{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T01:01:48Z","timestamp":1780534908881,"version":"3.54.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>People with a total laryngectomy (PTL) rely on a permanent opening in their neck (stoma) to breathe. This altered anatomy may increase susceptibility to contracting and transmitting SARS\u2010CoV\u20102.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To report on (1) the frequency and characteristics of PTL who tested positive for COVID\u201019, (2) the receipt of advice regarding shielding and patient self\u2010reports of shielding, (3) hospital admissions and length of stay, and (4) mortality rates in this group during the first UK national lockdown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>This is a cross\u2010sectional survey and case note review. National Health Service (NHS) centres providing care to PTL were invited to participate via the Royal College of Speech and Language Therapists\u2019 (RCSLT) Head &amp; Neck Clinical Excellence Networks and through social media. PTL were reviewed by their speech and language therapist either in person or via telehealth between 30 March and 30 September 2020. Data were collected within the time frame covered by the Control of Patient Information (COPI) notice issued for COVID\u201019 and included information on COVID\u201019 testing, shielding, hospital admissions, length of stay and deaths. Information was submitted to the lead NHS site using a custom designed data\u2010capture worksheet. Analysis was performed using descriptive statistics, including proportions and frequency counts. Pearson's Chi squared tests were used to compare categorical data using a 5% significance level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Data were obtained from 1216 PTL from 26 centres across the UK. A total of 81% were male; mean age was 70 years (28\u201397 years). Of the total group, 12% received a COVID\u201019 test. A total of 24 (2% of total sample) tested positive for COVID\u201019. Almost one\u2010third of PTL (32%) received a government letter or were advised to shield by a healthcare professional. During the data collection time frame, 12% had a hospital admission (<jats:italic>n<\/jats:italic> = 151) with a median length of stay of 1 day (1\u2013133 days), interquartile range (IQR) = 17 days. A total of 20 of these admissions (13%) had tested positive for COVID\u201019 with a median length of stay of 26 days, IQR = 49 days. The overall mortality was 4% (41 patients), with eight deaths occurring within 28 days of testing positive for COVID\u201019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>This study highlighted the lack of routine national data for neck\u2010breathers with which to compare the current findings. Greater testing in the community is necessary to understand the prevalence of COVID\u201019 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\u201019 in neck\u2010breathers requires further investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:sec><jats:title>What is already known on the subject?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>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\u201019 for PTL.<\/jats:p>\n<\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This is the first national audit to provide data on shielding, hospital admissions and mortality for patients with total laryngectomy in the UK over the pandemic. The overall mortality in PTL over the first lockdown did not appear to be higher than the \u201cbest case\u201d estimates from previous years. However, one in three PTL who acquired COVID\u201019 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 but also highlights important knowledge gaps.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>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.<\/jats:p>\n<jats:p>The need for further research on whether neck\u2010breathers should be tested via both nasopharyngeal and tracheal aspirates is important not just currently, but also in case of any future respiratory epidemics.<\/jats:p>\n<\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12656","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T14:05:54Z","timestamp":1628172354000},"page":"1064-1073","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Shielding, hospital admission and mortality among 1216 people with total laryngectomy in the UK during the COVID\u201019 pandemic: A cross\u2010sectional survey from the first national lockdown"],"prefix":"10.1111","volume":"56","author":[{"given":"Roganie","family":"Govender","sequence":"first","affiliation":[{"name":"University College London Hospital Head &amp; Neck Academic Centre  London UK"},{"name":"Department of Applied Health Research Institute of Epidemiology &amp; Healthcare University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Behenna","sequence":"additional","affiliation":[{"name":"ENT\/HNC SLT Department Nottingham University Hospitals Healthcare Trust  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grainne","family":"Brady","sequence":"additional","affiliation":[{"name":"Department of Speech Voice and Swallowing, The Royal Marsden NHS Foundation Trust  London UK"},{"name":"Department of Surgery and Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Coffey","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer Imperial College London  London UK"},{"name":"Imperial College Healthcare Trust, SLT Department Charing Cross Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Babb","sequence":"additional","affiliation":[{"name":"National Association of Laryngectomee Clubs  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne M.","family":"Patterson","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Institute of Population Health\/Liverpool Head and Neck Centre University of Liverpool  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Behenna K. 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