Risk Factors for Dysphagia in People Hospitalized with COVID-19: A Systematic Review

Abstract

Introduction: Hospitalized patients with COVID-19 are at increased risk for developing dysphagia and its associated complications. Identifying risk factors is essential for early referral, minimizing hospital stay duration, and reducing the need for prolonged rehabilitation. We aimed to identify risk factors associated with dysphagia in adults hospitalized with COVID-19.
Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers searched PubMed, SciELO, Cochrane Library, Index of Portuguese Medical Journals, and EBSCOHost using the terms: (risk factors) AND
(COVID-19 OR SARS-CoV-2) AND (dysphagia OR swallowing disorders). Inclusion criteria comprised primary studies involving hospitalized adults with COVID-19, published in English or Portuguese, with no time restrictions. Exclusion criteria included pediatric populations, secondary studies, and grey literature. The methodological quality and level of evidence were assessed using the Quality Assessment Tool for Quantitative Studies.
Results: Out of 6424 retrieved articles, 13 met the inclusion criteria. The included studies exhibited evidence levels ranging from moderate to weak. A total of 31 risk factors for dysphagia were identified, with five emerging as the most frequently reported.
Conclusion: The most prevalent risk factors for dysphagia in hospitalized COVID-19 patients were advanced age, prolonged hospitalization, mechanical ventilation, prone positioning, and tracheostomy. The high prevalence of dysphagia in this population underscores the need for timely identification and early intervention.