Abstract
Objective
To investigate the presence, degree, predictors and trajectory of dysphagia, dysphonia and dysarthria amongst adults hospitalised with COVID-19 across the Republic of Ireland (ROI) during the first wave of the pandemic.
Study Design
Prospective observational cohort study
Methods
Adults with confirmed COVID-19 who were admitted into fourteen participating acute hospitals across ROI and referred to speech and language therapy between March 1st to June 30th 2020 were recruited. Outcomes obtained at initial SLT evaluation and at discharge were oral intake status (Functional Oral Intake Scale), perceptual voice quality (GRBAS), and global dysarthria rating (Dysarthria Severity Scale).
Results
Data from 315 adults were analysed. At initial SLT assessment, 84% required modified oral diets, and 31% required tube feeding. There were high rates of dysphonia (42%) and dysarthria (23%). History of intubation (OR 19.959, 95% CI 6.272, 63.513; p=.000), COVID-19 neurological manifestations (OR 3.592, 95% CI 1.733, 7.445; p=.001) and age (OR 1.034; 95% CI 1.002, 1.066; p=0.036) were predictive of oral intake status. History of intubation was predictive of voice quality (OR 4.250, 95% CI 1.838, 9.827; p=.001) and COVID-19 neurological manifestations were predictive of dysarthria (OR 2.275; 95% CI 1.162, 4.456; p=0.017). At discharge, there were significant improvements in oral intake (Z=-7.971; p=.000), voice quality (Z=-5.971; p=.000), and dysarthria severity (Z=-2.619; p=0.009), although need for modified oral intake (59%), dysphonia (23%) and dysarthria (14%) persisted.
Conclusion
Dysphagia, dysphonia and dysarthria were widespread amongst adults hospitalised with COVID-19 and they persisted for many at discharge. Prompt SLT evaluation is required to minimise complications.
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