RT Journal Article SR Electronic T1 Against the odds: unlikely COVID-19 recovery JF BMJ Supportive & Palliative Care JO BMJ Support Palliat Care FD British Medical Journal Publishing Group SP bmjspcare-2020-002477 DO 10.1136/bmjspcare-2020-002477 A1 Elspeth Bisson A1 Edward Presswood A1 Jasmine Kenyon A1 Fenella Shelton A1 Toby Hall YR 2020 UL http://spcare.bmj.com/content/early/2020/07/03/bmjspcare-2020-002477.abstract AB 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.