Oropharyngeal Dysphagia and Aspiration Pneumonia Following Coronavirus Disease 2019: A Case Report

Dysphagia. 2020 Aug;35(4):545-548. doi: 10.1007/s00455-020-10140-z. Epub 2020 Jun 12.

Abstract

Cranial nerve involvement is a finding often observed in patients infected with severe acute respiratory syndrome coronavirus 2 during the pandemic outbreak of coronavirus disease 2019 (COVID-19). To our knowledge, this is the first report of oropharyngeal dysphagia associated with COVID-19. A 70-year-old male developed dysphagia and consequent aspiration pneumonia during recovery from severe COVID-19. He had altered sense of taste and absent gag reflex. Videoendoscopy, videofluorography, and high-resolution manometry revealed impaired pharyngolaryngeal sensation, silent aspiration, and mesopharyngeal contractile dysfunction. These findings suggested that glossopharyngeal and vagal neuropathy might have elicited dysphagia following COVID-19. The current case emphasizes the importance of presuming neurologic involvement and concurrent dysphagia, and that subsequent aspiration pneumonia might be overlooked in severe respiratory infection during COVID-19.

Keywords: Coronavirus disease 2019; Deglutition; Deglutition disorder; Severe acute respiratory syndrome coronavirus 2; Vagus nerve.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Aged
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / pathology
  • Deglutition Disorders / etiology*
  • Deglutition Disorders / virology
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung / virology
  • Male
  • Oropharynx / pathology
  • Oropharynx / virology
  • Pandemics
  • Pneumonia, Aspiration / etiology*
  • Pneumonia, Aspiration / virology
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / pathology
  • Tomography, X-Ray Computed