Table 2

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

Healthy patientsHealthy patients with contactSick patient—COVID-19 suspectedSick patient—COVID-19 positive
Oral corticosteroidsPt not on oral corticosteroidsTo be started98 (70.5%)43 (30.9%)7 (5%)5 (3.6%)
Pt on low-dose oral corticosteroidsTo be maintained129 (92.8%)77 (55.4%)36 (25.9%)28 (20.1%)
To be decreased22 (15.8%)75 (54%)103 (74.1%)111 (79.9%)
To be tapered and stopped16 (11.5%)62 (44.6%)98 (70.5%)105 (75.5%)
Pt on higher-dose oral corticosteroidsTo be maintained86 (61.9%)43 (30.9%)17 (12.2%)10 (7.2%)
To be decreased63 (45.3%)96 (69.1%)123 (88.5%)128 (92.1%)
To be tapered and stopped34 (24.5%)70 (50.4%)110 (79.1%)118 (84.9%)
Intravenous methyl prednisoloneTo be started73 (52.5%)25 (18%)7 (5%)6 (4.3%)
Local corticosteroidsPt not on oral corticosteroidsTo be preferred to systemic therapy101 (72.7%)122 (87.8%)123 (88.5%)122 (87.8%)
Pt on low-dose oral corticosteroidsTo be preferred to increasing the dose of systemic therapy106 (76.3%)121 (87.1%)126 (90.6%)122 (87.8%)
Conventional IMTTo be started82 (59%)36 (25.9%)7 (5%)3 (2.2%)
To be maintained125 (89.9%)72 (51.8%)18 (12.9%)11 (7.9%)
To be decreased18 (12.9%)71 (51.1%)116 (83.5%)121 (87.1%)
To be stopped12 (8.6%)49 (35.3%)112 (80.6%)123 (88.5%)
BiologicsTo be started69 (49.6%)23 (16.5%)6 (4.3%)6 (4.3%)
To be continued123 (88.5%)73 (52.5%)18 (12.9%)10 (7.2%)
To be stopped17 (12.2%)63 (45.3%)116 (83.5%)123 (88.5%)
TocilizumabTo be started85 (61.2%)57 (41%)39 (28.1%)40 (28.8%)
To be continued128 (92.1%)98 (70.5%)66 (47.5%)62 (44.6%)
To switch to44 (31.7%)32 (23%)41 (29.5%)45 (32.4%)
  • Consensus for ‘No’

  • Consensus for ‘Yes’

  • *High-risk category: patients with uveitis or rheumatologic disease with one of the following risk factors: use of biologics; high doses or multiple immunosuppressives; active systemic disease associated with uveitis; presence of other co-morbidities or multisystem disease including heart, lung and/or renal involvement; neutropenia; smoking; pregnancy; older age; previous history of infection while on IMT.

  • IMT, immunosuppressive therapy; Pt, patients.