Post-Covid: Swallowing and voice after Covid-19

decorative image If your voice has not completely returned to normal 6-8 weeks after having Covid-19, speak to your GP. It may be helpful for you to be seen by an ear, nose and throat doctor, and you may benefit from speech and language therapy. If you have any questions or concerns about the information on this web page please contact the Speech and Language Therapy Department on 0330 726 0077 or by e-mailing us at cpm-tr.adultslt@nhs.net.

Voice

The types of difficulties you may experience with speaking include:

  • Weak, quiet, hoarse or breathy voice
  • Dry or sore mouth and throat
  • Only being able to say a few words on one breath
  • Increased effort and discomfort when speaking.

Things you can do to help

  • Take a moment to notice any tension in your shoulders/ neck/jaw and release as much as you can. Aim to do this frequently throughout the day
  • Sit as upright as you comfortably can
  • Make sure you are face-to-face with the person you are speaking to and avoid speaking over background noise (TV or music)
  • Take a relaxed breath before talking and take regular breaths to avoid straining. Speak in shorter sentences and take your time
  • Avoid shouting or forcing/pushing your voice out – speak in a soft, gentle voice
  • Don’t intentionally whisper as this makes your voice box work harder
  • Stay hydrated by drinking plenty of water – sip water frequently throughout the day. Avoid caffeine and alcohol
  • Try gentle steaming with hot water (nothing added to the water). Breathe in and out gently through your nose or mouth. The steam should not be so hot that it brings on coughing
  • Avoid hot, dry, air-conditioned environments - they can dry and irritate your throat.

Swallowing and speaking involve using many muscles in the mouth, throat and chest. The co-ordination of breathing plays an important part: to produce voice and to protect our lungs from food and fluid going down the wrong way when swallowing. People who have had Covid-19 may have difficulties eating, drinking and speaking due to:

  • Difficulties breathing: you may become breathless very easily
  • Weaker muscles because they haven’t been used for a while (for example if you needed a tube to feed you)
  • Soreness and inflammation in the throat and voice box
  • You may become tired very easily: swallowing and speaking may take more effort than usual.

If you needed a tube to help you breathe this may also have affected your swallowing and speaking, as it passes through your mouth and throat, and directly through your vocal cords into your windpipe. This can cause swelling and soreness and occasionally other, more prolonged problems with your voice or throat. These difficulties should resolve as your general condition improves. In the meantime there are many things you can do to help.

Eating and drinking

The types of difficulties you may experience with swallowing include:

  • Coughing/choking during or after eating, drinking or taking tablets
  • Wet or ‘gurgly’ sounding voice
  • Finding it harder to breathe while eating and drinking
  • Difficulty chewing
  • The sensation of food, fluids or tablets sticking in your mouth or throat.

If you have any of these symptoms you may be at risk of choking, or food/fluid going down the wrong way into the lungs, which could cause chest infections. You may also struggle to get enough to eat and drink.

Things you can do to help

Always sit as upright as you can for eating, drinking and taking tablets

  • Reduce distractions so that you can concentrate (turn off the TV)
  • Take small sips of drink and small mouthfuls of food; take tablets one at a time
  • Eat and drink at a slower pace – one sip or bite at a time - give yourself time for extra swallows to clear any food or fluid sticking in your mouth or throat
  • Sips of drink between mouthfuls can help clear food sticking in the throat
  • Stop and rest if you are feeling breathless or tired
  • Softer, moister food that requires less chewing may be easier It may help to add sauce or gravy
  • Eat smaller amounts at a time – little and often throughout the day rather than main meals.

If you are following this advice but are still having swallowing problems, or have new chest infections/are feeling more chesty than usual, please contact your GP.

Mouth care

You may have experienced a dry or sore mouth and throat, cracked lips or bad breath. Regular mouth care is important as it can improve your comfort, help swallowing and help prevent chest infections.

  • Brush your teeth twice a day using toothpaste
  • Drink plenty of fluids (regular sips throughout the day)
  • If you wear dentures, remove them and clean both the dentures and your mouth twice a day and always take dentures out at night
  • Use lip balm if your lips are dry
  • Oral gel or spray may help reduce dryness (available from chemists or ask your GP).

Do you need to print this information?

A leaflet version of the information above is available here to print out:  LC - SALT.pdf 109KB

As a patient

As a patient, relative or carer using our services, sometimes you may need to turn to someone for help, advice, and support. 

Patient Advice and Liaison service  Contact the Trust