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COVID-19 pneumonitis requiring oxygen — SCE Acute Medicine MCQ

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HardRespiratory medicineCOVID-19 pneumonitis requiring oxygenSCE Acute Medicine

A 69-year-old man with type 2 diabetes is admitted with COVID-19 pneumonitis on day 8 of symptoms. Oxygen saturation is 90% on air and 95% on 2 L/min oxygen; CRP is 86 mg/L and chest radiograph shows bilateral peripheral infiltrates. He is not already taking corticosteroids and has no evidence of bacterial sepsis. What is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Start dexamethasone because he requires supplemental oxygen

COVID-19 patients who require supplemental oxygen benefit from systemic corticosteroids unless contraindicated, with glucose monitoring in diabetes. Corticosteroids are not indicated for COVID-19 patients who do not need oxygen, which is the common distinction tested. Antibiotics should be reserved for suspected bacterial co-infection rather than given as the principal treatment here.

Reference: NICE NG191 COVID-19 rapid guideline