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Dysphagia in patients with coronavirus disease undergoing orotracheal intubation
Vinícius Pereira Barbosa Almeida1, Letícia Félix1, Tracy Lima Tavares1
1Otorhinolaryngology Service, Department of Laryngology and Cervicofacial Surgery Institute of Medical Assistance to the State Public Servant (IAMSPE) São Paulo Brazil.
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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