The prevalence of dysphagia and changes in the quality of swallowing in patients infected with COVID-19




Swallowing Disorders; Coronavirus Infections; Respiratory aspiration.


Introduction: The emergence of COVID-19 has given rise to research on possible consequences on swallowing and on the quality of swallowing in individuals who were infected by SARS-CoV2. Pulmonary infections, the need for orotracheal intubation, tracheostomy, symptoms, comorbidities, and other factors caused uncertainties about the interference of these factors in the function of swallowing and in quality of life. Objective: To verify the association between the prevalence of swallowing disorders and the quality of life of patients with possible risk factors infected with COVID-19. Methods: This is an observational, analytical, cross-sectional, quantitative study. It was carried out from August to September 2020, in a Hospital in Brasília – DF, with patients hospitalized due to COVID-19 infection. 90 individuals participated in this study; they were adults and elderly with a mean age of 59.9 ± 16.09. Among participants, 55 were men (61.1%) and 35 were women (38.9%) who had a history of swallowing disorders. Data were collected through the analysis of patients' medical records, application of the EAT-10 Test, and the Quality of Life in Swallowing Disorders (SWAL-QOL) validated for Brazilian Portuguese. Results: Considering the scores obtained by the EAT-10 questionnaire, the analysis showed a statistical significance for the variables senescence and tracheostomy (p < 0.05). The analysis of the SWAL-QOL test was performed by domains and showed a statistical significance between the variables senescence, tracheostomy, ageusia, anosmia, and hyporexia. Conclusion: Elderly people infected with COVID-19 and in need of tracheostomy have a greater chance of dysphagia. In addition, factors such as senescence, tracheostomy, age and hyporexia can improve the quality of swallowing in these patients.


Andrade PA, Santos CA, Firmino HH, Rosa CO. The importance of dysphagia screening and nutritional assessment in hospitalized patients. Einstein. 2018; 16(2): 1-6. DOI: 10.1590/S1679-45082018AO4189

Applebaum J et al. Characterization of geriatric dysphagia diagnoses in age-based cohorts. Oto Open. 2020; 4(3): 1-6. DOI: 10.1177/2473974X20939543

Arrese LC, Carrau R, Plowman EK. Relationship between the Eating Assessment Tool-10 and objective clinical ratings of swallowing function in individuals with head and neck câncer. Dysphagia. 2017; 32(1): 83-89. DOI: 10.1007/s00455-016-9741-7

Aziz M, Perisetti A, Lee-Smith WM, Gajendran M, Bansal P, Goyal H. Taste changes (dysgeusia) in COVID-19: a systematic review and metaanalysis. Gastroenterology. 2020; 159(3):1132-1133. DOI:10.1053/j.gastro.2020.05.003

Bagheri SHR, Asghari AM, Farhadi M, Shamshiri AR, Kabir A, Kamrava SK, Jalessi M, Mohebbi A, Alizadeh R, Honarmand AA et al. Coincidence of COVID-19 epidemic and olfactory dysfunction outbreak. Med J Islam Repub Iran. 2020; 34(62): 1-7. DOI: 10.34171/mjiri.34.62

Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the covid-19 virus targeting the cns: Tissue distribution, host–virus interaction, and proposed neurotropic mechanisms. ACS Chemical Neuroscience. 2020; 11(7): 995-998. DOI: 10.1021/acschemneuro.0c00122

Chen X, Liu S, Zhang C, Pu G; Sun J; Shen J, Chen Y. Dynamic chest ct evaluation in three cases of 2019 novel coronavirus pneumonia. Arch Iran Med. 2020; 23(4):277-280. DOI: 10.34172/aim.2020.11

Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X et al. CT imaging features of 2019 novel coronavirus. Radiology. 2020; 295(1):202-207. doi:

David D, Gonda MD, Meng H et al. Protecting Against Postoperative Dyspnea and Dysphagia After Occipitocervical Fusion. Operative Neurosurgery. 2020; 3(18): 254-269. DOI: 10.1093/ons/opz122

Fernández-Ruiz VE, Paredes-Ibáñez R, Armero-Barranco D, Sánchez-Romera JF, Ferrer M. Analysis of quality of life and nutritional status in elderly patients with dysphagia in order to prevent hospital admissions in a COVID-19 pandemic. Life (Basel). 2020; 11(1): 22. DOI: 10.3390/life11010022

Florie M, Pilz W, Kremer B, Verhees F, Waltman G, Winkens B, Winter N, Baijens L. EAT-10 scores and fiberoptic endoscopic evaluation of swallowing in head and neck cancer patients. Laryngoscope. 2021; 131(1): E45-E51. DOI: 10.1002/lary.28626. Epub 2020 Apr 4. PMID: 32246779; PMCID: PMC7754346.

