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

Enrico Brunetti, MD


May 11, 2023

A combination of ritonavir and nirmatrelvir is an antiviral that may be considered for treatment of moderate COVID-19 illness. When started within 3 days of symptom onset, a combination of ritonavir and nirmatrelvir was reported to decrease the risk for COVID-19-related hospital admission or all-cause mortality by 89% vs placebo.

While hospitalisation for patients with moderate disease may be desirable to help monitor patients closely, hospitalisation is only required for those with severe COVID-19 disease. Empirical antibiotic treatment is only recommended if there is a suspicion of bacterial infection. Supportive care with isotonic fluid resuscitation should be reserved for hospitalised patients with volume depletion.

The patient and her physician agree to treatment with a combination of ritonavir and nirmatrelvir.


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