Emerging Infections — COVID-19, H1N1

A 34-year-old female from Mumbai presents with acute onset of fever (39.2°C), severe myalgia, arthralgia (especially wrists and ankles), and a maculopapular rash on the trunk and limbs that appeared 2 days after fever onset. She reports recent travel to a dengue-endemic area 4 days ago. On examination, she has mild conjunctival injection without exudate, and the rash blanches on pressure. Laboratory investigations show platelet count 95,000/μL, hemoglobin 13.5 g/dL, WBC 3,200/μL, and elevated transaminases (ALT 85 U/L). Dengue serology (IgM) is negative. RT-PCR for dengue is negative. What is the most likely diagnosis?

Which of the following is the primary mechanism of action of remdesivir in COVID-19?

A 58-year-old male from Delhi presents with a 5-day history of fever (38.5°C), dry cough, and dyspnea. He reports loss of taste and smell for 2 days. On examination, SpO₂ is 88% on room air, respiratory rate 28/min, and bilateral crackles on auscultation. His wife tested positive for COVID-19 3 days ago. Chest X-ray shows bilateral ground-glass opacities. RT-PCR for SARS-CoV-2 is positive. His D-dimer is 1.2 μg/mL (normal <0.5), ferritin 450 ng/mL (normal <200), and CRP 95 mg/L (normal <10). What is the most appropriate next step in management?

A 42-year-old man from Mumbai presents with a 3-day history of fever (40.2°C), severe myalgia, headache, and cough. He reports recent contact with his daughter who had similar symptoms 1 week ago. On examination, he is alert, respiratory rate 22/min, and SpO₂ 96% on room air. Throat is mildly erythematous. Rapid influenza diagnostic test (RIDT) is positive for influenza A. Chest X-ray is normal. What is the most appropriate management?

A 38-year-old woman from Delhi presents to the emergency department with a 5-day history of fever (39.5°C), dry cough, and progressive dyspnea. She reports loss of taste and smell for 2 days. On examination, oxygen saturation is 88% on room air, respiratory rate 28/min, and bilateral crackles on auscultation. Chest X-ray shows bilateral ground-glass opacities. RT-PCR for SARS-CoV-2 is positive. Her D-dimer is 1.2 µg/mL (normal <0.5), and LDH is 650 U/L. What is the most appropriate next step in management?