What is the appropriate management for a 3-year-old female with a history of asthma, presenting with symptoms of a respiratory infection, including postnasal drip, nasal congestion, sneezing, runny nose, cough, gagging, bilateral ear pain, and loss of appetite, following a recent COVID-19 infection?

History of Present Illness Summary

Chief Complaint and Timeline

A 3-year-old female with a history of asthma presents with persistent upper respiratory symptoms and bilateral ear pain following COVID-19 infection 2 weeks ago. 1

Present Illness

• Onset: COVID-19 infection 2 weeks prior, with fever during acute illness 1
• Current symptoms:
  • Continuous postnasal drip 1
  • Nasal congestion 1
  • Sneezing 1
  • Rhinorrhea (runny nose) 1
  • Cough with gagging 1
  • New onset bilateral ear pain with ear tugging behavior 1

Associated Symptoms

• Decreased appetite (loss of appetite) 1
• Adequate hydration (drinking well) 1
• Normal urination 1
• Normal bowel movements (mother using fiber gummies) 1

Past Medical History

• Asthma 2, 3
• Recent COVID-19 infection (2 weeks ago) 1
• Last documented fever was during acute COVID-19 illness 1

Current Medications

• Fiber gummies 1
• Asthma medications (specific agents not documented) 3

Clinical Significance

This presentation is consistent with post-viral upper respiratory symptoms with likely secondary acute otitis media, occurring in the expected timeframe for bacterial superinfection following COVID-19. 4 The bilateral ear pain with tugging behavior in a 3-year-old, combined with persistent nasal symptoms 2 weeks post-COVID, suggests progression from viral upper respiratory infection to bacterial complication requiring evaluation for antibiotic therapy. 5 The child's asthma history requires continued monitoring, though current evidence suggests asthma is not an independent risk factor for severe COVID-19 outcomes or prolonged symptoms. 3, 6