Evidence-based position paper on physical and rehabilitation medicine professional practice for persons with COVID-19, including post COVID-19 condition: the European PRM position (UEMS PRM Section)

European Journal of Physical and Rehabilitation Medicine, Journal Year: 2024, Volume and Issue: 59(6)

Published: Jan. 1, 2024

Although multiple factors still pose challenges to inpatient/outpatient rehabilitation for survivors of COVID-19, plays a key role this patient population. This study aimed improve Physical and Rehabilitation Medicine (PRM) physician’s professional practice persons with COVID-19-related functioning limitations, promote functional recovery reduce activity limitations and/or participation restrictions. A systematic review the scientific literature was performed from December 2019 August 2022, followed by production recommendations through 5 Delphi rounds, consensus among delegates all European countries represented in Union Medical Specialists PRM Section. The is reported together thirty-two resulting procedure. develop, foster, monitor implementation an individual project tailored patient’s age, previous medical status, current comorbidities complications, restrictions personal environmental factors. done applying concept multi-specialty integrated service model multi-professional/interdisciplinary teams, providing care at stages COVID-19 illness. evidence-based position paper represents official UEMS

Language: Английский

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Defining the physiological profile of dysphagia in the COVID-19 patient using Flexible Endoscopic Evaluation of Swallowing (FEES)

Deleted Journal, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 16

Published: Jan. 5, 2025

Little is known about the biomechanics of dysphagia in COVID-19, a pivotal aspect for guiding rehabilitation. We aimed to define physiological profile COVID-19 patients using Flexible-Endoscopic-Evaluation-of-Swallowing (FEES). All treated across two tertiary teaching hospitals (March 2020–2022) with confirmed on FEES were recruited. Key parameters recorded from initial descriptive and validated outcome measures (Penetration-Aspiration-Scale [PAS], Yale Pharyngeal-Residue-Severity-Rating-Scale, New-Zealand-Secretion-Scale [NZSS]), nature severity impairment. footage analysed by experienced speech-language-pathologists high inter-rater reliability established. Ten cases (8-male, mean age = 61yrs), no pre-existing dysphagia, required Intensive-Care-Unit (ICU) admission (mean ICU length-of-stay [LOS] 50 days, Hospital LOS 89 days). Mean intubation duration was 23-days, mechanical ventilation 36-days six tracheostomy. On FEES, all demonstrated impairments airway closure, tongue-base posterior-pharyngeal-wall contact, pharyngeal stripping laryngopharyngeal sensation variable secretion management (NZSS 2–7), rates laryngeal penetration aspiration fluids (PAS 2–8), residue more apparent at piriform fossae (Yale 3–5) compared valleculae 2–4). The patient complex involving motor sensory elements. This foundational knowledge may facilitate targeted rehabilitation this population.

Language: Английский

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A Systematic Review of the Prevalence and Characteristics of Oropharyngeal Dysphagia in Critically Ill Patients During the Acute and Postacute Recovery Phase

Critical Care Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 27, 2025

To determine the prevalence and characteristics of oropharyngeal dysphagia in critically ill adults during acute postacute care settings. This systematic review was registered on PROSPERO used Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines. Five electronic databases were searched (PubMed, Scopus, Cochrane Library, CINAHL, Embase) from time inception to September 2024 using search terms: dysphagia, deglutition disorders, swallowing sepsis, postintensive syndrome, COVID-19, critical illness. Independent articles conducted by two raters four inclusion criteria: 1) older than 18 years; 2) diagnosis illness, or ostintensive syndrome dysphagia; 3) underwent clinical swallow evaluation; 4) setting. Two independently assessed levels research evidence risk bias Oxford center Evidence-based Medicine Levels Evidence Modified Downs Black Checklist extracted demographics, study design, assessment methods, outcomes, comorbidities. After removing duplicates, 5058 identified 4844 screened out based title/abstract. Full-text completed 214 articles, 51 met inclusion. Prevalence ranged 15% 100%. Dysphagia persisted up 74% individuals at hospital discharge 22% patients 10 17 months posthospital discharge. Due design limitations, high bias, heterogeneity methods/outcomes, firm conclusions cannot be drawn. However, current data suggest a who persists greater equal 12 Given rates silent aspiration, prospective, longitudinal is needed further understand impact chronic health quality life adults.

Language: Английский

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Change in Feeding and Swallowing Function in Elderly Patients with Isolated Hospitalization for COVID-19: A Retrospective Cohort Study

Journal of General Internal Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 31, 2025

Language: Английский

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Impact of Frailty on the Duration and Type of Speech-Language-Hearing Therapy for Patients With COVID-19

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: April 9, 2025

Introduction This study aimed to explore the standard rehabilitation for patients with COVID-19 who did not receive invasive ventilation treatment and descriptively clarify timing content of speech-language-hearing therapy (SLT), categorizing based on presence or absence frailty before symptom onset. Methods retrospective observational included aged ≥18 years admitted COVID-19. SLT was performed at each hospital as per a common protocol. The exposure variable versus nonfrailty (defined clinical scale score ≥4). Multiple linear analyses adjusted baseline characteristics were used determine link between mean time. We investigated time (min/day), total time, days, session from weeks one four. Results Of 254 patients, 207 47 assigned frail nonfrail groups, respectively. in group significantly higher than that group. Furthermore, functional oral intake (FOIS) discharge, incidence hospital-acquired pneumonia, discharge home longer those considerably more indirect direct swallowing exercises Conclusions Daily days which substantially group, rates exercises.

