Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis

PHOSP-COVID Collaborative Group, Camilla Dawson (Lead / Corresponding author), Gemma Clunie, Felicity Evison, Sallyanne Duncan, Julie Whitney, Linzy Houchen-Wolloff, Charlotte E. Bolton, Olivia C. Leavy, Matthew Richardson, Elneima Omer, Hamish McAuley, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Ruth M. Saunders, Victoria C. Harris, Neil J. Greening, Claire Marie Nolan, Dan Gower WoottonEnya Daynes, Gavin Donaldson, Jack Sargent, Janet Scott, John Pimm, Lettie Bishop, Melitta McNarry, Nicholas Hart, Rachael A. Evans, Sally Singh, Tom Yates, Trudie Chalder, William Man, Ewen Harrison, Annemarie Docherty, Nazir I. Lone, Jennifer K. Quint, James Chalmers, Ling-Pei Ho, Alex Robert Horsley, Michael Marks, Krisnah Poinasamy, Betty Raman, Louise V. Wain, Chris Brightling, Neil Sharma, Margaret Coffey, Amit Kulkarni, Sarah Wallace

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Objective: Identify prevalence of self-reported swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19.

Design: Multicentre prospective observational cohort study using questionnaire data at visit 1 (2-7 months post discharge) and visit 2 (10-14 months post discharge) from hospitalised patients in the UK. Lasso logistic regression analysis was undertaken to identify associations.

Setting: 64 UK acute hospital Trusts.

Participants: Adults aged >18 years, discharged from an admissions unit or ward at a UK hospital with COVID-19.

Main outcome measures: Self-reported swallow, communication, voice and cognitive compromise.

Results: Compromised swallowing post intensive care unit (post-ICU) admission was reported in 20% (188/955); 60% with swallow problems received invasive mechanical ventilation and were more likely to have undergone proning (p=0.039). Voice problems were reported in 34% (319/946) post-ICU admission who were more likely to have received invasive (p<0.001) or non-invasive ventilation (p=0.001) and to have been proned (p<0.001). Communication compromise was reported in 23% (527/2275) univariable analysis identified associations with younger age (p<0.001), female sex (p<0.001), social deprivation (p<0.001) and being a healthcare worker (p=0.010). Cognitive issues were reported by 70% (1598/2275), consistent at both visits, at visit 1 respondents were more likely to have higher baseline comorbidities and at visit 2 were associated with greater social deprivation (p<0.001).

Conclusion: Swallow, communication, voice and cognitive problems were prevalent post hospitalisation for COVID-19, alongside whole system compromise including reduced mobility and overall health scores. Research and testing of rehabilitation interventions are required at pace to explore these issues.

Original languageEnglish
Article numbere001647
Number of pages17
JournalBMJ Open Respiratory Research
Issue number1
Publication statusPublished - 26 Jul 2023


  • Adult
  • Female
  • Humans
  • Aftercare
  • Cognition
  • Communication
  • COVID-19/epidemiology
  • Hospitalization
  • Patient Discharge
  • Prevalence
  • Prospective Studies
  • Male


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