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ABSTRACT BACKGROUND: The cause of oropharyngeal dysphagia in patients with coronavirus disease (COVID-19) can be multifactorial and may underly limitations in swallowing rehabilitation. OBJECTIVE: Analyze the factors related to dysphagia in patients with COVID-19 immediately after orotracheal extubation and the factors that influence swallowing rehabilitation. DESIGN AND SETTING: A retrospective study. METHODS: The presence of dysphagia was evaluated using the American Speech-Language Hearing Association National Outcome Measurement System (ASHA NOMS) scale and variables that influenced swallowing rehabilitation in 140 adult patients who required invasive mechanical ventilation for >48 h. RESULTS: In total, 46.43% of the patients scored 1 or 2 on the ASHA NOMS (severe dysphagia) and 39.29% scored 4 (single consistency delivered orally) or 5 (exclusive oral diet with adaptations). Both the length of mechanical ventilation and the presence of neurological disorders were associated with lower ASHA NOMS scores (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.74–0.87 P < 0.05; and OR: 0.13, 95% CI: 0.61–0.29; P < 0.05, respectively). Age and the presence of tracheostomy were negatively associated with speech rehabilitation (OR: 0.92; 95% CI: 0.87–−0.96; OR: 0.24; 95% CI: 0.80–−0.75), and acute post-COVID-19 kidney injury requiring dialysis and lower scores on the ASHA NOMS were associated with longer time for speech therapy outcomes (β: 1.62, 95% CI, 0.70–3.17, P < 0.001; β: −1.24, 95% CI: −1.55–−0.92; P < 0.001). CONCLUSION: Prolonged orotracheal intubation and post-COVID-19 neurological alterations increase the probability of dysphagia immediately after extubation. Increased age and tracheostomy limited rehabilitation. BACKGROUND COVID19 COVID 19 (COVID-19 OBJECTIVE COVID-1 SETTING study METHODS SpeechLanguage Speech Language 14 48 >4 h RESULTS total 4643 46 43 46.43 severe 3929 39 29 39.29 single orally exclusive adaptations. adaptations . adaptations) odds OR [OR] 080 0 80 0.80 95 CI [CI] 074087 74 87 0.74–0.8 0.05 005 05 013 13 0.13 0.61–0.29 061029 61 respectively. respectively respectively) (OR 0.92 092 92 0.87–−0.96 087096 96 0.24 024 24 0.80–−0.75, 080075 0.80–−0.75 , 75 0.80–−0.75) postCOVID19 postCOVID post post-COVID-1 β (β 162 62 1.62 070317 70 3 17 0.70–3.17 0.001 0001 001 124 −1.24 −1.55–−0.92 155092 55 0.001. 0.001) CONCLUSION COVID1 (COVID-1 COVID- > 464 46.4 392 39.2 [OR 08 8 0.8 9 [CI 07408 7 0.74–0. 0.0 00 01 0.1 0.61–0.2 06102 6 0.9 09 0.87–−0.9 08709 0.2 02 08007 0.80–−0.7 postCOVID1 post-COVID- 16 1.6 07031 0.70–3.1 0.00 000 12 −1.2 −1.55–−0.9 15509 (COVID- 46. 39. 0. 0740 0.74–0 0.61–0. 0610 0.87–−0. 0870 0800 0.80–−0. post-COVID 1. 0703 0.70–3. −1. −1.55–−0. 1550 (COVID 074 0.74– 0.61–0 061 0.87–−0 087 0.80–−0 070 0.70–3 −1 −1.55–−0 155 07 0.74 0.61– 06 0.87–− 0.80–− 0.70– − −1.55–− 15 0.7 0.61 0.87– 0.80– 0.70 −1.55– 0.6 0.87 −1.55 −1.5

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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