Language: Английский

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Rehabilitation and COVID-19: update of the rapid living systematic review by Cochrane Rehabilitation Field as of February 28th, 2022

European Journal of Physical and Rehabilitation Medicine, Journal Year: 2022, Volume and Issue: 58(3)

Published: May 25, 2022

rehabilitation and coVid-19: update of the rapid living systematic review by cochrane field as february 28 th , 2022The present follows methodology defined in 3 rd edition (rlsr) conducted part rEh-coVEr (rehabilitation coVid-19 Evidence-based response) action. 1 table i lists main characteristics this update. We identified 7407 studies from databases.After removing duplicates title abstract screening, we evaluated 105 which included 38 qualitative synthesis.tables ii 2-40 iii 41 distribution selected stratified limitations functioning interest (lfri), disease phase setting (table ii), research question, study design iii).figures are displayed face cumulative data all papers rlsr (and published May st 2021 through 2022).The findings current bi-monthly concern:• relevance dysphagia patients admitted to intensive care units (icus).two prospective cohort studies, totaling 55 cases, focused attention on two comparable cohorts adults (mean age: 61 17 vs.65 years; 16 males: 79% vs.81.5% ) order evaluate dose-effectiveness treatment.in addition, because typically bilateral involvement ul Ms, future should explore possibility implement an alternating ciMt protocol increase functionality both arms.We recommend need for define standardized dose-effective CIMT protocols with a clearly number length sessions, frequency percentage constraint that could be feasible inpatient outpatient settings.

Language: Английский

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Prevalence of oropharyngeal dysphagia and risk of mortality among hospitalized COVID-19 patients: A meta-analysis

Journal of Global Health, Journal Year: 2022, Volume and Issue: 12

Published: Dec. 29, 2022

Abstract Background Post-extubation and neurologic complications in COVID-19 patients have been shown to cause oropharyngeal dysphagia (OD). We performed the first meta-analysis explore estimate pooled prevalence of OD, risk mortality, associated factors among hospitalized patients. Methods searched Scopus, PubMed, Embase, CINAHL, WHO database, Web Science for literature on used generalized linear mixed model (GLMM) determine estimates OD R software DerSimonian-Lard random-effects Comprehensive Meta-Analysis mortality presented as odds ratios (ORs) corresponding 95% confidence intervals (CIs). Cochran's Q, τ2, I2 statistic assess heterogeneity conducted a moderator analysis identify variables. Results included eighteen studies with total 2055 participants from 910 retrieved electronic databases. The was estimated at 35% (95% CI = 21-52; low certainty evidence) high (OR 6.41; 1.48-27.7; moderate evidence). Intubation 16.3; 7.10-37.3; evidence), use tracheostomies 8.09; 3.05-21.5; proning 4.97; 1.34-18.5; were highly developing OD. higher who admitted intensive care units (ICU), intubated, mechanically ventilated. Conclusions is mortality. assessment are managed an ICU, prone position, mechanical ventilated deserves more attention. Registration PROSPERO CRD42022337597

Language: Английский

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Is Postextubation Dysphagia Underestimated in the Era of COVID‐19? A Systematic Review and Meta‐analysis

Otolaryngology, Journal Year: 2023, Volume and Issue: 168(5), P. 935 - 943

Published: Feb. 26, 2023

Abstract Objective To investigate the incidence rate of postextubation dysphagia (PED) in patients with COVID‐19, as well relative factors potentially influencing clinical course dysphagia. Data Sources Six databases including PubMed, MEDLINE, Embase, ScienceDirect, Cochrane Central Register Controlled Trials (CENTRAL), and Web Science were searched no restriction on language. Review Methods The Preferred Reporting Items for Systematic Reviews Meta‐Analyses (PRISMA) guidelines followed. extracted cross‐examined among 3 authors. random‐effects model was adopted statistical synthesis. percentage 95% confidence interval (CI) effect measurements PED rate. Subgroup analyses, sensitivity metaregression also performed to identify heterogeneity studies. Results A total 594 enrolled analyzed from 10 eligible weighted COVID‐19 66.5% (95% CI: 49.7%‐79.9%). Age potential factor after adjusted by analysis. Conclusion Compared current evidence reporting only 41% non‐COVID experienced PED, our study further disclosed that a higher suffered which deserves global physicians' attention. With association between having been more clearly understood, future clinicians are suggested intubated patients' risk earlier strengthen care programs era COVID‐19.

Language: Английский

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Dysphagia in patients with severe COVID-19: a retrospective study

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: March 21, 2024

To investigate dysphagia after extubation in patients with severe coronavirus disease 2019 (COVID-19). We retrospectively examined COVID-19 treated our hospital between August 2021 and March 2022. Feeding outcomes were categorized into two groups-(1) total oral intake, (2) difficulty intake. assess the feeding outcome, we used modified water-swallowing test (MWST) for all patients. However, cases where aspiration or recurrent laryngeal nerve palsy was suspected, conducted fiberoptic endoscopic evaluation of swallowing MWST. Patient data collected from medical records. Forty-six included. Among 46 patients, 14 (30.4%) experienced difficulties Older age, longer length hospitalization, duration mechanical ventilation, tracheostomy, diabetes, higher serum levels C-reactive protein (CRP) procalcitonin (PCT) at time intubation associated The rate intake 30.4%, which is not as high reported previous studies. CRP PCT prevalence difficulty, suggesting that early attention should be paid to high-risk who have preexisting deterioration function due aging comorbidities, prolonged tracheostomy prevent pneumonia.

Language: Английский

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Long-term effects on swallowing and laryngeal function after treatment for severe COVID-19 disease in intensive care

European Archives of Oto-Rhino-Laryngology, Journal Year: 2024, Volume and Issue: 281(7), P. 3679 - 3691

Published: April 20, 2024

This study aimed to assess swallowing and laryngeal function at long-term follow-up in patients treated for severe COVID-19 the ICU.

Language: Английский

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