What is the appropriate management for a 45-year-old woman with a positive SARS‑CoV‑2 test and isolated sore throat, without any comorbidities?

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Management of COVID-19 Positive 45-Year-Old Woman with Isolated Sore Throat

For a 45-year-old woman with confirmed COVID-19 and only sore throat without comorbidities, supportive care with symptom management is recommended, and antiviral therapy should be considered only if she has risk factors for severe disease progression. 1

Risk Stratification and Treatment Decision

  • This patient does not require antiviral therapy unless she has underlying risk factors for progression to severe COVID-19 (diabetes, cardiovascular disease, immunosuppression, obesity, chronic lung disease). 1

  • The European League Against Rheumatism states that for non-hospitalized patients with SARS-CoV-2 infection without risk factors, there is no evidence to support immunomodulatory therapy. 1

  • Nirmatrelvir-ritonavir (Paxlovid) is indicated only for patients at high risk for progression to severe COVID-19 and must be initiated within 5 days of symptom onset. 2

Symptomatic Management

Sore Throat Treatment

  • Provide symptomatic relief for sore throat with supportive measures including adequate hydration and rest. 3

  • Consider povidone-iodine mouth spray as adjunctive treatment to reduce viral load in the pharynx. 4

  • For fever >38.5°C, ibuprofen 200 mg orally every 4-6 hours (maximum 4 times in 24 hours) can be used. 3

Nutritional Support

  • Ensure protein-rich foods with ideal energy intake of 25-30 kcal/(kg·d) and protein intake of 1.5 g/(kg·d) to support immune function. 3

Monitoring and Follow-Up

  • Monitor for symptom progression including development of fever, cough, dyspnea, or oxygen desaturation, which would indicate need for escalation of care. 1, 3

  • Instruct the patient to seek immediate medical attention if she develops shortness of breath, chest pain, confusion, or inability to stay awake. 1

  • Complete the full isolation period per current public health recommendations to prevent transmission to others. 2

Important Clinical Pitfalls

  • Do not prescribe antibiotics unless there is clear evidence of bacterial superinfection; isolated sore throat with COVID-19 does not warrant empiric antibacterial therapy. 3

  • Avoid hydroxychloroquine as it does not provide benefit and could worsen prognosis. 1

  • Be aware that sore throat is a common early symptom of COVID-19, reported in mild cases, and does not by itself indicate bacterial co-infection. 5, 6

  • Loss of smell or taste (anosmia/ageusia), if it develops, is highly predictive of COVID-19 and associated with a seven-fold increased odds of positive testing. 6

When to Escalate Care

  • Re-evaluate within 48-72 hours if symptoms worsen or new symptoms develop (cough, dyspnea, persistent fever). 1, 3

  • If the patient develops oxygen requirement, respiratory distress, or signs of pneumonia, hospitalization with systemic glucocorticoids (dexamethasone) becomes indicated. 1

References

1
Guideline

COVID-19 Treatment Approach

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

3
Guideline

Treatment of Viral Pneumonia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

4
Guideline

Bacterial Pharyngitis/Tonsillitis Treatment in Young Adults

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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