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

The most striking finding is that under a range of conditions, most cancer patients are at > 5% risk of death if infected with COVID-19. It is notable that the 5% is greater than or equal to the benefit from most adjuvant chemotherapy for adult solid tumours. Although we accept that exact negative impact of COVID-19 in subgroups remains unclear, previous data during outbreaks of seasonal respiratory viral infections suggests that they are associated with an approximate doubling in risk. However, in contrast to outbreaks of seasonal infections, the majority of the population is expected to be infected with COVID-19 over a short-time period (3 -6 months), there is no pre-existing immunity or vaccine, and the case-fatality rate is approximately 5 fold higher. For those reasons, decision-making in seasonal viral outbreaks does not directly transfer to the COVID-19 pandemic. Decisions about initiating or continuing cytotoxic chemotherapy in the context of a COVID pandemic need to be made carefully, and in light of the available data.