Dysphagia and mechanical ventilation in SARS-COV-2 pneumonia: It's real.
Clin Nutr
; 41(12): 2927-2933, 2022 Dec.
Article
in English
| MEDLINE | ID: covidwho-2149546
ABSTRACT
BACKGROUND & AIMS:
Dysphagia can be a consequence of prolonged hospitalization in intensive care units (ICUs) due to severe SARS-CoV-2 pneumonia. This study aims at Identifying the risk factors for dysphagia in ICU patients with COVID-19 pneumonia requiring invasive mechanical ventilation, and at determining the frequency of postextubation dysphagia in this population.METHODS:
Observational, descriptive, retrospective, cohort study of SARS-CoV-2 pneumonia patients admitted into the ICUs from March to May 2020. The Modified Viscosity Volume Swallowing Test (mV-VST) was used to screening for dysphagia during the first 48 h of extubation in patients requiring mechanical ventilation. Descriptive statistics, univariate and multivariate analyses were conducted. A logistic regression was applied to construct a predictive model of dysphagia.RESULTS:
A total of 232 patients were admitted into the ICUs (age [median 60.5 years (95% CI 58.5 to 61.9)]; male [74.1% (95% CI 68.1 to 79.4)]; APACHE II score [median 17.7 (95% CI 13.3 to 23.2)]; length of mechanical ventilation [median 14 days (95% CI 11 to 16)]; prone position [79% (95% CI 72.1 to 84.6)]; respiratory infection [34.5% (95% CI 28.6 to 40.9)], renal failure [38.5% (95% CI 30 to 50)])). 72% (167) of patients required intubation; 65.9% (110) survived; and in 84.5% (93) the mV-VST was performed. Postextubation dysphagia was diagnosed in 26.9% (25) of patients. APACHE II, prone position, length of ICU and hospital stay, length of mechanical ventilation, tracheostomy, respiratory infection and kidney failure developed during admission were significantly associated (p < 0.05) with dysphagia. Dysphagia was independently explained by the APACHE II score (OR 1.1; 95% CI 1.01 to 1.3; p = 0.04) and tracheostomy (OR 10.2; 95% CI 3.2 to 32.1) p < 0.001). The predictive model forecasted dysphagia with a good ROC curve (AUC 0.8; 95% CI 0.7 to 0.9).CONCLUSIONS:
Dysphagia affects almost one-third of patients with SARS-COV-2 pneumonia requiring intubation in the ICU. The risk of developing dysphagia increases with prolonged mechanical ventilation, tracheostomy, and poorer prognosis on admission (worst APACHE II score).Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia
/
Deglutition Disorders
/
COVID-19
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Topics:
Long Covid
Limits:
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Clin Nutr
Year:
2022
Document Type:
Article
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