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Society of swallowing and dysphagia of Japan: Position statement on dysphagia management during the COVID-19 outbreak.
Auris Nasus Larynx. 2020 Oct; 47(5):715-726.AN

Abstract

On April 14, the Society of Swallowing and Dysphagia of Japan (SSDJ) proposed its position statement on dysphagia treatment considering the ongoing spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main routes of transmission of SARS-CoV-2 are physical contact with infected persons and exposure to respiratory droplets. In cases of infection, the nasal cavity and nasopharynx have the highest viral load in the body. Swallowing occurs in the oral cavity and pharynx, which correspond to the sites of viral proliferation. In addition, the possibility of infection by aerosol transmission is also concerning. Dysphagia treatment includes a broad range of clinical assessments and examinations, dysphagia rehabilitation, oral care, nursing care, and surgical treatments. Any of these can lead to the production of droplets and aerosols, as well as contact with viral particles. In terms of proper infection control measures, all healthcare professionals involved in dysphagia treatment must be fully briefed and must appropriately implement all measures. In addition, most patients with dysphagia should be considered to be at a higher risk for severe illness from COVID-19 because they are elderly and have complications including heart diseases, diabetes, respiratory diseases, and cerebrovascular diseases. This statement establishes three regional categories according to the status of SARS-CoV-2 infection. Accordingly, the SSDJ proposes specific infection countermeasures that should be implemented considering 1) the current status of SARS-CoV-2 infection in the region, 2) the patient status of SARS-CoV-2 infection, and 3) whether the examinations or procedures conducted correspond to aerosol-generating procedures, depending on the status of dysphagia treatment. This statement is arranged into separate sections providing information and advice in consideration of the COVID-19 outbreak, including "terminology", "clinical swallowing assessment and examination", "swallowing therapy", "oral care", "surgical procedure for dysphagia", "tracheotomy care", and "nursing care". In areas where SARS-CoV-2 infection is widespread, sufficient personal protective equipment should be used when performing aerosol generation procedures. The current set of statements on dysphagia management in the COVID-19 outbreak is not an evidence-based clinical practice guideline, but a guide for all healthcare workers involved in the treatment of dysphagia during the COVID-19 epidemic to prevent SARS-CoV-2 infection.

Authors+Show Affiliations

Department of Otolaryngology, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan.Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan. Electronic address: UEHAR-OTO@h.u-tokyo.ac.jp.Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan.Department of Rehabilitation, Japanese Red Cross Society Suwa Hospital, Suwa, Japan.Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan.Department of Oral Medicine and Hospital Dentistry, Tokyo Dental College, Chiba, Japan.The University of Tokyo Hospital, Rehabilitation Center, Tokyo, Japan.Aichi Cancer Center, Nursing Department, Aichi, Japan.Department of Otorhinolaryngology, Aichi Medical University, Aichi, Japan.Department of Otolaryngology, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan; Department of Speech and Hearing Sciences, International University of Health and Welfare, and the Voice and Swallowing Center, Fukuoka Sanno Hospital, Fukuoka, Japan.

Pub Type(s)

Journal Article
Practice Guideline

Language

eng

PubMed ID

32736887

Citation

Kimura, Yurika, et al. "Society of Swallowing and Dysphagia of Japan: Position Statement On Dysphagia Management During the COVID-19 Outbreak." Auris, Nasus, Larynx, vol. 47, no. 5, 2020, pp. 715-726.
Kimura Y, Ueha R, Furukawa T, et al. Society of swallowing and dysphagia of Japan: Position statement on dysphagia management during the COVID-19 outbreak. Auris Nasus Larynx. 2020;47(5):715-726.
Kimura, Y., Ueha, R., Furukawa, T., Oshima, F., Fujitani, J., Nakajima, J., Kaneoka, A., Aoyama, H., Fujimoto, Y., & Umezaki, T. (2020). Society of swallowing and dysphagia of Japan: Position statement on dysphagia management during the COVID-19 outbreak. Auris, Nasus, Larynx, 47(5), 715-726. https://doi.org/10.1016/j.anl.2020.07.009
Kimura Y, et al. Society of Swallowing and Dysphagia of Japan: Position Statement On Dysphagia Management During the COVID-19 Outbreak. Auris Nasus Larynx. 2020;47(5):715-726. PubMed PMID: 32736887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Society of swallowing and dysphagia of Japan: Position statement on dysphagia management during the COVID-19 outbreak. AU - Kimura,Yurika, AU - Ueha,Rumi, AU - Furukawa,Tatsuya, AU - Oshima,Fumiko, AU - Fujitani,Junko, AU - Nakajima,Junko, AU - Kaneoka,Asako, AU - Aoyama,Hisaaki, AU - Fujimoto,Yasushi, AU - Umezaki,Toshiro, Y1 - 2020/07/23/ PY - 2020/06/12/received PY - 2020/07/01/revised PY - 2020/07/13/accepted PY - 2020/8/2/pubmed PY - 2020/9/29/medline PY - 2020/8/2/entrez KW - Aerosol generating procedure KW - COVID-19 KW - Dysphagia management KW - Personal protective equipment KW - SARS-CoV-2 SP - 715 EP - 726 JF - Auris, nasus, larynx JO - Auris Nasus Larynx VL - 47 IS - 5 N2 - On April 14, the Society of Swallowing and Dysphagia of Japan (SSDJ) proposed its position statement on dysphagia treatment considering the ongoing spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main routes of transmission of SARS-CoV-2 are physical contact with infected persons and exposure to respiratory droplets. In cases of infection, the nasal cavity and nasopharynx have the highest viral load in the body. Swallowing occurs in the oral cavity and pharynx, which correspond to the sites of viral proliferation. In addition, the possibility of infection by aerosol transmission is also concerning. Dysphagia treatment includes a broad range of clinical assessments and examinations, dysphagia rehabilitation, oral care, nursing care, and surgical treatments. Any of these can lead to the production of droplets and aerosols, as well as contact with viral particles. In terms of proper infection control measures, all healthcare professionals involved in dysphagia treatment must be fully briefed and must appropriately implement all measures. In addition, most patients with dysphagia should be considered to be at a higher risk for severe illness from COVID-19 because they are elderly and have complications including heart diseases, diabetes, respiratory diseases, and cerebrovascular diseases. This statement establishes three regional categories according to the status of SARS-CoV-2 infection. Accordingly, the SSDJ proposes specific infection countermeasures that should be implemented considering 1) the current status of SARS-CoV-2 infection in the region, 2) the patient status of SARS-CoV-2 infection, and 3) whether the examinations or procedures conducted correspond to aerosol-generating procedures, depending on the status of dysphagia treatment. This statement is arranged into separate sections providing information and advice in consideration of the COVID-19 outbreak, including "terminology", "clinical swallowing assessment and examination", "swallowing therapy", "oral care", "surgical procedure for dysphagia", "tracheotomy care", and "nursing care". In areas where SARS-CoV-2 infection is widespread, sufficient personal protective equipment should be used when performing aerosol generation procedures. The current set of statements on dysphagia management in the COVID-19 outbreak is not an evidence-based clinical practice guideline, but a guide for all healthcare workers involved in the treatment of dysphagia during the COVID-19 epidemic to prevent SARS-CoV-2 infection. SN - 1879-1476 UR - https://www.unboundmedicine.com/medline/citation/32736887/Society_of_swallowing_and_dysphagia_of_Japan:_Position_statement_on_dysphagia_management_during_the_COVID_19_outbreak_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0385-8146(20)30165-6 DB - PRIME DP - Unbound Medicine ER -