Box 1.

Examples of hypothetical patient-led conversations with clinicians informed by OurRisk.CoV

Scenario 1
66-year-old man. Maths teacher in primary school. Heart failure and type 2 diabetes.
OurRisk.CoV: 7.4% (95% CI: 6.6–8.9%) risk of 1-year mortality at baseline
This information could be used to guide a discussion about mortality risk at baseline and the role of other markers of severity, eg echocardiography, where data are not available at present. For that, joining up data from the National Heart Failure Registry (www.bsh.org.uk/resources/national-heart-failure-audit/) and the Diabetes Audit (digital.nhs.uk/data-and-information/clinical-audits-and-registries/national-diabetes-audit with other sources of NHS health data would be necessary.
OurRiskCoV 7.9%(7–8.7%) projected risk of 1-year mortality during pandemic
This could be used to discuss the importance of secondary prevention during the pandemic, while also following government COVID-19 guidance regarding social distancing, wearing masks in public, closed areas (www.gov.uk/coronavirus).
Scenario 2
33-year-old female. Has leukaemia and asthma, currently not on treatment. Works as a business executive, being encouraged to go back to the office. She may need chemotherapy in the next year or two, according to specialists.
OurRisk.CoV (patient): 3.0% (0.6–5.3%) risk of 1-year mortality at baseline; 3.4% (0.7–6.1%) risk of 1-year mortality during pandemic
If put in ‘Chemotherapy’ instead of ‘Cancer (leukaemia)’:
3.8% (2.9–4.6%) risk of 1-year mortality at baseline; 4.1% (3.2–5%) risk of 1-year mortality during pandemic
Could use to discuss indirect effects of pandemic and cancer services, eg delayed chemotherapy during the pandemic. What this score does not include are data from specific cancer registries like NCRAS (National Cancer Registration and Analysis): (www.ncin.org.uk/cancer_type_and_topic_specific_work/cancer_type_specific_work/haematological_cancers/)
Scenario 3 (Beyond COVID-19)
72-year-old man deciding on whether he should have a coronary bypass surgery after the COVID-19 pandemic, based on a perioperative mortality risk of 1% (EUROSCORE II: www.euroscore.org/calc.html). Stable angina for many years but now has worsening chest pain. Has diabetes.
OurRisk.CoV (patient): 6.3% (5.9–6.6%) risk of 1-year mortality at baseline
Could use to discuss difference between baseline risk and perioperative risk which is shorter term and calculated differently using other scores and tools.