Postorotracheal intubation dysphagia in patients with COVID-19: a retrospective study

Autores

Palavras-chave:

Deglutition, Intubation, COVID-19, Deglutition disorders, Rehabilitation, Post orotracheal intubation, Dysphagia, Swallowing, Tracheostomy

Resumo

BACKGROUND: The cause of oropharyngeal dysphagia in patients with coronavirus disease (COVID-19) can be multifactorial and may underly limitations in swallowing rehabilitation.
OBJECTIVE: Analyze the factors related to dysphagia in patients with COVID-19 immediately after orotracheal extubation and the factors that influence swallowing rehabilitation.
DESIGN AND SETTING: A retrospective study.
METHODS: The presence of dysphagia was evaluated using the American Speech-Language Hearing Association National Outcome Measurement System (ASHA NOMS) scale and variables that influenced swallowing rehabilitation in 140 adult patients who required invasive mechanical ventilation for >48 h.
RESULTS: In total, 46.43% of the patients scored 1 or 2 on the ASHA NOMS (severe dysphagia) and 39.29% scored 4 (single consistency delivered orally) or 5 (exclusive oral diet with adaptations). Both the length of mechanical ventilation and the presence of neurological disorders were associated with lower ASHA NOMS scores (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.74–0.87 P < 0.05; and OR: 0.13, 95% CI: 0.61–0.29; P < 0.05, respectively). Age and the presence of tracheostomy were negatively associated with speech rehabilitation (OR: 0.92; 95% CI: 0.87–−0.96; OR: 0.24; 95% CI: 0.80–−0.75), and acute post-COVID-19 kidney injury requiring dialysis and lower scores on the ASHA NOMS were associated with longer time for speech therapy outcomes (β: 1.62, 95% CI, 0.70–3.17, P < 0.001; β: −1.24, 95% CI: −1.55–−0.92; P < 0.001).
CONCLUSION: Prolonged orotracheal intubation and post-COVID-19 neurological alterations increase the probability of dysphagia immediately after extubation. Increased age and tracheostomy limited rehabilitation.

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Biografia do Autor

Jean Henri, Centro Universitário Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil

MD. Physician , Centro Universitário Faculdade de Medicina do ABC (FMABC), Santo André (SP), Brazil.

Ceila Maria Sant’Ana, Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo, Brazil

PhD. Physician, Intensive Care Unit Physician, Instituto de Infectologia Emílio Ribas (IIER), São Paulo (SP), Brazil.

Rosa Maria, Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo, Brazil

MSc. Statistician, Instituto de Infectologia Emílio Ribas (IIER), São Paulo (SP), Brazil.

Augusto César Penalva de, Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo, Brazil

PhD. Neurologist, Instituto de Infectologia Emílio Ribas (IIER), São Paulo (SP), Brazil.

Lucio Antonio Nascimento, Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo, Brazil

Speech Therapist, Instituto de Infectologia Emílio Ribas (IIER), São Paulo (SP), Brazil.

Graziela, Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo, Brazil

MSc. Physiotherapist, Head of the Diagnostic and Therapeutic Support Department, Instituto de Infectologia Emílio Ribas (IIER), São Paulo (SP), Brazil.

José Angelo Lauletta, Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo, Brazil

PhD. Physician, Director of the Diagnostic and Therapeutic Support Department, Instituto de Infectologia Emílio Ribas (IIER), São Paulo (SP), Brazil.

Maria Inês Rebelo, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

PhD. Speech therapist and Professor, Department of Speech Therapy, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.

Jaques, Instituto de Infectologia Emílio Ribas, São Paulo, São Paulo, Brazil

MD. Physician, Head of the Intensive Care Unit, Instituto de Infectologia Emílio Ribas (IIER), São Paulo (SP), Brazil.

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Publicado

2025-06-06

Como Citar

1.
Mariana, Jean Henri, Ceila Maria Sant’Ana, Rosa Maria, Augusto César Penalva de, Lucio Antonio Nascimento, Graziela, José Angelo Lauletta, Maria Inês Rebelo, Jaques. Postorotracheal intubation dysphagia in patients with COVID-19: a retrospective study. Sao Paulo Med J [Internet]. 6º de junho de 2025 [citado 16º de junho de 2025];142(6):1-8. Disponível em: https://periodicosapm.emnuvens.com.br/spmj/article/view/3219

Edição

v. 142 n. 6 (2024)

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Artigo Original

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Copyright (c) 2025 São Paulo Medical Journal

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Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.