Covid

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍Covid-19

Covid test ‍positivenegativenot performed

Exposure to Covid cases: ‍none ‍

Symptoms include:

‍fever, up to ‍°, over ‍ ‍hoursdays

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm

‍shortness of breath

‍fatigue

‍body aches

‍headache, ‍diffuse, ‍persistentintermittent, ‍pressurethrobbing, ‍mild

‍loss of taste or smell

‍sore throat

‍congestion or runny nose

‍nausea or vomiting

‍diarrhea, ‍ episodes ‍per day, ‍



Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍smoking

‍recent travel

no history of: ‍immunodeficiency, ‍incomplete immunization, ‍pneumonia, ‍chronic obstructive pulmonary disease, ‍asthma, ‍heart disease





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Ears: tympanic membranes ‍normal ‍, auditory canal ‍ on ‍rightleft, hearing ‍intact

Nose: ‍clear, discharge ‍clear, ‍

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Skin: ‍rashlesions on ‍

Extremities: ‍warm, ‍dry, cap refill ‍< 3> 3 sec, pulses ‍intact, ‍edema ‍bilaterally, ‍

Musculoskeletal: joints ‍ ‍normal, ‍limited ROM





ASSESSMENT:

‍COVID-19 ‍likelysuspectedpossible

DDx: COVID-19, influenza, viral URI, pneumonia, bronchitis, asthma exacerbation, COPD exacerbation, acute sinusitis, allergic rhinitis, pulmonary embolism, heart failure, tuberculosis, ARDS, bacterial superinfection, sepsis, multisystem inflammatory syndrome in children (MIS-C), post-acute sequelae of SARS-CoV-2 infection (PASC), anxiety, foreign body aspiration





PLAN:

Investigations:

- Covid test

- Chest X-ray

- Blood work: ‍CBC, ‍CRP, ‍Ferritin, ‍LDH, ‍electrolytes, ‍creatinine, ‍LFTs, ‍D-dimer, ‍troponin

- CT chest

Treatments:

- Rest and hydration

- ‍Acetaminophen

- ‍Ibuprofen

- ‍Cough suppressants

- ‍Paxlovid if high risk

- ‍Remdesivir if hospitalized



- ‍Dexamethasone if hospitalized and requiring oxygen

- ‍Anticoagulants

- Oxygen therapy to maintain SpO2 > 90%

- Prone positioning

- Avoid contact with others

Further care:

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as difficulty breathing or chest pain

- Referral to ER if severe shortness of breath, chest pain, confusion, fainting or cyanosis