Estimating the Risks from COVID-19 Infection in Adult Chemotherapy Patients

Matt Williams; Kerlann Le Calvez; Ella Mi; Jiarong Chen; Seema Dadhania; Lillie Pakzad-Shahabi

There is a clear impact of age on risk of death (Table 1 ). Data on risk of death with cancer in the context of influenza infection suggests and increased risk in the range of 3 -12 fold. We chose the lowest reported odds ratio (3.67) as our optimistic estimate of risk. Combined with our agebased CFRs, these lead to estimates of risk by age in patients receiving chemotherapy who become COVID infected (Table 2) . We summarise these results in figure 1, highlighting some potential benefit thresholds (3%, 5%, 10%) that are typically seen in adult solid tumour chemotherapy. Of the 9 scenarios, risk of death if COVID infected was higher than expected benefit in six of the seven, balanced in one and favoured chemotherapy in two cases. Readers can explore these data in a small associated program, available at https://gitlab.com/computational.oncology/covidcancerrisk Although the instantaneous risk of COVID infection is small, the risk over the entire duration is likely to be considerable. While we can assume that the risk of infection in patients is the same as the expected population-level infection rate, population level infection may take many months to occur. A more time limited horizon is given by estimating the number of cases of time, and integrating that number.