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SMH Covid Study; Determining swallowing physiology following prolonged intubation in patients with COVID-19

COVID-19 Research Area(s): Healthcare Delivery & Policy

As patients are optimized within the Intensive Care Unit (ICU) and survive COVID-19, the impact of multiple intubations and extubation attempts, proning, tracheostomy, critical illness, and delirium become apparent in their clinical outcomes. Disordered swallow function is likely a prevalent issue; however, given the high risk of aerosol generation during swallow instrumentation, very few institutions throughout the world are conducting imaging for the assessment of the swallow. To the best of our knowledge, no one has reported on swallowing physiology as assessed through gold standard instrumentation following prolonged intubation in those with COVID-19. Based on research in other populations, it is likely that the dysphagia is characterised by pharyngeal and laryngeal impairments undetectable and unmeasurable at the bedside; however, this remains to be determined. Our aim is to be the first to report on the oral and pharyngeal physiology in patients with severe COVID-19 following prolonged intubation. 2) Hypothesis: We hypothesize that most patients with severe COVID-19 illnesses have both oral and pharyngeal impairments. While determining associated and predictive risk factors is out of this study's scope, exploratory analyses may reveal that multiple intubations and extubation attempts, proning, tracheostomy, critical illness, and delirium in Covid-19 patients is associated with impaired swallowing function.