Modified Monday: Post-COVID dysphagia - Looking for Patterns
I tend to overthink and overworry, so generally I love to be wrong. However, last year, very very early in the pandemic, a colleague told me that a major hospital system was setting up a rehab unit specifically for post-COVID patients. Knowing what we know now…this makes complete sense. But at the time, I remember questioning what a dysphagia SLP could contribute to this. At that moment, the thinking was that it was a viral infection that would just… go away… with recovery in survivors. The term “long haulers” wasn’t around, and we had yet to see any post-COVID patients for dysphagia assessment.
Now here we are in mid-May 2021, and though we still have quite a bit to learn about post-COVID dysphagia- it is clear that lingering dysphagia is prevalent outcome. There is very little literature out there so far, so we don’t yet know the extent-or even the etiology (deconditioning? respiratory compromise? neurological damage? all of the above?). I asked our teams to start collecting examples of our post-COVID studies, and at this point, we have more than I can look at in a year.
Right now, they are characterized by everything from timing to incomplete airway closure, post swallow residue throughout the pharynx, difficulty in coordination of breathing and swallowing to …completely normal, just like we can see with patients post-CVA, TBI or with CA. My prediction at this moment is that there is no “profile” for post-COVID dysphagia, and that we will need to thoroughly assess each patient and use good clinical judgement that takes into account the clinical and instrumental findings, patient needs, and medical status to establish a plan of care. I could always be wrong again… but even so, looking at all the factors that can impact patient outcomes should always be our main objective, regardless of where it came from. The video is actually a compilation of several different patients-each clip is a different patient-to highlight the variety of impairments seen.
Swallowing and Voice Outcomes in Patients Hospitalized With COVID-19: An Observational Cohort Study - PubMed (nih.gov)
Dysphagia presentation and management following COVID-19: an acute care tertiary centre experience (nih.gov)
Impact of COVID-19 on the Speech and Language Therapy Profession and Their Patients (nih.gov)