Dysphagia is the difficulty in swallowing because of the presence of certain diseases; it particularly compromises the oral and/or pharyngeal stages. In severe acute respiratory syndrome coronavirus 2 infection, neuromuscular complications, prolonged bed rest, and endotracheal intubation target different levels of the swallowing network. Thus, critically ill patients are prone to dysphagia and aspiration pneumonia. In this review, we first discuss the possible cause and pathophysiology underlying dysphagia associated with coronavirus disease 2019, including cerebrovascular events, such as stroke, encephalomyelitis, encephalopathy, peripheral neuropathy, and myositis, that may lead to the dysphagia reported as a complication associated with the coronavirus disease 2019. Next, we present some recommendations for dysphagia evaluation with modifications that would allow a safe and comprehensive assessment based on available evidence to date, including critical considerations of the appropriate use of personal protective equipment and optimization individual’s noninstrumental swallowing tasks evaluation, while preserving instrumental assessments for urgent cases only. Finally, we discuss a practical managing strategy for dysphagia rehabilitation to ensure safe and efficient practice in the risks of severe acute respiratory syndrome coronavirus 2 exposure, in which swallowing therapy using newer technology, such as telerehabilitation system or wearable device, would be considered as a useful option.

Patients with chronic obstructive pulmonary disease (COPD) are commonly referred for pulmonary rehabilitation (PR), but the use of PR is not common for patients with restrictive lung disease, neuromuscular diseases, and those who have sustained a severe respiratory illness or undergone thoracic surgery. We investigated the effects of PR in patients with restrictive lung diseases in comparison with COPD patients using a home-based setting. Twenty-six restrictive lung diseases patients and 40 COPD patients who had a Medical Research Council (MRC) dyspnea score ≥ 2, a clinically stable condition, and who had completed a 6-month PR program, were enrolled in the present study. The definition of restrictive lung disease was a forced vital capacity (FVC) of ≤ 80% of the predicted value with a forced effort volume in one second/FVC of > 70%. Our PR consisted of breathing retraining, exercise training, respiratory muscle stretching calisthenics, level walking, inspiratory and expiratory muscle exercises, and a monthly education program. Patients were strongly instructed to practice this program daily at home, and were supervised by a respiratory therapist every 2 weeks in our hospital. Patients with restrictive lung diseases showed the significant increases in inspiratory and expiratory muscle forces, the 6-minute walking distance, the Chronic Respiratory Disease Questionnaire and the Short-Form 36, and decreased MRC scores after 6 months. In conclusion, our home-based PR improves respiratory muscle forces, exercise tolerance, health-related quality of life, and the perception of dyspnea in patients with restrictive lung disease to the same extent as in COPD patients.