People with total laryngectomy (PTL) have
an altered anatomy for breathing and speaking. The presence of a neck stoma
poses an additional virus entry point aside from the nose, mouth and
conjunctiva. This could increase the susceptibility to COVID-19 for PTL.
Govender and colleagues from the University
College Hospital in London performed a national audit to provide data on
shielding, hospital admissions and mortality for patients with total
laryngectomy in the UK over the pandemic. Eight of the 24 PTL that were hospitalized
with COVID -19 died within 28 days. Although the overall mortality in PTL over
the first lockdown did not appear to be higher than the “best case” estimates
from previous years one in three PTL who acquired COVID-19 and were admitted to
hospital, died within 28 days of testing positive. These findings are relevant
to the current care and management of PTL over the pandemic.
This study highlights gaps in the
collection of baseline information on hospital admissions, length of stay and
mortality for people with laryngectomy in the UK, restricting comparisons
between the current data and historical data.
The need for further research on whether
neck-breathers should be tested via both nasopharyngeal and tracheal aspirates
is important not just currently, but also in case of any future respiratory
epidemics.
