Clinical Manifestation, Evaluation, and Rehabilitative Strategy of Dysphagia Associated With COVID-19

Yoichiro Aoyagi, Yoko Inamoto, Seiko Shibata, Hitoshi Kagaya, Yohei Otaka, Eiichi Saitoh

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)


Dysphagia is the difficulty in swallowing because of the presence of certain diseases; it particularly compromises the oral and/or pharyngeal stages. In severe acute respiratory syndrome coronavirus 2 infection, neuromuscular complications, prolonged bed rest, and endotracheal intubation target different levels of the swallowing network. Thus, critically ill patients are prone to dysphagia and aspiration pneumonia. In this review, we first discuss the possible cause and pathophysiology underlying dysphagia associated with coronavirus disease 2019, including cerebrovascular events, such as stroke, encephalomyelitis, encephalopathy, peripheral neuropathy, and myositis, that may lead to the dysphagia reported as a complication associated with the coronavirus disease 2019. Next, we present some recommendations for dysphagia evaluation with modifications that would allow a safe and comprehensive assessment based on available evidence to date, including critical considerations of the appropriate use of personal protective equipment and optimization individual's noninstrumental swallowing tasks evaluation, while preserving instrumental assessments for urgent cases only. Finally, we discuss a practical managing strategy for dysphagia rehabilitation to ensure safe and efficient practice in the risks of severe acute respiratory syndrome coronavirus 2 exposure, in which swallowing therapy using newer technology, such as telerehabilitation system or wearable device, would be considered as a useful option.

Original languageEnglish
Pages (from-to)424-431
Number of pages8
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number5
Publication statusPublished - 01-05-2021

All Science Journal Classification (ASJC) codes

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation


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