71f42a102311a4964963a10ace38bb45 292224.pdf e23f88e81f8df91aa529ae2efe6f4255dfc92fda 292224.pdf 1b1fb9e2ac50416704226e7992611c776bfb2e362e11198c284393039f8e4eb4 292224.pdf Title: A Comparative Study between the Three Waves of the Pandemic on the Prevalence of Oropharyngeal Dysphagia and Malnutrition among Hospitalized Patients with COVID-19 Subject: Background: 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. Methods: 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 mPas or 800 mPas). Results: 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 (p = 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. Keywords: swallowing disorders; oropharyngeal dysphagia; COVID-19; malnutrition; nutritional risk; fluid thickening Author: Paula Viñas, Alberto Martín-Martínez, Claudia Alarcón, Stephanie A. Riera, Jaume Miró, Cristina Amadó, Pere Clavé and Omar Ortega Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Sep 16 12:07:49 2022 CEST ModDate: Fri Sep 16 14:45:46 2022 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1332351 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YQFJFW+VnURWPalladioL Type 1 Custom yes yes no 10 0 NBHULN+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 SVCSBX+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 BTICOL+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 EEQVUF+CMSY10 Type 1 Builtin yes yes no 28 0 XWOCXD+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 HGMNRX+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 75 0 IIKGOB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 89 0 IIKGOD+PalatinoLinotype TrueType WinAnsi yes yes no 92 0 IIKGPF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 95 0 IIKGOB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 112 0 IIKGOD+PalatinoLinotype TrueType WinAnsi yes yes no 115 0 IIKGPF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 118 0 IIKGOB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 130 0 IIKGOD+PalatinoLinotype TrueType WinAnsi yes yes no 133 0 IIKGPF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 136 0 XDGBEU+URWPalladioL-BoldItal Type 1 Custom yes yes no 144 0 IIKGOB+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 153 0 IIKGOC+PalatinoLinotype CID TrueType Identity-H yes yes yes 156 0 IIKGOD+PalatinoLinotype TrueType WinAnsi yes yes no 162 0 IIKGPF+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 165 0 IIKMAI+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 168 0 RIJDHR+CMBSY10 Type 1 Builtin yes yes no 180 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-25 02:37:12 CEST RepresentationInformation: 292224.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-05-24 13:03:06 CEST Size: 1332351 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 461 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Population Destination: subsection.2.1 Item: Title: Study Design Destination: subsection.2.2 Item: Title: Clinical Assessment Destination: subsection.2.3 Item: Title: Swallowing Assessment Destination: subsection.2.4 Item: Title: Nutritional Assessment Destination: subsection.2.5 Item: Title: Nutritional Intervention Destination: subsection.2.6 Item: Title: Data Management and Statistical Analysis Destination: subsection.2.7 Item: Title: Results Destination: section.3 Children: Item: Title: Demographics and Clinical Characteristics of the Study Population Destination: subsection.3.1 Children: Item: Title: Total Participants Destination: subsubsection.3.1.1 Item: Title: Three Waves Description Destination: subsubsection.3.1.2 Item: Title: Swallowing and Masticatory Function Destination: subsection.3.2 Children: Item: Title: Total Participants Destination: subsubsection.3.2.1 Item: Title: Three Waves Description Destination: subsubsection.3.2.2 Item: Title: Nutritional Status Destination: subsection.3.3 Children: Item: Title: Total Participants Destination: subsubsection.3.3.1 Item: Title: Three Waves Description Destination: subsubsection.3.3.2 Item: Title: Biochemical Analysis Destination: subsection.3.4 Children: Item: Title: Total Participants Destination: subsubsection.3.4.1 Item: Title: Three Waves Description Destination: subsubsection.3.4.2 Item: Title: Risk Factors Associated with OD, MN and Mortality Destination: subsection.3.5 Children: Item: Title: Oropharyngeal Dysphagia Destination: subsubsection.3.5.1 Item: Title: Malnutrition Destination: subsubsection.3.5.2 Item: Title: Mortality Destination: subsubsection.3.5.3 Item: Title: Multivariate Analysis: Independent Risk Factors Associated with OD, MN and Mortality Destination: subsection.3.6 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: A Comparative Study between the Three Waves of the Pandemic on the Prevalence of Oropharyngeal Dysphagia and Malnutrition among Hospitalized Patients with COVID-19 Author: Paula Viñas, Alberto Martín-Martínez, Claudia Alarcón, Stephanie A. Riera, Jaume Miró, Cristina Amadó, Pere Clavé and Omar Ortega Subject: Background: 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. Methods: 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 mPas or 800 mPas). Results: 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 (p = 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. 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