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KMID : 1024320230130010024
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Journal of the Korean Dysphagia Society
2023 Volume.13 No. 1 p.24 ~ p.33
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The Comparison of Dysphagia between COVID-19 Pneumonia and Aspiration Pneumonia
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Jeon Hyeong-Eun
Ku Young-Su
Lee Young-Gon
Jung Han-Young
Lee Jung-Hwan
Joa Kyung-Lim
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Abstract
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Objective: Patients recovering from moderate-to-severe coronavirus disease 2019 (COVID-19) reportedly have dysphagia or dif?culty in swallowing. The current study compares the differences in dysphagia characteristics arising from COVID-19 pneumonia and aspiration pneumonia. We further identify factors affecting the severity of dysphagia.
Methods: Fifty-four patients diagnosed with COVID-19 pneumonia with dysphagia and 44 patients with aspiration pneumonia were referred for a videofluoroscopic swallowing study (VFSS) since they presented with signs and symptoms of dysphagia. The electronic medical records were reviewed to compare the dysphagia characteristics of the patients.
Results: Intensive care unit (ICU) admission, intubation, tracheostomy, and a diagnosis of Acute Respiratory Distress Syndrome (ARDS) after admission were more common in patients with COVID-19 pneumonia (P＜0.001 for other variables and P=0.007 for tracheostomy) than in patients with aspiration pneumonia. Compared to patients with aspiration pneumonia, the COVID-19 patients had a significantly higher total modified videofluoroscopic dysphagia scale (mVDS) score, indicating more severe dysphagia (P=0.038). Among the mVDS sub-scores, tracheal aspiration was significantly higher in the COVID-19 pneumonia group (P＜0.001). In logistic regression analysis, age (P=0.034), COVID-19 (P=0.001), ICU admission (P=0.012), tracheostomy (P=0.029), and ARDS diagnosis after admission (P=0.036) were significantly associated with tracheal aspiration. After adjusting for age, sex, comorbidities, and clinical variables, COVID-19 was still significantly associated with worse tracheal aspiration scores (P=0.042).
Conclusion: Patients with COVID-19 pneumonia showed more severe dysphagia than subjects with aspiration pneumonia. This is particularly related to tracheal aspiration, as revealed by the VFSS. The dysphagia also correlated with a greater incidence of ICU admission, intubation, tracheostomy, and ARDS diagnosis in the COVID-19 pneumonia group.
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KEYWORD
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COVID-19 pneumonia, Aspiration pneumonia, Dysphagia, Videofluoroscopic swallowing study, Severity
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