Skill Checkup: An 18-Year-Old Woman With Fever, Headache, Malaise, Muscle Pain and Shortness of Breath

Enrico Brunetti, MD


May 11, 2023

Editor's Note: The information in this quiz is current as of May 11, 2023. For the most recent COVID information, see

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

An 18-year-old Asian woman presents to her general practitioner via telemedicine Tuesday morning, with a positive result on a coronavirus disease 19 (COVID-19) antigen test as well as a fever, headache, malaise, muscle pain and some shortness of breath when she walks to the bathroom. The patient reports that her temperature is 38.4°C (101.2°F), height is 1.6 m (5 ft 3 in) and weight is 68.49 kg (151 lb).

Prior, she attended a party at her university on Friday evening and came home to visit her mother on Saturday afternoon. She began to experience symptoms when she woke up at her mother's house on Monday morning. The patient and her mother suspected COVID-19, and each tested with rapid tests that morning; her mother's result was negative. Since then, the patient has remained quarantined in her bedroom except to use the bathroom. Her mom has been caring for her by bringing food and medicine to her door.

Of note, the patient was diagnosed with type 1 diabetes 4 years ago at the age of 14 years and is currently taking a treatment regimen that includes both long- and rapid-acting insulin. The patient is unvaccinated.


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