Dysphagia in Patients With Severe Coronavirus Disease 2019—Potential Neurologic Etiologies

Rainer Dziewas, MD; Lisa-Marie Hufelschulte, BA; Johannes Lepper, MD; Jan Sackarnd, MD; Jens Minnerup, MD; Inga Teismann, MD; Sigrid Ahring, BA; Inga Claus, MD; Bendix Labeit, MD; Paul Muhle, MD; Sonja Suntrup-Krüger, MD; Tobias Warnecke, MD; Jan-Sören Padberg, MD

doi:10.1097/CCE.0000000000000332

Critical Care Explorations (Jan 2021)

Dysphagia in Patients With Severe Coronavirus Disease 2019—Potential Neurologic Etiologies

Rainer Dziewas, MD,
Lisa-Marie Hufelschulte, BA,
Johannes Lepper, MD,
Jan Sackarnd, MD,
Jens Minnerup, MD,
Inga Teismann, MD,
Sigrid Ahring, BA,
Inga Claus, MD,
Bendix Labeit, MD,
Paul Muhle, MD,
Sonja Suntrup-Krüger, MD,
Tobias Warnecke, MD,
Jan-Sören Padberg, MD

Affiliations

Rainer Dziewas, MD: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Lisa-Marie Hufelschulte, BA: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Johannes Lepper, MD: 2 Department of Cardiology, University Hospital Münster, 48149 Münster, Germany.
Jan Sackarnd, MD: 2 Department of Cardiology, University Hospital Münster, 48149 Münster, Germany.
Jens Minnerup, MD: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Inga Teismann, MD: 3 Department for Stroke and Respiratory Medicine, Alexianer Misericordia GmbH, Düesbergweg 124, 48153 Münster, Germany.
Sigrid Ahring, BA: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Inga Claus, MD: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Bendix Labeit, MD: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Paul Muhle, MD: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Sonja Suntrup-Krüger, MD: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Tobias Warnecke, MD: 1 Department of Neurology, University Hospital Münster, 48149 Münster, Germany.
Jan-Sören Padberg, MD: 2 Department of Cardiology, University Hospital Münster, 48149 Münster, Germany.

DOI: https://doi.org/10.1097/CCE.0000000000000332
Journal volume & issue: Vol. 3, no. 1
p. e0332

Abstract

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Importance:. Dysphagia is a common complication of critical illness, and many known risk factors are also present in critically ill coronavirus disease 2019 victims. Objectives:. To investigate dysphagia in patients with severe coronavirus disease 2019. Design, Setting, and Participants:. In this case series, we report results of dedicated evaluation of swallowing function in six consecutive, tracheotomized coronavirus disease 2019 patients after they had survived acute respiratory distress syndrome and were weaned from the respirator. Main Outcomes and Measures:. Dysphagia was assessed with flexible endoscopic evaluation of swallowing. Results:. Three patients suffered from severe dysphagia and airway compromise precluding decannulation, whereas in the other, three swallowing was less critically impaired, and the tracheal cannula could be removed. Four patients presented with additional laryngeal dysfunctions not typically seen in acute respiratory distress syndrome survivors. Conclusion and Relevance:. Dysphagia with impaired airway protection is a key feature in coronavirus disease 2019 acute respiratory distress syndrome survivors. Apart from critical illness polyneuropathy, coronavirus disease 2019–related involvement of the peripheral and central nervous system may contribute to swallowing impairment and laryngeal dysfunction.

Published in Critical Care Explorations

ISSN: 2639-8028 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Medical emergencies. Critical care. Intensive care. First aid
Website: https://journals.lww.com/ccejournal/pages/default.aspx

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