Abstract
Objective : During the third wave of the coronavirus disease 2019 (COVID–19) pandemic in Japan in December 2020, vaccination programs had not yet begun. Many elderly people in aged care facilities were infected and hospitalized. Many of them were too sick to be discharged from the hospital, resulting in fewer hospital beds for newly admitted COVID–19 patients. Our hospital had already been collaborating in accepting patients in the recovery phase of COVID–19 from a designated medical facility for infectious diseases since the first wave in April 2020, and we had accepted many elderly patients in the third wave. In this study, we evaluated the outcomes of dysphagia treatment in the recovery phase of elderly COVID–19 patients with underlying diseases.
Methods : The courses of disease and treatment of 14 elderly COVID–19 patients were examined retrospectively. They were infected in aged care facilities, hospitalized in a designated medical facility for infectious diseases and transferred to our hospital after acute treatment. Dysphagia treatment was initiated by doctors, nurses and physiotherapists, and speech–language and hearing therapists were involved after patients completed a period of quarantine.
Results : Fourteen patients were aged 86±7 (mean±SD, range 72–95) years, 8 had dementia and 2 had neurodegenerative diseases. Of the COVID–19 patients, 86% showed pneumonia, and 64% required oxygen. All patients were able to eat orally before the onset of COVID–19. On admission to our hospital 18.2±5.6 (11–33) days after onset, 9 (63%) patients were unable to eat orally. After admission, five patients recovered enough to be able to feed orally after undergoing a swallowing assessment and dysphagia treatment. However, two patients with neurodegenerative diseases did not recover from their dysphagia, one patient with dementia did not recover enough to feed due to a disability in his pre–oral stage, and another patient died.
Conclusion : Feeding and swallowing function was restored in 83% of elderly people who recovered from COVID–19. Swallowing assessment and successful dysphagia treatment may have contributed to improving patient prognosis.
