Shielding, hospital admission and mortality among 1216 people with total laryngectomy in the UK during the COVID‐19 pandemic: A cross‐sectional survey from the first national lockdown

Abstract

Background 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‐CoV‐2. Aims To report on (1) the frequency and characteristics of PTL who tested positive for COVID‐19, (2) the receipt of advice regarding shielding and patient self‐reports of shielding, (3) hospital admissions and length of stay, and (4) mortality rates in this group during the first UK national lockdown. Methods & Procedures This is a cross‐sectional 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’ (RCSLT) Head & 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‐19 and included information on COVID‐19 testing, shielding, hospital admissions, length of stay and deaths. Information was submitted to the lead NHS site using a custom designed data‐capture 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. Outcomes & Results Data were obtained from 1216 PTL from 26 centres across the UK. A total of 81% were male; mean age was 70 years (28–97 years). Of the total group, 12% received a COVID‐19 test. A total of 24 (2% of total sample) tested positive for COVID‐19. Almost one‐third 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 ( n = 151) with a median length of stay of 1 day (1–133 days), interquartile range (IQR) = 17 days. A total of 20 of these admissions (13%) had tested positive for COVID‐19 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‐19. Conclusions & Implications This study highlighted the lack of routine national data for neck‐breathers with which to compare the current findings. 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. What this paper adds What is already known on the subject? People with total laryngectomy (PTL) have an altered anatomy for breathing and speaking...

A bibliometric analysis of linguistic research on COVID-19

“…A study by Jayes et al ( 2022 ) described how UK Speech and language therapists (SLTs) supported differently abled individuals with communication disabilities to make decisions and participate in mental capacity assessments, best interest decision-making, and advance care planning during the COVID-19 pandemic. Govender et al ( 2021 ) investigated how people with a total laryngectomy (PTL) were impacted by COVID-19. Feldhege et al ( 2021 ) conducted an observational study on changes in language style and topics in an online Eating Disorder Community at the beginning of the COVID-19 pandemic.…”

“…Representing a linguistic focus, another recent study by Heras-Pedrosa et al (2022) consisted of a systemic analysis of publications in health communication and COVID-19. It found that, in 2020, concepts related to mental health, mass communication, misinformation, and communication risk were more frequently used, and in the succeeding year (2021), vaccination, infodemic, risk perception, social distancing, and telemedicine were the most prevalent keywords.…”

“…The COVID-19 pandemic also changed the in-person and on-campus testing into placement testing. Ockey (2021) provides an overview of COVID-19's impact on English language university admissions and placement tests.…”

“…Schnepf et al (2021) provided recommendations for persuading audiences with a high conspiracy mentality, a group known to be mistrustful of scientific evidence. Janssen et al (2021) inquired into how the use of lexical hedges (LHs) impacted the trustworthiness ratings of communicators endeavoring to convey the efficacy of mandatory mask-wearing. The study found that scientists were perceived as being more competent and having greater integrity than politicians.…”

“…Contributing to the sociolinguistics of crisis communication, Ahmad and Hillman (2021) examined the communication strategies employed by Qatar's government in dealing with the COVID-19 pandemic. While a study by Gallardo-Pauls (2021) proposed a specifically linguistic/discursive model of risk communication, Tu et al (2021) inquired into how pronouns "we" and "you" affected the likelihood to stay at home differently. In another study, Tian et al (2021) investigated the role of pronouns in crafting supportive messages and hope appeals and facilitating people to cope with COVID-19.…”