TY - JOUR T1 - Against the odds: unlikely COVID-19 recovery JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care DO - 10.1136/bmjspcare-2020-002477 SP - bmjspcare-2020-002477 AU - Elspeth Bisson AU - Edward Presswood AU - Jasmine Kenyon AU - Fenella Shelton AU - Toby Hall Y1 - 2020/07/03 UR - http://spcare.bmj.com/content/early/2020/07/03/bmjspcare-2020-002477.abstract N2 - 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. ER -