Case history #1
A 61-year-old man presents to the 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 exam, his pulse is 120 bpm, his temperature is 101.6°F (38.7°C), 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 venous thromboembolism prophylaxis. Blood and sputum cultures are ordered. 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 is started on dexamethasone.
Case history #2
A 26-year-old woman presents at her local COVID-19 testing clinic with symptoms of a sore throat and loss of taste. She denies having a fever, and has not knowingly been in contact with a confirmed case of COVID-19. After being tested, she is advised to go home, self-isolate until her test results are sent to her via text message, and call her doctor if her symptoms get worse. She receives a text message later that day confirming that her test is positive for SARS-CoV-2, and that she must self-isolate according to her local public health recommendations.
See the Diagnosis section for more information on other presentations.
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