A Comparative Study between the Three Waves of the Pandemic on the Prevalence of Oropharyngeal Dysphagia and Malnutrition among Hospitalized Patients with COVID-19

The phenotype of patients affected by COVID-19 disease changed between the waves of the pandemic. We assessed the prevalence of oropharyngeal dysphagia (OD), malnutrition (MN), and mortality between the first three waves of COVID-19 patients in a general hospital. A prospective observational study b...

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Bibliographic Details
Authors: Viñas, Paula|||0000-0003-4747-2534, Martín-Martínez, Alberto|||0000-0002-6805-764X, Alarcón Pedrero, Claudia|||0000-0003-2700-7993, Riera, Stephanie|||0000-0003-4477-1248, Miró Ramos, Jaume|||0000-0002-5900-9822, Amadó Ruiz, Cristina|||0000-0003-4498-3937, Clavé i Civit, Pere|||0000-0002-0696-8560, Ortega, Omar|||0000-0001-6178-3748
Format: article
Publication Date:2022
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:292224
Online Access:https://ddd.uab.cat/record/292224
https://dx.doi.org/urn:doi:10.3390/nu14183826
Access Level:Open access
Keyword:COVID-19
Fluid thickening
Malnutrition
Nutritional risk
Oropharyngeal dysphagia
Swallowing disorders
Description
Summary:The phenotype of patients affected by COVID-19 disease changed between the waves of the pandemic. We assessed the prevalence of oropharyngeal dysphagia (OD), malnutrition (MN), and mortality between the first three waves of COVID-19 patients in a general hospital. A prospective observational study between April 2020-May 2021. Clinical assessment for OD was made with the volume-viscosity swallowing test; nutritional assessment was performed consistent with GLIM criteria. A multimodal intervention was implemented in the second and third wave, including (a) texturized diets-fork mashable (1900 kcal + 90 g protein) or pureed (1700 kcal + 75 g protein), (b) oral nutritional supplements (500-600 kcal + 25-30 g protein), and (c) fluid thickening (250 mPa·s or 800 mPa·s). We included 205 patients (69.3 ± 17.6 years) in the 1st, 200 (66.4 ± 17.5 years) in the 2nd, and 200 (72.0 ± 16.3 years;) in the 3rd wave (p = 0.004). On admission, prevalence of OD was 51.7%, 31.3% and 35.1%, and MN, 45.9%, 36.8% and 34.7%, respectively; mortality was 10.7%, 13.6% and 19.1%. OD was independently associated with age, delirium, and MN; MN, with age, OD, diarrhea and ICU admission; mortality, with age, OD and MN. Prevalence of OD, MN and mortality was very high among COVID-19 patients. OD was independently associated with MN and mortality. An early and proactive multimodal nutritional intervention improved patients' nutritional status.

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