Post-extubation Dysphagia and COVID-2019

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.