Frajkova Z, Tedla M, Tedlova E, Suchankova. Postintubation dysphagia during COVID-19 outbreak-contemporary review. Dysphagia. 2020; 35(4):549-557. DOI: 10.1007/s00455-020-10139-6. Epub 2020 May 28. PMID: 32468193; PMCID: PMC7255443.

Gharib AZ, Felix GB, Rossoni DF, Yamada SS. Effectiveness of therapy on post-extubation dysphagia: clinical and electromyographic findings. Clin Med Insights Ear Nose Throat. 2019; 12:1-6. DOI:10.1177/1179550619873364

Giacomelli A, Pezzati L, Conti F et al. Self-reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional study. Clin Infect Dis. 2020; 71(15): 889-890. DOI: 10.1093/cid/ciaa330

Guan WJ, Ni ZY, Hu Y et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020; 80(6): 656–665. DOI: 10.1056/NEJMoa2002032

Heidler MD. Dysphagie bei tracheotomierten patienten nach langzeitbeatmung. Anasthesiol Intensivmed Notfallmed Schmerzther. 2019; 54(3):218-222. DOI: 10.1055/a-0769-6551

Hong D, Yoo D. A comparison of the swallowing function and quality of life by oral intake level in stroke patients with dysphagia. J Phys Ther Sci. 2017; 29(9): 1552-4. DOI: 10.1589/jpts.29.1552

Lechien JR, Chiesa-Estomba CM, De Siati DR et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-tomoderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020; 277(8): 2251-2261. DOI: 10.1007/s00405-020-05965-1

Li Y, Wang M, Zhou Y, Chang J, Xian Y, Mao L et al. Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study. Stroke Vasc Neurol. 2020; 5(3): 279-284. DOI: 10.1136/svn-2020-000431

Liaw M. Y. et al. Respiratory muscle training in stroke patients with respiratory muscle weakness, dysphagia, and dysarthria - a prospective randomized trial. Medicine (Baltimore). 2020; 99(10): e19337. DOI: 10.1097/MD.0000000000019337

Mayo, B. C., Massel, D. H., Bohl, D. D. et al. Dysphagia following anterior cervical spine surgery: assessment using an abridged SWAL-QOL. Int J Spine Surg. 2019; 13(1): 102-109. DOI:10.14444/6014

McGrath, B. A., Brenner, M.J, Warrillow SJ et al. Tracheostomy in the COVID-19 era: global and multidisciplinary guidance. Lancet Respir Med. 2020; 8(7): 717-725. DOI:10.1016/S2213-2600(20)30230-7

Melgaard D et al. Systematic dysphagia screening of elderly persons in the emergency department - a feasibility study. Geriatrics. 2020; 5(4): 75. DOI: 10.3390/geriatrics5040075

Menezes, E. C. Disphagia in the elderly in long-stay institutions – a systematic literature review. CEFAC. 2019. DOI:

Moein, S. T, Hashemian, S. M. R., Mansourafshar B., Khorram-Tousi, A., Tabarsi, P., Doty, R. L.. Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol. 2020; 10(8):944-950. DOI: 10.1002/alr.22587

Moon J, Hahm S, Won Y, Cho H. The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia: a preliminary randomized clinical trial. Int J Rehabil Res. 2018; 41(3): 204-10. DOI: 10.1097/MRR.0000000000000282

Muzlovic I, Perme J, Stubljar D. Orotracheal tube as a risk factor for lower respiratory tract infection: preliminary data from a randomised trial. Wien. Klin. Wochenschr. 2018;130(9–10): 328–334. DOI: 10.1007/s00508-017-1304-x

Oliveira, A. C. Friche, A. A., Salomão, M. S., Bougo, G. C.; Vicente, L. C. Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation. Braz J Otorhinolaryngol. 2018; 84(6): 722-8. doi:

