How could COVID-19 affect my swallowing?

COVID can affect your breathing. This can interrupt the breath-swallow pattern as you need to hold your breath momentarily while you swallow. Due to this you may find that you become breathless while eating and drinking or that it is hard to hold your breath to swallow or cough when you swallow.

You may have had a stay in Intensive Care (ICU). This can result in weakening of the muscles used for swallowing as they haven’t been used while you were unwell or asleep. Over time, the muscles will rebuild strength as you build up your intake.

If you had a breathing tube this can sometimes cause some bruising and swelling to your throat and voice box.  Sometimes this can result in one or both of the vocal folds not moving properly, which can cause changes to your voice and reduced protection for your airway when you swallow.  Usually, these affects are temporary and will resolve over time.

Swallowing advice from a Speech and Language Therapist:

  • Make sure you are sat upright and that you are fully awake and alert when you are eating and drinking.
  • Take your time and take small mouthfuls. It can be helpful to reduce distractions around you.
  • You should avoid talking while eating and drinking as this opens the airway which could result in food or drink going 'the wrong way'. Talking can also make you more breathless which can in turn impact on your swallowing.
  • You may want to try making some modifications to the texture of your diet e.g., well chopped, softer consistencies, more moisture if your throat feels uncomfortable when you swallow.
  • It is also very important to keep your mouth clean and healthy with regular tooth brushing. If you notice that your tongue is coated or your mouth looks unclean, speak to your GP or pharmacist.
  • If you experience any persisting symptoms speak to your GP for a referral to Speech and Language Therapy for further assessment.

How could COVID-19 affect my voice?

  • COVID-19 can cause a sore throat, laryngitis and a cough, and some people may have needed a ventilator with a breathing tube through the voice-box which can cause an injury. Your voice may be weak and breathy or hoarse and you may have difficulties with voice projection.
  • You may have throat discomfort, such as soreness, an irritable cough, a sensation of mucous pooling in the throat and feel the need to throat clear.
  • Some people may feel their throat/upper airway becomes more sensitive to the environment around them. For example, a strong scent may trigger a cough, sensation of throat tightness or a restriction in your breathing at the top of your airway.
  • Other influences may be dehydration of your voice box, acid reflux, fatigue, and stress.
  • Your voice reflects your general health and how you are feeling including fatigue and worry.


  • Keep hydrated; drinking 8-10 glasses of water a day is recommended as dehydration caused by alcohol or caffeine in drinks can lead to vocal fold irritation.
  • If your voice is hoarse or weak, don’t whisper - use your voice gently to avoid strain.
  • Steam inhalation for 10-15 minutes can help with dryness and moisturizes the vocal tract.
  • Reflux is very common so avoid eating late at night and foods that cause indigestion.
  • Reduce or avoid smoking.
  • Avoid lots of dairy produce as this can cause thick secretions and throat clearing.
  • Try not to ‘throat clear’ - use sips of water and a hard swallow.

Will my voice return to normal?

The inflammation and damage to your voice box should get better over time without treatment.  However, if it doesn’t, please seek a referral to the Ear, Nose and Throat (ENT) department via your GP and ENT Speech and Language Therapy.


Sometimes people experience difficulties with their ability to communicate.

You may experience one of more of the following difficulties:

  • Understanding what people are saying to you
  • Reading
  • Putting your thoughts and feelings into words
  • Having a conversation
  • Finding the correct word
  • Having slurred speech.

These symptoms can be worse when you are fatigued or feeling stressed.  Take your time, let loved ones know this is part of Long Covid and use similar strategies to managing cognition listed above.