of the Study:

• To evaluate the outcomes of a cautious resumption of instrumental dysphagia assessments in hospitalized patients during the COVID-19 pandemic.
• To determine the safety and feasibility of performing Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Modified Barium Swallow (MBS) during the pandemic.
• To analyze patient and staff COVID-19 status in relation to these procedures.

Main Methods:

• Retrospective medical record review of patients undergoing swallowing evaluations.
• Data collection included patient demographics, evaluation type, and COVID-19 status.
• Analysis of staff COVID-19 infection rates related to workplace exposure during the study period.

Main Results:

• A total of 4482 FEES and 758 MBS evaluations were successfully completed.
• No healthcare staff members tested positive for COVID-19 due to workplace exposure during the study.
• The data indicates a low risk of transmission associated with these procedures.

Conclusions:

• A measured return to instrumental swallowing assessments is clinically appropriate and feasible during the COVID-19 pandemic.
• FEES and MBS can be safely implemented within hospital settings with appropriate precautions.
• These findings support the continued use of evidence-based dysphagia evaluation methods.