Table 1.
Consensus guidelines on immunomodulatory therapy in times of COVID-19 in increased risk patients* (n=139)
| Healthy patients | Healthy patients with close contact | Sick patient: COVID-19 suspected | Sick patient: COVID-19 positive | |||
|---|---|---|---|---|---|---|
| Oral corticosteroids | Pt not on oral corticosteroids | To be started | 123 (88.5%) | 44 (31.7%) | 7 (5%) | 8 (5.8%) |
| Pt on low-dose oral corticosteroids | To be maintained | 132 (95.0%) | 112 (80.6%) | 57 (41.0%) | 38 (27.3%) | |
| To be decreased | 11 (7.9%) | 51 (36.7%) | 92 (66.2%) | 104 (74.8%) | ||
| To be tapered and stopped | 13 (9.4%) | 38 (27.3%) | 83 (59.7%) | 98 (70.5%) | ||
| Pt on higher-dose oral corticosteroids | To be maintained | 102 (73.4%) | 55 (39.6%) | 19 (13.7%) | 11 (7.9%) | |
| To be decreased | 38 (27.3%) | 80 (57.6%) | 117 (84.2%) | 125 (89.9%) | ||
| To be tapered and stopped | 21 (15.1%) | 52 (37.4%) | 99 (71.2%) | 107 (77%) | ||
| Intravenous methyl prednisolone | To consider | 103 (74.1%) | 32 (23%) | 6 (4.3%) | 5 (3.6%) | |
| Local corticosteroids | Pt not on oral corticosteroids | To be preferred to systemic therapy | 83 (59.7%) | 118 (84.9%) | 128 (92.1%) | 122 (87.8%) |
| Pt on low-dose oral corticosteroids | To be preferred to increasing the dose of systemic therapy | 106 (76.3%) | 121 (87.1%) | 126 (90.6%) | 122 (87.8%) | |
| Conventional IMT | To be started | 104 (74.8%) | 38 (27.3%) | 3 (2.2%) | 1 (0.7%) | |
| To be maintained | 135 (97.1%) | 95 (68.3%) | 26 (18.7%) | 13 (9.4%) | ||
| To be decreased | 9 (6.5%) | 51 (36.7%) | 113 (81.3%) | 123 (88.5%) | ||
| To be stopped | 5 (3.6%) | 32 (23%) | 107 (77%) | 122 (87.8%) | ||
Consensus for ‘No’
Consensus for ‘Yes’
*Increased risk category: patients with uveitis or rheumatologic disease on immunosuppressives (not on biologics).
MT, immunosuppressive therapy; Pt, patients.