Orser, B. A. Recommendations for endotracheal intubation of COVID-19 patients. Anesth Analg. 2020;130(5):1109-1110. DOI:10.1213/ANE.0000000000004803

Pandian V, Brodsky MB, Brigham EP, Parker AM, Hillel AT, Levy JM, Rassekh CH, Lalwani AK, Needham DM, Brenner MJ. COVID-19 survivorship: how otolaryngologist-head and neck surgeons can restore quality of life after critical illness. Am J Otolaryngol. 2021; 42(3): 102917. DOI: 10.1016/j.amjoto.2021.102917

Parma, V., Ohla, K., Veldhuizen, M. G. et al. More than smell - COVID-19 is associated with severe impairment of smell, taste, and chemesthesis. Chem Senses. 2020; 45(7):609-622. doi: 10.1093/chemse/bjaa041

Pilz W, Passos VL et al. Swallow-related quality of life and oropharyngeal dysphagia in myotonic dystrophy. European Archives of Oto-Rhino-Laryngology. 2020; 277:2357–2362. DOI:

Rovira A et al. Tracheostomy care and decannulation during the COVID-19 pandemic. A multidisciplinary clinical practice guideline. Eur Arch Otorhinolaryngol. 2020; 278(2): 313-312. DOI: 10.1007/s00405-020-06126-0

Schröder J et al. Intubation, tracheostomy, and decannulation in patients with Guillain-Barré-syndrome-does dysphagia matter? Muscle Nerve. 2019; 59(2): 194-200. DOI: 10.1002/mus.26377

Sola, A. G., Soler, N. B., Marco, E et al. Effects of prophylactic swallowing exercises on dysphagia and quality of life in patients with head and neck cancer receiving (chemo) radiotherapy: the redyor study, a protocol for a randomized clinical trial. Trials. 2019; 20(1): 1-7. DOI: 10.1186/s13063-019-3587-x

Tian S, Hu N, Lou J et al. Characteristics of COVID-19 infection in Beijing. J Infect. 2020; 80(4): 401-406. DOI: 10.1016/j.jinf.2020.02.018

Von E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP; STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014; 12(12):1495-9. DOI: 10.1016/j.ijsu.2014.07.013. Epub 2014 Jul 18. PMID: 25046131.

Wang, D., Hu, B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11): 1061–1069. DOI: 10.1001/jama.2020.1585

Zareifopoulos N, Lagadinou M, Karela A, Karantzogiannis G, Velissaris D. Intubation and mechanical ventilation of patients with COVID-19: what should we tell them? Monaldi Arch Chest Dis. 2020; 90(1): 191-192. DOI: 10.4081/monaldi.2020.1296

Zhou, Peng; Yang, Xing-Lou; Wang, Xian-Guang; Hu, Ben; Zhang, Lei; Zhang, Wei; Si, Hao-Rui; Zhu, Yan; Li, Bei; Huang, Chao-Lin; Chen, Hui-Dong; Chen, Jing; Luo, Yun; Guo, Hua; Jiang, Ren-Di; Liu, Mei-Qin; Chen, Ying; Shen, Xu-Rui; Wang, Xi; Zheng, Xiao-Shuang; Zhao, Kai; Chen, Quan-Jiao; Deng, Fei; Liu, Lin-Lin; Yan, Bing; Zhan, Fa-Xian; Wang, Yan-Yi; Xiao, Geng-Fu; Shi, Zheng-Li. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798): 270–273. DOI: 10.1038/s41586-020-2012-7

Zhu, Zhang, Wang, Li, Yang, Song, Zhao, Huang, Shi, Lu, Niu, Zhan, Ma, Wang, Xu, Wu, F. Gao, D.Phil., & Tan. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382(8):727‐733. DOI: 10.1056/NEJMoa2001017




How to Cite

CARDOSO, A. M. de S. .; FIGUEIREDO, A. C. G. de; NUNES, M. C. de A. .; STECHMAN NETO, J. .; ARAÚJO, C. M. de; SANTOS, R. S. . The prevalence of dysphagia and changes in the quality of swallowing in patients infected with COVID-19. Research, Society and Development, [S. l.], v. 11, n. 10, p. e540111032135, 2022. DOI: 10.33448/rsd-v11i10.32135. Disponível em: Acesso em: 4 dec. 2023.



Health Sciences