Covid-19 Rx: Treatment Simulations

You are a health care provider in a developed country. Several patients await your care. These patients are suspected of having Covid-19 and have been triaged by severity of illness. We recommend starting with the mildly ill patient, but you are free to see them in any order.

Mild

Mary Kuri is a young woman who arrives to the emergency room with fever and cough. Although she may have a mild illness, ruling out Covid-19 and evaluating for disease severity is important.

Moderate

Although the majority of patients with viral respiratory illnesses recover spontaneously, some patients can deteriorate. Indeed, Mary Kuri returns and now feels short of breath.

Severe

Vivien Thomas is a man with a history of hypertension who just arrived at the ICU with Covid-19 and acute respiratory distress. Hint: Is this a syndrome?

Critical

Vivien Thomas suddenly deteriorates... In addition to severe respiratory disease, Covid-19 can result in a systemic multi-organ disease with an increased mortality rate.

Expert

Bagel Mage is an elderly man with a history of hypertension and COPD who was transferred to the ICU from an outside hospital, but his records were lost en route. He has probable Covid-19 and respiratory distress. His condition is dire, but timely critical care medicine can improve his chances of survival.

Once in the patient room, your task is to gather data, develop a differential diagnosis, order additional diagnostic tests, and treat the patient. Patient and disease factors and the choice and timing of treatments will impact the outcome of the illness. However, as in real life, sickness may prevail despite your best efforts.

You can also consult with several specialists in the simulation that may provide crucial life-saving information. Once you reach clinical stability, you will have the option to go to the call room until the end of your shift, but you may be called back if the patient deteriorates. You can also choose to conclude your shift and get feedback.

Consider starting with the Covid-19 Interactive Primer to learn basic concepts of managing floor patients who are suspected or confirmed of having Covid-19.

Each case may have different underlying diseases and outcomes if replayed. We encourage you to replay cases from this landing page, in particular critical and expert, and experience the spectrum of Covid-19 disease presentations.

All names and characters encountered in these simulations are purely fictional and any resemblance to real persons is unintentional.

Note for educators: We encourage the use of these patient encounters for synchronous or asynchronous teaching of clinical reasoning (diagnostic and management), both in groups or individually. The online nature of these cases is particularly suitable for remote learning. We hope you find these new resources to be useful in your teaching. The cases are under continuous development, any feedback, positive or negative, can be given through a survey and contacting us directly (see below).

Help us by completing our survey: Covid-19 Rx Survey

Credits

This effort is dedicated to those who work tirelessly and put themselves at personal risk to help maintain the delivery of health care.

Covid-19 Treatment Simulations

Creative Director and Simulation Creator
Raja-Elie “Baj” Abdulnour, M.D., Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital; Educational Innovation Director, NEJM Group
Editor and Producer
Jeffrey M. Drazen, M.D., NEJM Group Editor
Lead Developer
Jeff Seals
Art and Design
Daniel Muller, Kim Knoper, Kathy Stern
Medical Content
Ahmad Zaheen, M.D., Ken Wu, M.D., Krista Nottage, M.D.
Medical Reviewers
Eric Rubin, M.D., Joseph Lieber, M.D., Charles Faselis, M.D., Rebecca Sternschein, M.D., Robert M. Hayden, M.D., Anthony Massaro, M.D., Daniel Rubin
Executive Producers
Matthew O’Rourke, Kathy Charlton
Associate Developer
Dave Allen
Associate Producer
Sara Fleming
Acknowledgements
Bruce D. Levy, M.D., Patrick R. Burkett, M.D., Ph.D., Maria C. Basil, M.D., Ph.D., Karen Buckley

Device Support

These simulations are optimized for desktop PCs and most tablets, but mobile phones are currently not fully supported.

Covid-19 Interactive Primer

Case Author and Interactive Primer Creator
Robert M. Hayden, M.D., Internal Medicine, Brigham and Women’s Hospital
Peer and Faculty Reviewers
Edy Yong Kim, M.D., Ph.D., Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital
Jessica C. Stuart, M.D., Internal Medicine, Brigham and Women’s Hospital
NEJM Editors
Raja-Elie “Baj” Abdulnour, M.D., Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital; Educational Innovation Director, NEJM Group
Ahmad Zaheen, M.D., M.Sc., NEJM Editorial Fellow
Jeffrey M. Drazen, M.D., NEJM Group Editor

Contact Us

Email: covid19-rx@nejm.org

Twitter: @bagelemage