Could a patient with symptoms of high fever, runny nose, and cough, who is taking ibuprofen for fever relief, have COVID-19?

Could This Be COVID-19?

Yes, this patient's symptoms of high fever, runny nose, and cough are consistent with COVID-19 and warrant testing, as these represent common COVID-19 manifestations that should trigger diagnostic evaluation. 1

Why COVID-19 Should Be Considered

The symptom constellation you're describing aligns well with documented COVID-19 presentations:

• Fever is the most common COVID-19 symptom, present in 92.8% of patients 1
• Cough occurs in 69.8% of COVID-19 cases, typically dry but can vary 1
• Rhinorrhea (runny nose) is present in 4.0% of COVID-19 patients 1, and nasal congestion occurs in 28.3% 2
• The combination of fever plus respiratory symptoms meets the clinical criteria for COVID-19 testing 1

Testing Is Indicated

You should arrange for RT-PCR nasopharyngeal swab testing, which is the gold standard for COVID-19 diagnosis 1. The patient meets testing criteria because they have:

• Fever with respiratory symptoms (cough and runny nose) 3
• Clinical presentation consistent with suspected COVID-19 infection 3

Regarding Ibuprofen Use

Continue the ibuprofen for fever control. While early in the pandemic there were theoretical concerns about NSAIDs potentially worsening COVID-19 outcomes, these concerns have not been substantiated 1. The American Heart Association initially recommended caution, but this remains controversial and is not a contraindication 1.

Critical Next Steps

The patient should isolate immediately pending test results to prevent potential transmission 1. You need to:

• Arrange COVID-19 RT-PCR testing as soon as possible 1
• Instruct immediate isolation until results are available 1
• Monitor closely for progression to severe disease, particularly watching for:
  • Respiratory rate ≥30 breaths/min 1
  • Oxygen saturation ≤93% 1
  • Significant dyspnea or shortness of breath 1

When to Escalate Care

Re-evaluate within 48-72 hours if symptoms worsen or new symptoms develop, particularly:

• Shortness of breath or difficulty breathing 1
• Chest pain 1
• Persistent high fever >38.5°C 1
• Any signs of respiratory distress 1

Important Caveats

• If the initial RT-PCR is negative but symptoms persist or worsen, repeat testing should be considered as false negatives are common, particularly with timing of sample collection 1
• Co-infection with influenza or other respiratory viruses is possible and can complicate the clinical picture 4
• The presence of isolated upper respiratory symptoms doesn't rule out COVID-19, as the disease has a broad spectrum of presentations 3, 5