BACKGROUND . Severe SARS-CoV-2 pneumonia has brought intensive care units (ICUs) and the consequences of prolonged hospitalisation, such as dysphagia, into focus. METHODS . Study population : Patients with severe pneumonia due to SARS-CoV-2 who required admission to critical units from March to June 2020. Dysphagia diagnostic method : Modified Viscosity Volume Swallowing Test (mV-VST). Objectives: . To identify risk factors for dysphagia in patients with severe SARS-CoV-2 pneumonia requiring invasive mechanical ventilation and determine their incidence. Statistical analysis : Descriptive analysis of means or medians according to the normality of quantitative variables and proportions for the descriptive variables (95% CI ). Univariate analysis of dysphagia using simple logistic regression. Multivariate analysis and construction of a predictive model for dysphagia using logistic regression. RESULTS . Descriptive analysis . Sample size: 232 patients;72% (167) required intubation. Of these, 65.9% (110) survived and 84.5% (93) underwent the mV-VST, which diagnosed 26.9% (25) with dysphagia. Age: 60.5 years (95% CI: 58.5 to 61.9). Men: 74.1% (95% CI: 68.1 to 79.4). APACHE II score: 17.7 (95% CI: 13.3 to 23.2). Mechanical ventilation: 14 days (95% CI: 11 to 16);prone position: 79% (95% CI: 72.1 to 84.6);respiratory infection: 34.5% (95% CI: 28.6 to 40.9). Renal failure: 38.5% (95% CI: 30 to 50). Overall mortality: 25.9% (95% CI: 20.6 to 31.9). Mortality in intubated patients: 34.1% (95% CI: 27.3 to 41.7). No patient diagnosed with dysphagia died. Univariate analysis . APACHE II, prone position, days of mechanical ventilation and need for tracheostomy, respiratory infection, kidney failure developed during admission and length of ICU and hospital stay were significantly associated (p<0.05) with dysphagia. Multivariate analysis . Dysphagia is independently explained by APACHE II score (OR: 1.1;95% CI: 1.01 to 1.3;p=0.04) and tracheostomy (OR: 10.2;95% CI: 3.2 to 32.1;p<0.001). The resulting predictive model predicts dysphagia with a good ROC curve (AUC: 0.8;95% CI: 0.7 to 0.9) CONCLUSIONS . Dysphagia affects almost one-third of patients, and the risk of developing dysphagia increases with prolonged mechanical ventilation, tracheostomy and greater severity on admission (APACHE II score).
Dysphagia and Mechanical Ventilation in Sars-Cov-2 Pneumonia: It’s Real