Skill Checkup: A 68-Year-Old Woman With Low-Grade Fever, Headache, Body Aches, Fatigue, Nasal Congestion, and Sore Throat

Enrico Brunetti, MD


November 07, 2022

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

A 68-year-old woman in Europe has a video visit with her primary care physician. She presents with low-grade fever, headache, body aches, fatigue, nasal congestion, and a sore throat. It has been about 3 days since the symptom onset. Two days ago, she visited an urgent care visit and received both a rapid antigen and polymer chain reaction (PCR) test for coronavirus disease (COVID-19); the rapid antigen test was negative. However, the PCR test came back positive yesterday. The patient has not been vaccinated for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and this is the first time she has tested positive for the virus. She has a 20-year history of rheumatoid arthritis (RA), which she manages with glucocorticoid therapy. Body mass index is 24.8 kg/m2. At the time of the urgent care visit, her temperature was 37.44°C (99.4°F), respiratory rate was 15 breaths per minute, oxygen saturation was 98% on room air, pulse rate was 72 beats per minute, and blood pressure was 144/91 mmHg. Taste and smell have not been affected. The patient reports no gastrointestinal symptoms and shows no evidence of neurologic impact.


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