Corona: Recommendations for patients with liver disease

Frequently asked questions about the liver and the Coronavirus infection:

I have a chronic liver disease: Am I at risk of developing severe disease?
It appears unlikely that SARS-CoV-2 infection causes liver damage to an amount that substantially contributes to the disease. If a routine visit is scheduled within the next weeks, contact your liver specialist to inquire whether your appointment can be postponed. The same holds true for non-urgent gastroscopy or colonoscopy or liver biopsy. Please ask your specialist about the possibility of a consultation using telemedicine. I am taking immunosuppressive medications: Should I stop this treatment? No! Please continue to take your medication as usual and refer to your family doctor or liver specialist if you have any new symptoms. Some data suggest that immunosuppression may even provide some protection.

I am liver transplanted: Should I modify my therapy?
No! Please follow your scheduled treatment without changing any dose. Do not attend the outpatient clinic for routine visits, instead ask for the possibility of having a consultation using telemedicine. Check with your physician your vaccination status for influenza and pneumococcus.

I have a chronic liver disease: What medications can I take in case of COVID-19?
Do not take any antiviral treatment on your own initiative. Drugs (including alternative medicine) available from internet or other sources may have important side effects and/or they can have dangerous interactions with other drugs that you are taking. Always ask your general practitioner or liver specialist for advice. Avoid non-steroidal anti-inflammatory drugs if you have advanced chronic liver disease or cirrhosis and limit paracetamol (acetaminophen) use to 2 grams per day.

I have hepatocellular carcinoma and I take anticancer drugs: can I continue my treatment?
Yes. Unless there are major reasons related to side-effects of your treatment, keep taking your scheduled treatment.

Is SARS-CoV-2 dangerous in children with liver diseases or after liver transplantation?
There is no evidence that children with pre-existing liver disease are more vulnerable than their healthy peers. In general, children with SARS-CoV-2 infection have very mild symptoms. Although it has been shown in adults that SARS-CoV-2 infection can be associated with transient elevation in liver tests, pediatric data are still forthcoming. In general, any viral infection in children can lead to a transient elevation in liver test values which are of little clinical significance.