| Case no.: | TL-00197 |
| Status: | Live (This case is available for Library users) |
| Title: | Treatment of non-severe COVID-19 |
| Background: In early 2021, a middle-aged Indonesian lady with good past health presented with low grade fever, mild cough, runny nose, anosmia and ageusia for 3 days. She was tested positive for SARS-CoV-2 infection by nasopharyngeal swab with Ct value of 32. She was admitted to hospital for isolation. Her vital signs were normal, SpO2 was 99% in ambient air, blood tests including complete blood count, liver and renal function tests, C-reactive protein, lactate dehydrogenase levels were normal. CXR taken as shown |
 (Click image to enlarge)
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| Question: | Which of the following treatment should NOT be considered? |
Possible
answers: |
| (a): | Anti-histamine |
| (b): | Paracetamol |
| (c): | Rest |
| (d): | Dexamethasone(specified as the correct answer) |
| (e): | None of the above | |
| Reason: This lady had non-severe COVID-19 with no evidence of pneumonia, the mainstay of treatment should be supportive. Dexamethasone was not shown to be beneficial in non- severe COVID-19 patients in randomized controlled trial, and potential adverse effects of systemic glucocorticoids likely outweigh its potential benefits. |
| Further comments: No comments given for this case |
| References: |
| 1: | RECOVERY Collaborative Group, Horby P, Lim WS, et al. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021;384(8):693-704 |
| 2: | https://www.who.int/publications/i/item/WHO-2019-nCoV-therapeutics-2021.1 |
| 3: | No reference 3 given for this case | |
| Key words: |
| 1: | COVID-19 |
| 2: | SARS-CoV-2 |
| 3: | Dexamethasone | |
| Submitted by: Charles Wong |
Assembly/
Specialty: | Respiratory Infections (non-tuberculous) |
| Institution: | Pamela Youde Nethersole Eastern Hospital, HKSAR |
| Address: | 3 Lok Man Road, Chai Wan, Hong Kong |
| Phone: | +852 25956111 |
| Fax: | / |
| Email: | respirologistlesarch@gmail.com |
| Level of difficulty: Basic |
| Willing to answer queries from users until: 29 Nov 2021 |
| Additional notes to APSR Case Reviewers: No note given for this case |
