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COVID-19 pneumonitis — SCE Acute Medicine MCQ

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ModerateSepsis and Infectious EmergenciesCOVID-19 pneumonitisSCE Acute Medicine

A 68-year-old woman is assessed on the acute medical unit. She has confirmed SARS-CoV-2 infection, breathlessness and oxygen saturation 90% on air. Chest radiograph shows bilateral peripheral infiltrates. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most appropriate next step in management?

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Correct answer: D — Give oxygen to target saturation and assess for steroid therapy

Give oxygen to target saturation and assess for steroid therapy is the best answer because COVID-19 pneumonitis with hypoxia needs oxygen and assessment for corticosteroids according to oxygen requirement. Give broad-spectrum intravenous antibiotics within one hour is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Oxygen requirement is a key treatment discriminator in COVID-19.

Reference: NICE COVID-19 rapid guideline