Dysphagia, Dysphonia, and Dysarthria Outcomes Among Adults Hospitalized With COVID-19 Across Ireland.

Julie Regan, Margaret Walshe, Sarah Lavan, Eanna Horan, Patricia Gillivan Murphy, Anne Healy, Caoimhe Langan, Karen Malherbe, Breda Flynn Murphy, Maria Cremin, Denise Hilton, Jenni Cavaliere, Jacinta Curley, Andrea Moloney, Grace Flanagan, Alice Whyte

Journal: The Laryngoscope 2022;132(6):1251-1259

PMID: 34622966

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Abstract

OBJECTIVE

To investigate the presence, degree, predictors, and trajectory of dysphagia, dysphonia, and dysarthria among adults hospitalized 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 14 participating acute hospitals across ROI and referred to speech and language therapy between March 1st and 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 analyzed. 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 = .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 = .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 = .009), although need for modified oral intake (59%), dysphonia (23%), and dysarthria (14%) persisted.

CONCLUSION

Dysphagia, dysphonia, and dysarthria were widespread among adults hospitalized with COVID-19 and they persisted for many at discharge. Prompt SLT evaluation is required to minimize complications.

LEVEL OF EVIDENCE

3 Laryngoscope, 132:1251-1259, 2022.

Address: Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland.; Speech and Language Therapy Department, St. James' Hospital, Dublin, Ireland.; Speech and Language Therapy Department, Tallaght University Hospital, Dublin, Ireland.; Speech and Language Therapy Department, Mater Misericordiae University Hospital, Dublin, Ireland.; Speech and Language Therapy Department, Beaumont Hospital, Dublin, Ireland.; Speech and Language Therapy Department, St. Vincent's University Hospital, Dublin, Ireland.; Speech and Language Therapy Department, Galway University Hospital, Galway, Ireland.; Speech and Language Therapy Department, Midland Regional Hospital Tullamore & Portlaoise, Offaly, Ireland.; Speech and Language Therapy Department, University Hospital Kerry, Kerry, Ireland.; Speech and Language Therapy Department, Cavan General Hospital, Cavan, Ireland.; Speech and Language Therapy Department, University Hospital Waterford, Waterford, Ireland.; Speech and Language Therapy Department, Wexford General Hospital, Wexford, Ireland.; Speech and Language Therapy Department, St. Luke's Hospital, Kilkenny, Ireland.; Speech and Language Therapy Department, Sligo University Hospital, Sligo, Ireland.; Speech and Language Therapy Department, Naas General Hospital, Kildare, Ireland.

DOI: 10.1002/lary.29900