TY - JOUR
T1 - Assessment, diagnosis, and treatment of dysphagia in patients infected with SARS-CoV-2
T2 - A review of the literature and international guidelines
AU - Vergara, José
AU - Skoretz, Stacey A.
AU - Brodsky, Martin B.
AU - Miles, Anna
AU - Langmore, Susan E.
AU - Wallace, Sarah
AU - Seedat, Jaishika
AU - Starmer, Heather M.
AU - Bolton, Lee
AU - Clavé, Pere
AU - Freitas, Susana Vaz
AU - Bogaardt, Hans
AU - Matsuo, Koichiro
AU - de Souza, Cinthia Madeira
AU - Mourão, Lucia Figueiredo
N1 - Publisher Copyright:
© 2020 American Speech-Language-Hearing Association.
PY - 2020/11
Y1 - 2020/11
N2 - Purpose: Speech-language pathologists are playing a crucial role in the assessment and management of patients infected with severe acute respiratory syndrome coronavirus 2. Our goal was to synthesize peer-reviewed literature and association guidelines from around the world regarding dysphagia assessment and management for this specific population. Method: A review of publications available in the PubMed database and official guidelines of international groups was performed on May 23, 2020. The information was synthesized and categorized into three content areas for swallowing: clinical evaluation, instrumental assessment, and rehabilitation. Results: Five publications were identified in the PubMed database. Following title, abstract, and full-text review, only three publications met inclusion criteria: two reviews and one narrative report. Additionally, 19 international guidelines were reviewed. To assess swallowing, a modified clinical evaluation was recommended and only following a risk assessment. Instrumental assessments were often considered aerosol generating, especially transnasal procedures such as endoscopy and manometry. For this reason, many associations recommended that these examinations be performed only when essential and with appropriate personal protective equipment. Guidelines recommended that intervention should focus on compensatory strategies, including bolus modification, maneuvers/postural changes, and therapeutic exercises that can be conducted with physical distancing. Respiratory training devices were not recommended during rehabilitation. Conclusions: International associations have provided extensive guidance regarding the level of risk related to the management of dysphagia in this population. To date, there are no scientific papers offering disease and/or recovery profiling for patients with dysphagia and coronavirus disease 2019. As a result, research in this area is urgently needed.
AB - Purpose: Speech-language pathologists are playing a crucial role in the assessment and management of patients infected with severe acute respiratory syndrome coronavirus 2. Our goal was to synthesize peer-reviewed literature and association guidelines from around the world regarding dysphagia assessment and management for this specific population. Method: A review of publications available in the PubMed database and official guidelines of international groups was performed on May 23, 2020. The information was synthesized and categorized into three content areas for swallowing: clinical evaluation, instrumental assessment, and rehabilitation. Results: Five publications were identified in the PubMed database. Following title, abstract, and full-text review, only three publications met inclusion criteria: two reviews and one narrative report. Additionally, 19 international guidelines were reviewed. To assess swallowing, a modified clinical evaluation was recommended and only following a risk assessment. Instrumental assessments were often considered aerosol generating, especially transnasal procedures such as endoscopy and manometry. For this reason, many associations recommended that these examinations be performed only when essential and with appropriate personal protective equipment. Guidelines recommended that intervention should focus on compensatory strategies, including bolus modification, maneuvers/postural changes, and therapeutic exercises that can be conducted with physical distancing. Respiratory training devices were not recommended during rehabilitation. Conclusions: International associations have provided extensive guidance regarding the level of risk related to the management of dysphagia in this population. To date, there are no scientific papers offering disease and/or recovery profiling for patients with dysphagia and coronavirus disease 2019. As a result, research in this area is urgently needed.
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U2 - 10.1044/2020_AJSLP-20-00163
DO - 10.1044/2020_AJSLP-20-00163
M3 - Review article
C2 - 32960646
AN - SCOPUS:85096151881
SN - 1058-0360
VL - 29
SP - 2242
EP - 2253
JO - American Journal of Speech-Language Pathology
JF - American Journal of Speech-Language Pathology
IS - 4
ER -