Brigham and Women's Hospitals



The scale and speed of the COVID-19 pandemic represents an unprecedented scenario in the era of modern medicine. Our knowledge, the available data, and current resources are changing constantly. We are making our guidelines and protocols public in order to share the best of our current understanding with everyone who might benefit, and equally to learn from others’ information and experiences. Please share your practice patterns, new data, other guidelines, and new or missing literature. We hope this pandemic brings with it a new era of collaboration and speed in Evidence-Based Medicine.

Team and Process

We are a team of over 100 Brigham and Women’s Hospital physicians, respiratory therapists, pharmacists, and nurses from multiple different divisions. Each section has at least one editor, multiple contributors, and several senior advisors. We incorporate new information from clinical experience, user feedback, and newly published literature. A multidisciplinary committee meets twice weekly to discuss and debate the guidelines that pertain to multiple stakeholders.

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Managing Editor: C Lee Cohen MD MBA

Content Director: Edy Yong Kim MD PhD

Interdisciplinary Clinical Committee Coordinator: André Remillard MBA

Project Coordinator: Julia Jezmir MD MBA

Strategic Advisors: Mina Hsiang MEng MBA, Shuhan He MD, and James Flynn

Clinical Course and Epidemiology

Section Editors: Katherine H. Walker MD MSc, Benjamin S. Parker MD MBA

Contributors: Lao-Tsu S. Allan-Blitz MD, Geneva A. DeGregorio MD, Lisa E. Simon DMD, Priscilla Wang MD, Rebecca Zon MD, Jacob Johnson MD


Contributors: Jyotsna Mullur MD, Leela Davies MD PhD, Jeffrey C. Pearson PharmD BCIDP, Jacob Johnson MD, Katherine H. Walker MD MSc, Narath Carlile MD MPH, Julia Jezmir MD MBA


Section Editors: Katherine H. Walker MD MSc, Jeffrey C. Pearson PharmD BCIDP

Contributors: Rebecca M. Baron MD, Lindsey Baden MD MMSc, Francisco M. Marty MD SM, Sigal Yawetz MD, David A. Morrow MD MPH, Jean Connors MD, Peter A. Nigrovic MD, Erin A. Bohula MD DPhil, Richard M. Kaufman MD, Joshua P. Lang MD, Victor Kovac MD, Leela Davies MD PhD, Kevin M. Dube PharmD BCCCP BCPS, William Sauer MD, MSc, Matthew Moll MD, C. Lee Cohen MD MBA, Gustavo E. Velasquez MD MPH, Ann E. Woolley MD MPH, Sophia Koo MD, Mathias Lichterfeld MD PhD, Sheila Bond MD

Ambulatory, ED, and Floor Management

Ambulatory: Jennifer Johnson MD, Jacob Johnson MD, Leela Davies MD PhD, Laura Platt MD, Narath Carlile MD MPH, Scott Dryden-Peterson MD, Christin Price MD, Emily Yan MD MSc, Julia Jezmir MD MBA, Chanu Rhee MD MPH

Emergency: B. Christian Renne MD, Paul Chen MD MBA, Raghu Seethala MD MSc, Zheng Ben Ma MD

Floor: Katherine H. Walker MD MSc, Christopher L. Roy MD, Elizabeth M. Petersen MD MPH, Morgan C. Espérance MD MPH, Glen Kim MD, Herrick N. Fisher MD MPhil, Cheryl R. Clark MD ScD, Matthew G. Gartland MD.

Geriatrics: Tammy Hshieh MD, Clark DuMontier MD, Julia Loewenthal MD, Samir Tulebaev MD, Houman Javedan MD, Shosh Streiter MD


Section Editors: Steven Keller MD PhD, Bina Choi MD

Contributors: Paul Dieffenbach MD, William Feldman MD D.Phil, Jeremy Weinberger MD, Adam Smith BS RRT-ACCS, Julie Ng, MD, C. Lee Cohen MD MBA, Kevin Olsen MD, Bradley Wertheim MD, Anthony Massaro MD, Edy Kim MD, Samuel Y. Ash MD MPH, John C. Kennedy MD MSc

Sedation: Paul Dieffenbach MD, Adel El Boueiz, MD, Paul Szumita PharmD RPh FCCM BCCCP BCPS

Critical Care

Section Editors: C Lee Cohen MD MBA, Bina Choi MD

Cardiogenic Shock: See Cardiology

Cardiac Arrest: Jordan Anderson MD, Raghu Seethala MD, Karen M. Griswold RN MBA CPPS, Anthony Massaro MD, David Rubins MD

