Case history

Case history #1

A 61-year-old man presents to hospital with fever, dry cough, and difficulty breathing. He also reports feeling very tired and unwell. He has a history of hypertension, which is controlled with enalapril. On examination, his pulse is 120 bpm, his temperature is 38.7°C (101.6°F), and his oxygen saturation is 88%. He appears acutely ill. He is admitted to hospital in an isolation room and is started on oxygen, intravenous fluids, and empirical antibiotics. Chest x-ray shows bilateral lung infiltrates, and computed tomography of the chest reveals multiple bilateral lobular and subsegmental areas of ground-glass opacity. A nasopharyngeal swab is sent for real-time reverse transcriptase polymerase chain reaction testing, and the result comes back positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) the next day. The patient develops respiratory distress 7 days after admission and is transferred to the intensive care unit and started on mechanical ventilation.

Case history #2

A 26-year-old woman calls her doctor complaining of a sore throat and a persistent dry cough. She denies having a fever, and has not travelled in the last 14 days or knowingly been in contact with a confirmed case of COVID-19. She is advised to stay at home and self-isolate and to call her doctor if her symptoms get worse.

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