Link Between Post Covid Syndrome and Difficulty in Swallowing (Dysphagia)

Difficulty in Swallowing and Voice Problems Post-Covid

Some people who have had COVID-19 or coronavirus might have difficulty in swallowing or eating and drinking. This could affect your voice and communication. You might also become tired more easily or feel breathless at times.

Swallowing Problems

You normally hold your breath when you swallow. This prevents any food or fluid entering the lungs. When you have breathing difficulties, you might have trouble coordinating breathing and swallowing. There are things you could do to help manage this at home.

Not a CNS Problem?

To help any swallowing difficulties:

• Always sit up completely on a supportive chair when you are eating or drinking
• Take a few sips or bites
• Eat or drink slower than usual
• Stop and rest if you experience shortness of breath or fatigue
• Eat little and often - 3 smaller meals and 3 snacks every day is suggested
• Try eating softer foods which require to be chewed less
• Limit speaking during meals as this could cause breathlessness

When to Get Help

Some people heal quickly and do not require much support. But others will require more time and help in their recovery. If you require extra help, talk to a speech and language therapist (SLT). A speech and language therapist (SLT) might suggest rehabilitation to improve your swallowing, voice and communication skills.

If you do not get enough nutrients because of swallowing problems, a dietitian could help. Nutrition could affect your recovery and mobility. To get an appointment with a speech and language therapist (SLT) or a dietitian, talk to your healthcare team in hospital. If you are recovering at home, ask your general practitioner (GP) to refer you.

If You Are in Hospital

Tell your primary care physician or nurse if you feel more short of breath during or at the end of meals. If you had a tube to help you to breathe, you might have difficulty in swallowing when the tube comes out. This could last up to 3 weeks but many people feel better much sooner.

Call your general practitioner (GP) for advice if you:

• Are still having swallowing difficulties after following the advice on how to eat or drink comfortably
• Are coughing or choking while eating or drinking
• Having a moist or gurgling voice after swallowing
• Are feeling a sticking feeling in your throat when eating or drinking
• Have new frequent chest infections

Looking After Your Mouth

While you were ill with COVID-19, you might have had:

• A dry or sore mouth
• Cracked lips
• Bad breath

Mouth care is crucial as it could stop dryness and future infections. It is particularly crucial to look after your mouth if you have used a breathing mask in hospital. This is because breathing masks could dry out your mouth.

How to Look After Your Mouth

To care for your mouth, you must:

• Brush after each meal using a quantity of toothpaste the size of a pea
• Drink lots of liquids, take small sips on a regular basis
• Use lip balm in case your lips are dry

If you have dental prostheses, remove them and clean them twice a day. Always get your teething out at night.

Voice Problems after COVID-19

Talking could be more difficult if you are breathless. Your voice may sound weak, quiet, rough or hoarse. You might have a sore throat if you have been coughing a lot or if you required a breathing tube in hospital. You might feel that your voice is weak and your speech is not as clear as it used to be. This needs to improve as your symptoms resolve. Voice problems could take 6 to 8 weeks to recover. If your voice has not returned to normal by this time, contact your general practitioner (GP).

How Do We Take Care of Our Voice and Speak Clearly?

To help you recover your voice, you should stay hydrated while drinking lots of water.

You should also avoid:

• Shouting or forcing your voice out
• Continuous, deliberate throat clearing - try drinking water or doing a single, big cough instead
• Deliberate whispering - it doesn't 'save' the voice, it puts pressure on the voicemail
• Drinking a lot of caffeine and alcohol
• Smoking or vaping
• Medicated lozenges and gargles - the relief they offer might cause you to force your voice even more
• Hot or dry air
• Dusty environments

How to Speak More Clearly

To help people to hear you better, you could try:

• Sit in the vertical position and breathe before speaking
• Lowering the background noise when communicating with others
• Stop, take a break and try later if your voice feels tired

If you have a very loud or weak voice, avoid phone or video conversations. Try to use text-based alternatives instead.