Gastrointestinal and hepatic diseases during the COVID-19 pandemic: Manifestations, mechanism and management

Table 7 Recommendations of the American Association for the Study of Liver Diseases and European Association for the Study of the Liver on the use of immunosuppressive therapies in chronic liver disease during coronavirus disease 2019

	Suggestions
(1) Starting with corticosteroids and immunomodulators should proceed; and (2) Risk benefit ratio assessments should be carried out
Patients on immunosuppressive treatment and not infected with COVID-19	Decreases or adjustment of doses is not advisable
Patients infected with COVID-19 on immunosuppressive drugs	(1) Reduce corticosteroids dose after specialist physician (consider tapering to prevent adrenal insufficiency); and (2) Decreasing the doses of cyclosporine, mycophenolate, and azathioprine is recommended in severe COVID-19 (especially patients with lymphopenia)
Patients requiring initiation of immunosuppressive agents	Starting treatment is suggested in these patients regardless of COVID-19 status

COVID-19: Coronavirus disease 2019.