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Abstract
Background We present a 67-year-old male, with palliative hypopharyngeal squamous cell carcinoma, who contracted COVID-19 infection while in hospital. Cancer diagnosis, among other clinical features, increases the risk of poor outcome of COVID-19 infection. A recently validated risk calculator (COVID-GRAM) can help to guide prognosis.
Events COVID-19 infection caused significant clinical deterioration in this patient. A Treatment Escalation Plan of ward-based care was put in place and the palliative care team involved. The goal of care was comfort.
Results The patient improved clinically and retested negative for COVID-19. He was discharged to a nursing home for ongoing supportive care of his malignancy.
Discussion The validated COVID-GRAM calculator predicted a greater than 99% risk that this patient would require intensive therapy unit admission or die. This patient overcame significant physiological challenges to survive COVID-19, highlighting the challenges of prognostication and suggesting that palliation of COVID-19 is not detrimental to survival.
- head and neck
- end of life care
- respiratory conditions
- supportive care
- prognosis
- clinical decisions
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Footnotes
Contributors Nil external contibutorship to declare, all draft and design of article, including figure captions, completed by named authors as listed below. EB, GPST2, guarantor and contributing author, led design, draft and review of the publication. EP, Palliative Care consultant, was involved in the design, draft and review of the article with particular reference to the palliative management and discussion. JK, GPST2, was involved in the design, draft and review of the report and discussion. FS, ENT registrar was involved in draft and review of the article with particular reference to ear, nose and throat specific details. TH, consultant Radiologist, reported and provided access to the chest radiograph and accompanying caption. He was involved in draft and review of the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.