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. Data were obtained from 1216 PTL from 26 centers across the UK. A total of 24 (2% of total sample) tested positive for COVID-19. Eight of the 24 PTL that were hospitalized with COVID -19 died within 28 days. During the data collection time frame, 12% had a hospital admission (n = 151) with a median length of stay of 1 day (1–133 days). A total of 20 of these admissions (13%) had tested positive for COVID-19 with a median length of stay of 26 days. The overall mortality was 4% (41 patients), with eight deaths occurring within 28 days of testing positive for COVID-19.
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.
Greater testing in the community is necessary to understand the prevalence of COVID-19 in PTL and if this group is indeed more susceptible. The potential for nasopharyngeal and tracheal aspirates to show differing results when testing for COVID-19 in neck-breathers requires further investigation.
