Swallowing difficulties and voice problems after COVID-19

Some people who have had COVID-19 (coronavirus) may have difficulties eating and drinking. This can affect your voice and communication. You may also become tired more easily or feel breathless at times.

Swallowing problems

You naturally hold your breath when you swallow. This stops any food or fluid entering the lungs.

When you have breathing difficulties, you may have trouble coordinating breathing and swallowing.

There are things you can do to help manage this at home.

How to eat or drink comfortably

To help any swallowing difficulties:

  • always sit up fully on a supportive chair when you are eating or drinking
  • take small sips or bites
  • eat or drink at a slower pace
  • stop and rest if you are feeling breathless or tired
  • eat little and often - 3 smaller meals and 3 snacks every day is recommended
  • try eating softer foods that need to be chewed less
  • limit speaking during meals as this can cause breathlessness

Read more about eating well when recovering from COVID-19

When to get help

Some people recover quickly and do not need much support. But others will need more time and help in their recovery.

If you need extra help, talk to a speech and language therapist (SLT). An SLT may recommend rehabilitation to improve your swallowing, voice and communication skills.

If you don't get enough nutrients because of swallowing problems, a dietitian can help. Nutrition can affect your recovery and mobility.

To get an appointment with an SLT or a dietitian, talk to your healthcare team in hospital. If you are recovering at home, ask your GP for a referral.

If you are in hospital

Tell your doctor or nurse if you feel more short of breath during or at the end of meals.

If you had a tube to help you to breathe, you may have difficulty swallowing when the tube comes out. This can last up to 3 weeks but many people feel better much sooner.

Non-urgent advice: Call your GP for advice if:

you are recovering at home and you:

  • are still having swallowing problems after following the advice on how to eat or drink comfortably
  • are coughing or choking when eating or drinking
  • have a wet or ‘gurgly’ voice after swallowing
  • are feeling a sticking sensation in your throat when eating or drinking
  • have new frequent chest infections

Looking after your mouth

While you were sick with COVID-19, you may have had:

  • a dry or sore mouth
  • cracked lips
  • bad breath

Mouth care is important as it can prevent dryness and future infections. It is especially important to look after your mouth if you have used a breathing mask in hospital. This is because breathing masks can dry out your mouth.

How to look after your mouth

To care for your mouth, you should:

  • brush your teeth after every meal using a pea-sized amount of toothpaste
  • drink plenty of fluids - take regular small sips
  • use lip balm if your lips are dry

If you wear dentures, remove them and clean both the dentures and your mouth twice a day. Always take your dentures out at night.

Voice problems after COVID-19

Talking can be more difficult if you are breathless. Your voice might sound weak, quiet, rough or hoarse. You may have a sore throat if you have been coughing a lot or if you needed a breathing tube in hospital.

You may feel that your voice is weak and your speech is not as clear as it used to be. This should improve as your symptoms resolve.

Voice problems can take 6 to 8 weeks to recover. If your voice has not returned to normal by this time, contact your GP.

How to look after your voice and speak clearly

To help your voice recovery, you should stay hydrated by drinking plenty of water.

You should also avoid:

  • shouting or forcing your voice out
  • persistent, deliberate throat clearing - try drinking water or doing a single, big cough instead
  • deliberately whispering - this does not 'save' the voice, it puts strain on the voice box
  • drinking a lot of caffeine and alcohol
  • smoking or vaping
  • medicated lozenges and gargles - the relief they provide may cause you to force your voice even more
  • hot or dry air
  • dusty environments

How to speak more clearly

To help people to hear you better, you can try:

  • sitting in an upright position and take a breath before talking
  • reducing the background noise when communicating with others
  • stopping, resting and trying later if your voice feels tired

If your voice is very hoarse or weak, avoid speaking on the telephone or video conversations. Try to use text-based options instead.

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