Skill Checkup: A 70-Year-Old Man With Loss of Smell, Dry Cough, and Headache

Enrico Brunetti, MD


November 07, 2022

The patient should be referred for an in-person evaluation if he develops dyspnea, particularly if this symptom occurs during rest or begins to interfere with daily activities. Currently, this patient is considered to have moderate COVID-19, having demonstrated lower respiratory disease during clinical assessment or imaging but maintaining an SpO2 ≥ 94% on room air. But given his older age, obesity, preexisting type 2 diabetes and hypertension, and unvaccinated status, he is considered to be at high risk for COVID-19 disease progression and hospitalization.

The patient and/or his family members or caregivers should be counseled on red flags that suggest high acuity of COVID-19: chest pain or tightness, dizziness, confusion or other neurologic signs, or SpO2 ≤ 94% on room air. Because possible respiratory decline may occur, on average, 1 week after the onset of illness, and considering this patient's high risk for disease progression, follow-up is recommended.


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