Table 3.

Consensus guidelines on immunomodulatory therapy in times of COVID-19 in very high-risk patients* (n=139)

			Healthy patients	Healthy patients with contact	Sick patient—COVID-19 suspected	Sick patient—COVID-19 positive
Oral corticosteroids	Pt not on oral corticosteroids	To be started	80 (57.6%)	40 (28.8%)	12 (8.6%)	9 (6.5%)
	Pt on low-dose oral corticosteroids	To be maintained	112 (80.6%)	66 (47.5%)	31 (22.3%)	27 (19.4%)
		To be decreased	43 (30.9%)	84 (60.4%)	105 (75.5%)	110 (79.1%)
		To be tapered and stopped	33 (23.7%)	73 (52.5%)	102 (73.4%)	107 (77%)
	Pt on higher-dose oral corticosteroids	To be maintained	74 (53.2%)	35 (25.2%)	9 (6.5%)	7 (5%)
		To be decreased	72 (51.8%)	98 (70.5%)	124 (89.2%)	126 (90.6%)
		To be tapered and stopped	43 (30.9%)	80 (57.6%)	108 (77.7%)	115 (82.7%)
Intravenous methyl prednisolone		To be started	57 (41%)	24 (17.3%)	9 (6.5%)	5 (3.6%)
Local corticosteroids	Pt not on oral corticosteroids	To be preferred to systemic therapy	106 (76.3%)	121 (87.1%)	123 (88.5%)	121 (87.1%)
	Pt on low-dose oral corticosteroids	To be preferred to increasing the dose of systemic therapy	113 (81.3%)	127 (91.4%)	126 (90.6%)	124 (89.2%)
Conventional IMT		To be started	78 (56.1%)	30 (21.6%)	5 (3.6%)	2 (1.4%)
		To be maintained	111 (79.9%)	60 (43.2%)	21 (15.1%)	12 (8.6%)
		To be decreased	41 (29.5%)	84 (60.4%)	118 (84.9%)	126 (90.6%)
		To be stopped	25 (18%)	59 (42.4%)	116 (83.5%)	125 (89.9%)
Biologics		To be started	64 (46%)	26 (18.7%)	11 (7.9%)	8 (5.8%)
		To be continued	109 (78.4%)	60 (43.2%)	17 (12.2%)	11 (7.9%)
		To be stopped	30 (21.6%)	74 (53.2%)	118 (84.9%)	124 (89.2%)
Tocilizumab		To be started	72 (51.8%)	46 (33.1%)	41 (29.5%)	42 (30.2%)
		To be continued	115 (82.7%)	90 (64.7%)	63 (45.3%)	62 (44.6%)
		To switch to	47 (33.8%)	38 (27.3%)	46 (33.1%)	52 (37.4%)

Consensus for ‘No’

Consensus for ‘Yes’

*Very high-risk category: patients with uveitis or rheumatologic disease with two or more risk factors.

IMT, immunosuppressive therapy; Pt, patients.