Nutrition: Amanda Scippa RD LDN CNSC

Infectious Disease

Section Editors: Jeffrey Pearson PharmD BCIDP and Jacob Johnson MD

Contributors: Leela Davies MD PhD, Alison Castle MD, Sheila Bond MD, Lindsey Baden MD MMSc, Francisco M. Marty MD SM, Sigal Yawetz MD, Gustavo Velasquez MD MPH, Jacob Rosenberg MD PhD, Ann E. Woolley MD MPH, C. Lee Cohen MD MBA


Section Editor: Joshua P. Lang MD

Contributors: Erin A. Bohula MD DPhil, David A. Morrow MD, Mandeep Mehra MD (Transplant)


Section Editors: Matthew Moll MD and Jean Connors MD

Anticoagulation: Katelyn Sylvester PharmD, CACP, BCPS, Marlise Luskin MD MSCE

Leukopenia: Rebecca Zon MD, Nathan Connell MD MPH

Thrombocytopenia: J Erika Haydu MD PhD, Nathan Connell MD MPH


Section Editor: Ayman Al Jurdi MD, Bina Choi MD

Contributors: Peter Czarnecki MD, Orhan Efe MD


Section Editors: Erika Williams MD PhD, Priya Srikanth MD PhD, Henri Vaitkevicius MD

Direct Neurologic Effects: Wendy Yau MD, Shibani Mukerji MD PhD

Stroke: Erika Williams MD PhD, Matthew Bevers MD PhD, Steve Feske MD

Seizure: Amrit Misra MD PhD, Dan Hoch MD PhD

Headache: Erika Williams MD PhD, Angeliki Vgontzas MD

Neuromuscular: Caleb McEntire MD, Meabh O’Hare MBBCh, Priya Srikanth MD PhD, Chris Doughty MD

MS and NMO: Denis Balaban MD, Shamik Bhattacharyya MD MS

Brain death: Erika Williams MD PhD, Galen Henderson MD

Targeted Temperature Management: Samuel B Snider MD, Jong W. Lee MD PhD


Section Editor: Emilie Mitten, MD

Contributors: Kunal Jajoo MD, Bina Choi MD, Sanchit Gupta MD, Alicia Corwin, MD


Contributors: Nadine Palermo DO, Paul Szumita PharmD RPh FCCM BCCCP BCPS, Marie McDonnell MD, Kevin M. Dube PharmD BCCCP BCPS

Immunosuppressed Patients

Oncology: Katherine H. Walker MD MSc, Martha Wadleigh MD, Marlise R. Luskin MD MSCE, Amy C. Bessnow MD MPH

Immunosuppressants: Alisa A. Mueller MD PhD, Erin H. Penn MD, A. Helena Jonsson MD PhD

Transplant: TBD

Palliative Care

Section Editor: Richard Leiter MD MA

Contributors: Janet Abrahm MD, Samantha Gelfand MD, Mihir Kamdar MD, Stephanie Kiser MD MPH, Andrew Lawton MD, Barbara Reville DNP ANP-BC ACHPN, Kate Sciacca MSN NP, Jaclyn Shameklis MD, Lorie Smith MD, Jane deLima Thomas MD, Mark Zhang DO MMSc


Section Editors: Adrienne Taylor, MD

Contributor: Sara Vasudeva, MD


Section Editors: Khady Diouf MD, Sarah Rae Easter MD

Contributors: Daniela Carusi MD MSc, Katherine E. Economy MD MPH, Kate Gregory RN PhD, Stephanie Guseh MD, Sarah Lassey MD, Julianna Schantz-Dunn MD, Sigal Yawetz MD, Hope Yu MD


Contributors: Stephanie Nitzchke MD, Robert Riviello MD MPH


Contributors: Emily Baumrin MD, Scott Elman MD, Rebecca Gaffney MD, Zachary Holcomb MD, Christopher Iriarte MD, Cristina Thomas MD, Joseph Merola MD MMSc

Health Equity and Ethics

Health Equity: Dalia Larios MD, Ayrenne Adams MD, Sunny Kung MD, Yssra Soliman, MD,

Ethics: William Feldman MD, Aimee Miliken PhD RN HEC


Bedside Procedures: Alissa Sodickson MD

Bronchoscopy: Majid Shafiq MD MPH

Intubation: Kevin Olsen MD, Josh Finkel MD, Alissa Sodickson MD, Suzanne Klainer MD, Caroline Gross MD, Calvin Brown MD