75 yo COVID-19 Positive | Figure 1
DrMo-UC
75 yo COVID-19 Positive
75 yo who is on blood pressure and cholesterol medications. 2 days of cough and sinus congestion with no fevers or chills or shortness of breath. No history of COVID and has had all US guidelines COVID vaccinations and boosters. How would you manage with or without medications?
The author made an update to this case
Update 1
Patient had requested antiviral medication which I prescribed and she felt better by day 2 after starting medications.
Background
COVID‐19 is a highly infectious respiratory illness caused by a new strain of virus. The outbreak has spread rapidly on a global scale. People infected with this virus may not show signs of the disease, others may develop symptoms, including fever, cough, shortness of breath and sore throat. In some people the infection is more severe and can cause severe breathing difficulties, leading to hospitalization, admission to intensive care or death. Currently, no vaccine or specific treatment is available.
People who have recovered from COVID‐19 develop natural defenses to the disease in their blood (antibodies). Antibodies are found in part of the blood called plasma. Plasma from blood donated from recovered patients, which contains COVID‐19 antibodies, can be used to make two preparations: convalescent plasma and hyperimmune immunoglobulin.
Our methods
We searched major medical databases for clinical studies on treatment with convalescent plasma or hyperimmune immunoglobulin for people with COVID‐19. Studies could be conducted anywhere in the world and include participants of any age, gender or ethnicity, with mild, moderate or severe COVID‐19.
Key results
We included eight completed studies, with 32 participants who received convalescent plasma. None of the studies randomly allocated participants to different treatments (randomised trials produce the best evidence).
- All participants in the studies were alive at the end of follow-up, but not all had been discharged from hospital. Follow-up varied from 3 to 37 days after treatment with convalescent plasma.
- Six studies used the level of breathing support that participants required as a measure of recovery. All six studies reported clinical improvement in at least some of their participants, but it remains uncertain whether this improvement was related to convalescent plasma or other treatments.
- Six studies reported time to discharge from hospital for some of their participants, all of whom received convalescent plasma. The time to discharge ranged from 4 to 35 days after treatment.
- Six studies included participants with severe COVID‐19. Most had improved at final follow-up, but this improvement may have been due to other treatments, the natural progression of the disease, or the convalescent plasma treatment.
- Two participants reported unwanted effects related to convalescent plasma.
Certainty of the evidence
Our certainty in the evidence was very limited because the studies were not randomised and did not use reliable methods to measure their results. Furthermore, they had only a small number of participants.
Conclusion
We are very uncertain whether plasma from people who have recovered from COVID‐19 is an effective treatment for people with COVID‐19. However, our searches found 48 ongoing studies; we will update this review with their results when these studies are completed.
Male patient in his 30s presented for COVID-19 antibody testing
Male patient in his 30s presented for COVID-19 antibody testing (fingerstick blood). Patient reports a positive COVID-9 rapid antigen test 19 days ago with nearly all symptoms resolved besides decreased taste/smell.
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