Key Points
  1. Post-extubation dysphagia and dysphonia are multifactorial and can lead to prolonged ICU stay, prolonged tube feeding, aspiration pneumonia and increased morbidity and mortality.
  2. In this multi-site prospective cohort study across eleven acute hospitals, 90% of adults required an altered oral diet post-extubation and 36% were unable for any oral intake based on SLT evaluation. Sixty-six percent presented with post-extubation dysphonia.
  3. Age, proning and pre-existing respiratory disease were predictors of post-extubation oral intake status, whereas intubation injury and pre-existing respiratory disease were predictors of post-extubation dysphonia.
  4. Over a third (37%) required dysphagia rehabilitation post-extubation whereas 20% needed voice rehabilitation.
  5. Dysphagia and dysphonia persisted in 27% and 37% cases respectively at hospital discharge, indicating that SLTs should be included in outpatient multidisciplinary COVID clinics in the community.