Diet Outcomes in Patients With COVID-19 Who Were Intubated and Proned

Abstract

Objective: During the first wave of the COVID-19 (SARS CoV-2) pandemic, patients being treated for acute respiratory distress syndrome were proned while intubated with mechanical ventilation. In this study, we aimed to compare the diet outcomes at the time of acute hospital discharge of patients with COVID-19 who were proned while endotracheally intubated (ETT-proned) with those who were intubated with but not proned (ETT-supine). Design: The design used is a single-center, retrospective, descriptive study. Results: Between March 1, 2020, and August 2020, 193 critically ill adult patients with severe COVID-19 requiring endotracheal intubation with mechanical ventilation were referred for a swallowing evaluation at our acute care tertiary hospital; 114 of these patients were ETT-proned. At the time of discharge from the hospital, there was no significant difference in diet level between ETT-proned and ETT-supine patients. Significant factors associated with restricted diet at discharge included older age ( p < .001) and non–English-speaking status ( p = .05). Conclusions: In this study, diet levels at the time of discharge did not differ significantly between the patient groups by time of discharge. These results should be interpreted with caution in relation to the clinical swallow evaluation, which was curtailed by practice restrictions imposed by pandemic protocols. Future research should objectively assess swallow function in patients who were proned during intubation with mechanical ventilation, utilizing evidence-based swallow screening protocols, standardized assessment of physiology via imaging (videofluoroscopic swallow studies or flexible endoscopic evaluation of swallowing), and long-term follow-up to directly and objectively determine the impact proning has on swallow physiology.