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Background <p>Isolation was implemented for elderly patients with coronavirus disease 2019 (COVID-19), which interrupted care including oral intake support.</p> Objective <p>To assess the changes in feeding and swallowing function measured by the functional oral intake scale (FOIS) and their association with post-discharge mortality in elderly COVID-19 patients.</p> Design <p>Single-center retrospective cohort study.</p> Participants <p>We included patients aged ≥ 65 years and admitted for COVID-19 between December 1, 2021 and March 31, 2023. Those with FOIS before onset (pre-FOIS) 1–3 were excluded.</p> Main Measures <p>We measured FOIS (1–7, 1: no oral intake, 7: normal) before onset and at discharge, and assessed mortality for 180 days after onset. The primary outcome was decrease in FOIS during hospitalization; in-hospital mortality was assumed as 4-level decreases in FOIS. The secondary outcome was 180-day mortality. Association of each pre-FOIS (6, 5, 4) relative to pre-FOIS 7 with the primary outcome was estimated as adjusted common odds ratios (ORs) and 95% confidence intervals (CIs). Association of decreases in FOIS with 180-day mortality was assessed with Kaplan–Meier curve.</p> Key Results <p>We included 337 patients whose median age was 81 years, and 56% of them were men. The distribution of pre-FOIS was 7 (190 patients), 6 (89), 5 (40), and 4 (18). The severity of COVID-19 was generally similar among pre-FOIS levels. The pre-FOIS was significantly associated with decreases in FOIS: adjusted common OR 2.23 [95%CI 1.27–3.92] for pre-FOIS 6, 2.96 [1.46–6.05] for pre-FOIS 5, 2.89 [1.14–7.40] for pre-FOIS 4. The degree of decrease in FOIS was significantly associated with 180-day mortality: no decrease, 4.7%; 1-level decrease, 1.2%; 2-level decrease, 27.9%; 3-level decrease, 46.0%.</p> Conclusions <p>Lower pre-FOIS was associated with further decreases in FOIS in elderly patients who were isolated due to COVID-19, and the degree of decrease was further associated with post-discharge mortality.</p>

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Change in Feeding and Swallowing Function in Elderly Patients with Isolated Hospitalization for COVID-19: A Retrospective Cohort Study

  • 期刊论文

  • 发表日期：

    2025年3月31日

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  • Kenya Hamazaki,
  • Toru Morikawa,
  • Mari Nezu,
  • Koji Oh,
  • Chihiro Nishio,
  • Takeshi Morimoto

摘要

Background

Isolation was implemented for elderly patients with coronavirus disease 2019 (COVID-19), which interrupted care including oral intake support.

Objective

To assess the changes in feeding and swallowing function measured by the functional oral intake scale (FOIS) and their association with post-discharge mortality in elderly COVID-19 patients.

Design

Single-center retrospective cohort study.

Participants

We included patients aged ≥ 65 years and admitted for COVID-19 between December 1, 2021 and March 31, 2023. Those with FOIS before onset (pre-FOIS) 1–3 were excluded.

Main Measures

We measured FOIS (1–7, 1: no oral intake, 7: normal) before onset and at discharge, and assessed mortality for 180 days after onset. The primary outcome was decrease in FOIS during hospitalization; in-hospital mortality was assumed as 4-level decreases in FOIS. The secondary outcome was 180-day mortality. Association of each pre-FOIS (6, 5, 4) relative to pre-FOIS 7 with the primary outcome was estimated as adjusted common odds ratios (ORs) and 95% confidence intervals (CIs). Association of decreases in FOIS with 180-day mortality was assessed with Kaplan–Meier curve.

Key Results

We included 337 patients whose median age was 81 years, and 56% of them were men. The distribution of pre-FOIS was 7 (190 patients), 6 (89), 5 (40), and 4 (18). The severity of COVID-19 was generally similar among pre-FOIS levels. The pre-FOIS was significantly associated with decreases in FOIS: adjusted common OR 2.23 [95%CI 1.27–3.92] for pre-FOIS 6, 2.96 [1.46–6.05] for pre-FOIS 5, 2.89 [1.14–7.40] for pre-FOIS 4. The degree of decrease in FOIS was significantly associated with 180-day mortality: no decrease, 4.7%; 1-level decrease, 1.2%; 2-level decrease, 27.9%; 3-level decrease, 46.0%.

Conclusions

Lower pre-FOIS was associated with further decreases in FOIS in elderly patients who were isolated due to COVID-19, and the degree of decrease was further associated with post-discharge mortality.