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  Post-extubation Dysphagia and COVID-2019 [Turk J Neurol]
Turk J Neurol. 2021; 27(1): 21-25 | DOI: 10.4274/tnd.2021.13360  

Post-extubation Dysphagia and COVID-2019

Dilek Yılmaz1, Tuğçe Mengi1, Sema Sarı2
1Nigde Omer Halisdemir Training and Research Hospital, Clinic of Neurology, Nigde, Turkey
2Nigde Omer Halisdemir Training and Research Hospital, Intensive Care Unit, Nigde, Turkey

Objective: Coronavirus disease-2019 (COVID-19) is a global pandemic that affects worldwide. Most patients who need intensive care due to COVID-19 develop acute respiratory distress syndrome and patients need long-term mechanical ventilation. This situation increases the risk of dysphagia, aspiration, and aspiration pneumonia in patients. Information about COVID-19-associated dysphagia is still limited. Thus, this study aimed to evaluate the frequency of postextubation dysphagia (PED) and its effect on clinical outcomes.
Materials and Methods: Patients with COVID-19 in the adult intensive care unit (ICU) who were left on a mechanical ventilator for at least 24 h and are extubated were retrospectively screened. Gugging swallowing screen (GUSS) test was performed 24 h after extubation to evaluate swallowing function. Patients were examined in two groups as with and without dysphagia.
Results: This study included 40 patients who were followed up on a mechanical ventilator and extubated due to COVID-19. According to the bedside GUSS test results, patients were divided into two groups as dysphagia group (n=24) and the non-dysphagia group (n=16). The mean age was higher in the dysphagia group (p<0.001). Re-intubation rate and ICU, and in-hospital mortality were higher in the dysphagia group (p<0.001 for all), whereas the length of stay in the ICU and mechanical ventilation time were longer (p=0.005 and p=0.001). ICU mortality was higher in patients with severe dysphagia (p=0.026).
Conclusion: Our study revealed that the risk of PED increased with the age of patients with COVID-19 and PED increased the incidence of re-intubation, which was an important prognostic parameter that indicates mortality. Recognizing dysphagia with the early evaluation of swallowing in extubated patients with COVID-19 diagnosis is important to minimize the risk of aspiration pneumonia with proper nutrition, reduce the increased health cost, and prevent poor clinical outcomes.

Keywords: Dysphagia, COVID-19, postextubation

Dilek Yılmaz, Tuğçe Mengi, Sema Sarı. Post-extubation Dysphagia and COVID-2019. Turk J Neurol. 2021; 27(1): 21-25

Corresponding Author: Dilek Yılmaz, Türkiye

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