How to Distinguish Among COVID, Flu, and RSV in a High-Risk Patient

Charles P. Vega, MD


December 15, 2022

Is This COVID?

Agnes is a 53-year-old woman with a history of obesity (body mass index of 41) and type 2 diabetes. She has a telehealth appointment today after a 3-day history of cough, myalgias, and fatigue. She had a temperature of 38.5 °C yesterday. She does not report any shortness of breath or loss of taste or smell. A review of symptoms is otherwise negative.

Agnes had COVID-19 in March 2021 and feels that her current symptoms are similar. She has been taking care of her 3-year-old niece for the past 5 days, and the child had a cough and congestion throughout but had not received a diagnosis.

The patient did an antigen test for SARS-CoV-2 at home yesterday and it was negative. She received one dose of the COVID-19 vaccine in May 2020 but did not follow-up with the second dose because she experienced diffuse myalgias the day after the vaccine. She did receive an influenza vaccine 4 weeks ago.


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