Post-COVID Swallowing Problems: Coronavirus Dysphagia Explained

For most people, COVID-19 causes a temporary illness from which they recover fully. But for a significant minority, symptoms persist for weeks or months - a condition now widely known as Long COVID. Among the many symptoms that can linger, difficulty swallowing is increasingly being recognised. Coronavirus dysphagia, as it is sometimes called, can affect people who were seriously ill and those who were not.

How coronavirus and COVID-19 can affect swallowing

Swallowing difficulties after COVID-19 can arise in several different ways, depending on how the illness affected you.

For people who were hospitalised and required a ventilator or prolonged intubation, swallowing difficulties are relatively common. The physical presence of a tube in the airway for an extended period can affect the muscles, nerves, and structures involved in swallowing - a condition sometimes called post-intubation dysphagia.

But swallowing problems after coronavirus are not limited to those who were seriously ill. Long COVID can involve neurological symptoms, fatigue, and changes to sensation and muscle function that affect the swallow - even in people who managed their illness entirely at home.

Long COVID and swallowing difficulties

Long COVID dysphagia is a recognised feature of post-COVID syndrome. The mechanisms are not fully understood, but current thinking points to a combination of neurological involvement, generalised muscle deconditioning, and persistent inflammation.

People with Long COVID and swallowing difficulties often describe the problem as coming on gradually rather than appearing immediately after the acute illness. Some notice it worsening with fatigue - swallowing feels manageable early in the day but increasingly effortful by evening. Others find that certain textures have become difficult that were previously fine.

The important thing to understand is that Long COVID dysphagia is not imagined and it is not inevitable. It responds to targeted intervention.

Signs of post-COVID dysphagia

• Coughing or choking when eating or drinking
• Food or liquid feeling like it is sticking in the throat
• A sensation of something being in the throat when nothing is there
• Increased effort or time needed to swallow
• Avoiding certain food textures or drinks you previously managed fine
• A wet or gurgly voice after eating
• Fatigue during or after meals
• Unexplained weight loss

Some people also experience changes to their voice, reduced breath support, or difficulty coordinating breathing and swallowing. All of these can affect safe eating and drinking.

Can post-COVID swallowing difficulties be treated?

Yes. Post-COVID dysphagia is treatable, and many people make a significant or full recovery with the right support.

Treatment is delivered by a Speech and Language Therapist with specialist dysphagia training. Assessment will identify exactly where in the swallow the difficulty lies - whether that is the muscles of the mouth and throat, the timing and coordination of the swallow, sensory changes, or fatigue-related breakdown.

From there, a tailored programme may include targeted exercises to rebuild strength and coordination in the swallowing muscles, strategies for pacing and safer eating, advice on food and drink textures to manage symptoms while recovery progresses, and guidance on positioning and other compensatory techniques.

Recovery timelines vary. Some people improve quickly with a short course of targeted therapy; others, particularly those with significant Long COVID, need a longer programme. Either way, the sooner assessment happens, the sooner an effective plan can be put in place.

You do not need to wait

If you are experiencing coronavirus swallowing problems, you do not need to wait for an NHS referral. A private assessment can typically be arranged within days and gives you immediate access to specialist input, a clear explanation of what is happening and why, and a personalised treatment plan.

If you are in Hampshire or the surrounding area, contact Hampshire Feeding Clinic to arrange an initial assessment. You may also find it helpful to read more about what dysphagia is and what an adult dysphagia assessment involves.