This study aimed to characterize the abnormal swallowing features observed during Videofluoroscopic Swallowing Studies (VFSS) in moderate to severe COVID-19 patients. From the JH CROWN cohort database (January 2020 to March 2022), a total of 3,660 patients with moderate to severe COVID − 19 disease requiring oxygen supplementation were identified. The study abstracted and reported VFSS referral rates and swallowing characteristics using Modified Barium Swallow Impairment Profile (MBSImP). 16% (n = 588) of patients exhibited dysphagia; only half underwent VFSS. Among those referred, 39.3% had COVID-19 severity level 7, 39% exhibited aspiration, and 30% had silent aspiration. Abnormal MBSImP scores were reported in the following components: tongue control during bolus hold (score 2/3, 40%), bolus transport and lingual motion (score 3/4, 34%), oral residue (score 2/4, 57.7%), initiation of pharyngeal swallow (score 3/4, 65.2%), laryngeal vestibular closure (score 1/2, 64.5%), and pharyngeal residue (score 2/4, 50.5%). In conclusion, this large cohort of COVID-19 patients exhibited a myriad of swallowing abnormalities in the oral and pharyngeal phases, with a notably high rate of silent aspiration. Moreover, differentiating COVID-19-induced dysphagia from post-extubation dysphagia is challenging.