A 62-year-old man with type 2 diabetes presents on day 3 of PCR-confirmed COVID-19 with cough and SpO2 96% on room air. He is not hospitalised. Which therapy is most appropriate?
- A Nirmatrelvir-ritonavir orally for 5 days ✓
- B Remdesivir intravenously for 5 days
- C Tocilizumab single dose
- D Dexamethasone 6 mg daily
Correct answer: A. Nirmatrelvir-ritonavir orally for 5 days
Explanation
Nirmatrelvir-ritonavir is indicated for non-hospitalised adults with mild to moderate COVID-19 who are at high risk of progression, started within 5 days of symptom onset. Remdesivir requires intravenous administration and is mainly used in hospitalised patients requiring oxygen. Tocilizumab and dexamethasone are reserved for hospitalised patients with severe disease requiring oxygen or ventilation, so they have no role in ambulatory mild disease.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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Written and medically reviewed by the StethoPrep medical team.