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Titre : | Swallowing and Voice Outcomes in Patients Hospitalized With COVID-19: An Observational Cohort Study (2021) |
Auteurs : | Sally K. Archer ; Christina M. Iezzi ; Louisa Gilpin |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 102, n° 6, 2021) |
Article en page(s) : | p. 1084-1090 |
Note générale : | https://doi.org/10.1016/j.apmr.2021.01.063 |
Langues: | Anglais |
Descripteurs : |
HE Vinci COVID-19 ; Pathologie de la parole et du langage (spécialité) ; Réadaptation ; Trachéostomie ; Troubles de la déglutition |
Résumé : |
Objective
To evaluate the presentations and outcomes of inpatients with coronavirus disease 2019 (COVID-19) presenting with dysphonia and dysphagia to investigate trends and inform potential pathways for ongoing care. Design Observational cohort study. Setting An inner-city National Health Service Hospital Trust in London, United Kingdom. Participants All adult inpatients hospitalized with COVID-19 (N=164) who were referred to Speech and Language Therapy (SLT) for voice and/or swallowing assessment for 2 months starting in April 2020. Interventions SLT assessment, advice, and therapy for dysphonia and dysphagia. Main Outcome Measures Evidence of delirium, neurologic presentation, intubation, tracheostomy, and proning history were collected, along with type of SLT provided and discharge outcomes. Therapy outcome measures were recorded for swallowing and tracheostomy pre- and post-SLT intervention and Grade Roughness Breathiness Asthenia Strain Scale for voice. Results Patients (N=164; 104 men) aged 56.8±16.7 years were included. Half (52.4%) had a tracheostomy, 78.7% had been intubated (mean, 15±6.6d), 13.4% had new neurologic impairment, and 69.5% were delirious. Individualized compensatory strategies were trialed in all and direct exercises with 11%. Baseline assessments showed marked impairments in dysphagia and voice, but there was significant improvement in all during the study (P<.0001 on average patients started some oral intake days after initial slt assessment range and were eating drinking normally discharge but of those with dysphagia dysphonia remained impaired at hospital discharge. a total tracheostomized decannulated the median time to decannulation was among completed input while inpatients transferred another had voice required community follow-up for dysphagia.> Conclusions Inpatients with COVID-19 present with significant impairments of voice and swallowing, justifying responsive SLT. Prolonged intubations and tracheostomies were the norm, and a minority had new neurologic presentations. Patients typically improved with assessment that enabled treatment with individualized compensatory strategies. Services preparing for COVID-19 should target resources for tracheostomy weaning and to enable responsive management of dysphagia and dysphonia with robust referral pathways. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999321000897#! |