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

• Published in: Nutrients Vol. 14; no. 18; p. 3826
• Main Authors: Viñas, Paula, Martín-Martínez, Alberto, Alarcón, Claudia, Riera, Stephanie A, Miró, Jaume, Amadó, Cristina, Clavé, Pere, Ortega, Omar
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-09-2022; MDPI
• Subjects: Adaptation; China; Comparative studies; Coronaviruses; COVID-19; COVID-19 - epidemiology; Deglutition disorders; Deglutition Disorders - complications; Deglutition Disorders - epidemiology; Deglutition Disorders - therapy; Diarrhea; Diet; Dietary supplements; Disease; Dysphagia; Epidemics; fluid thickening; G proteins; Health aspects; Hospital patients; Hospitalization; Hospitals; Humans; Immune system; Infections; Malnutrition; Malnutrition - complications; Malnutrition - epidemiology; Medical research; Medicine, Experimental; Mental disorders; Mortality; Nutrition; Nutrition assessment; Nutrition research; nutritional risk; Nutritional Status; oropharyngeal dysphagia; Pandemics; Patients; Phenotypes; Pneumonia; Prevalence; Product/Service Evaluations; Proteins; Severe acute respiratory syndrome coronavirus 2; Spain; swallowing disorders; Thickening; Viscosity; China; Spain; Netherlands; COVID-19; malnutrition; oropharyngeal dysphagia; nutritional risk; swallowing disorders; fluid thickening
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu14183826

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 (
= 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. (4) Conclusions: 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.